Jeff Malmuth & Co. – Career and Vocational Services – Jeff ...

( Upper Back ( Mid Back ( Lower Back ( Buttocks ( Leg(s) ( Knee(s) ( Ankle (s) ( Foot ( Chest ( Internal ( Groin Other: Please describe the quality of claimant’s pain: ( Dull ( Throbbing ( Shooting ( Stabbing ( Pinching ( Sharp ( Stinging ( Cramping ( Radiating ( Aching ( Tingling ................
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