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Location:
New Hyde Park, New York, United States
Salary:
10000000
Posted:
August 16, 2018

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Resume:

Job site:

JFK TWA

Injured worker name:

Dylan King – R&J Construction

DOB:

*/**/**

SSN:

***-**-***

Address:

** ******** ******, ****** ****, NY 11001

Phone:

516-***-****

1.Accident description:

Claimant was lifting metal studs on the 6th floor of the north hotel building when he felt sharp pain to his right elbow

2.Injured sites:

Right elbow

3.Medical treatment (provider name and number):

Site Medic – then left saying he would seek offsite treatment

4.Statements obtained:

a.Claimant

Yes

No

Pending - claimant has not returned to site. Scheduled to return on 7/30/18. No one home during visit to house on 7/26/18.

b.Witness 1 – name – Maria Jimenez, site medic

Yes

No

Pending

N/A

c.Witness 2 – name – David Mikhlin

Yes

No

Pending

N/A

d.Witness 3 – name – Andrew Finn

Yes

No

Pending

N/A

5.Evidence secured (list all items)

None

6.Red flags

Claimant mentioned to coworker Finn that he had sustained several dislocated right shoulders in the past due to football

7.Photos (attach them here)

Most Important Points

Pending

oObtain statement from claimant

o

o



Contact this candidate