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Patient:                                            Oscar Orange
Gender:                                           Male
Ethnicity:                                         Indian (43)
DOB:                                                07/09/1979
Address:                                         4600A Happy Drive
                                                         Seatoun
                                                         Wellington 6022
                                                         New Zealand

 


Employment Status:                     Employee (1)
Occupation:                                   Baker (7412)
Work Type Code:                          Heavy (4)

 

Employer:                                       Yummy Bakery
Employer Address:                       101 Cakery Road
                                                         Island Bay
                                                         Wellington 6023
Country:                                          New Zealand
Employer Address Type:              Home

 

Accident date:                                03/12/2017
Accident location code:                Porirua City (347)
Accident Scene Code:                   Road or Street (30)
Cause of Accident:                        Car accident on highway - Car crashed into passenger side of car. Claimant was sitting in front passenger seat
Involves Vehicle:                            True
Medical Treatment Injury:           False
Sporting Injury:                              False
Gradual Process Injury:                False

 

Diagnosis code:                             (SNOMED - 208754006) (READ - S410.)
Diagnosis code type:                    1
Diagnosis description:                 Closed traumatic dislocation of shoulder
Diagnosis side:                              Right
 

Diagnosis code:                            (SNOMED - 91613004) (READ - SE311)
Diagnosis code type:                   1
Diagnosis description:                Contusion of elbow
Diagnosis side:                             Right
 

 

Work Capacity
Can Resume Normal Work:       False

Incapacity 1:
Incapacity type 1:                        fully unfit for work
Incapacity from date:                 05/12/2017
Incapacity to date:                      11/12/2017

Incapacity 2:

Incapacity type 2:                        fit for selected work
Incapacity from date:                 12/12/2017
Incapacity to date:                      15/12/2017
alternate work type:                   Sedentary (1)
physical restrictions:                   Lifting
restricted hours per day:           8

Contact Required:                       False