J.H. was a 72 year old female who fell at work striking her head. Following her accident she had a headache which persisted for 1½ years despite extensive neurologic evaluation, multiple physical therapy visits and a variety of medications prescribed by a neurologist. She was referred to Alabama Comp where she was diagnosed with severe muscle contraction headache with underlying cervical arthritis. She was treated with scalp injections followed by 8 visits of appropriate physical therapy resulting in complete resolution of her headache for the 1st time in 1½ years and a very grateful patient who was released at MMI with PPI 0%.

T.T. was a 39 year old male who was burned on his right leg by hot metal. He was seen at an urgent care clinic where his wound was managed over the following 2 weeks (including an ER visit) where his condition steadily worsened and his care was transferred to Alabama Comp. He was found to have a prominent deep painful non-healing `ulceration in his right thigh. He received proper wound care while on restricted duty and without need for specialty referral. Following 4 weeks of treatment, full wound healing was achieved and he was return to his regular job.

J.W. was a 37 male resident of Huntsville who developed left shoulder pain while cutting tree limbs. He was seen at an urgent care clinic in north Alabama and taken off of work x 2 weeks. When symptoms were unimproved, orthopedic referral was advised (while still off of work). His employer transferred his care to Alabama Comp where MRI was performed and surgical disease was ruled out. He was treated with an injection and a home exercise program and returned to restricted duty (which was accommodated in north Alabama from where he commuted for treatment). After 4 weeks symptoms were fully resolved and he was happy to be released to regular job. Substantial cost savings were achieved despite the great inconvenience of location.

H.C. was a 24 year old female who had a marble table top fell onto her left foot. She was seen at an urgent care center and x-rays were performed. She was told she had a fracture on the top of her foot and was placed in a walking boot, given crutches and taken off of work. She was followed weekly for a month without improvement and orthopedic referral was advised. Her care was transferred to Alabama Comp. Her exam was not indicative of a fracture and her repeat left foot x-ray was normal. CT scan of the left foot was performed and confirmed the absence of a fracture. She was reassured as to the absence of any significant injury and was instructed to wean from her walking boot. She returned to the clinic in 1 week pain free with a street shoe and normal gait and was released to regular duty with 0% PPI.

J.M. was a 24 year old male who struck a piece of metal with a hammer with a small piece breaking off and flying into the skin of his neck. He was seen at a local hospital-owned occupational medicine clinic where he was advised that removal of the piece of metal would require surgery and was not worth the expense or risk of removal. Surgical referral was offered. He was sent by direction of the work comp insurance carrier to Alabama Comp. X-rays revealed the presence of a small metallic foreign body near the surface of his left neck which was removed with a simple office procedure and the employee was returned to full duty the same day with no complications.

C.C. was a 33 year old female struck from behind while driving a car with resultant neck pain. She was treated for 6 weeks at a local hospital-owned occupational medicine clinic with physical therapy and repeated trigger point injections without improvement. She was referred to Alabama Comp where a muscular cervical strain was diagnosed. She was treated with appropriate physical therapy while working full duty, and released symptom free after 4 weeks.