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INSTITUTE FOR LOW BACK �' <br /> • <br /> AND NECK CARE ( 1 t <br /> 2800 Chicago Avenue South Minneapolis, MN 55407 TELEPHONE: (612) 879 -2500 FAX: (612) 879 -2555 <br /> wit ow Web site ar Mmanrw vano.con, <br /> omit teclr&neeJ@lmne.com <br /> Neurosurgeons <br /> June 4, 1998 Charles k Burton. M.D. <br /> Alexander Ufaon, M.D. <br /> Orthopedic Surgeons <br /> Rtehard M. Salib, M.D. <br /> Sunny S. Kim, M.D. <br /> Phyaiatrist <br /> Maria R. Zorawska, M.D. <br /> Spinal infections <br /> Mr. Michel S. Krug Thomas W. Hennessey, M.D. <br /> Krug & Zupke - Suite 226 <br /> 1021 Bandana Blvd. East Administrator <br /> St Paul MN 55108 ThomaeRSpkzka <br /> Re: Margaret L. Kilian Neurosurgeon <br /> SS #475 38 9423 CharMs4Ray,M.D. <br /> CHART #215746 Dirdxor Emerihra <br /> Dear Mr. Krug: <br /> I have received your letter of inquiry in regard to the above <br /> patient. On the basis of this inquiry, I have reviewed this <br /> patient's extensive medical records and have also considered the <br /> information that you have provided regarding the State of <br /> Minnesota Disability Schedule 5223.0420 as well as 5223.0390. <br /> This patient, who is a 56- year -old resource counselor, who has <br /> undergone previous surgery and has been documented as having <br /> lumbosacral adhesive arachnoiditis, has been treated before me in <br /> regard to a causalgic pain syndrome involving the left leg and <br /> associated permanent nerve injury. In addition to this, MRI <br /> confirmed multilevel degenerative disc changes consistent with a <br /> diagnosis of juvenile discogenic disease. <br /> The patient has undergone implantation of an electronic epidural <br /> neurostimulating electrode system. She was last seen and evaluated at <br /> ILBNC on 5- 11 -98. Ms. Kilian's status continues to be that of being <br /> permanently disabled in regard to gainful employment. She is, <br /> however, functioning in the activities of daily living. Causalgic <br /> pain syndromes are uniquely disabling to the individual on the -basis <br /> of causalgic pain. The standard disability schedules simply do not <br /> encompass this pathologic entity, nor do they account for it in any <br /> reasonable manner. <br /> The disability determination which was completed on 2 -24 -97 was <br /> directed to the patient's pathology, specifically in reference to the <br /> lumbar spine and specifically in regard to the treatment of lateral <br /> spinal stenosis. You have asked at this time for a comprehensive <br /> disability determination referencing not only the patient's spinal <br /> pathology but her peripheral nerve condition, causalgia, and the <br /> A Comprehensive Multidisciplinary Spine Center <br /> DIAGNOSTIC SERVICES NONSURGICAL CARE SURGICAL SERVICES <br /> Clinical <br /> EleetrnehvaiNow Lumbar 8 cervical deaeneradve disorder* <br />