ig@q(qd 2 VIRGINIA: 3 4 IN THE CIRCUIT COURT OF THE CITY OF RICHMOND JOHN MARSHALL COURT BUILDING 5 6 BOYCE T. DOWNS, 7 Plaintif f , 8 VS. AT LAW NO.: LB-2065-1 9 CSX TRANSPORTATION, INC., 10 Defendant. --------------------------------- is DEPOSITION 16 OF 17 STEPHEN L. GOLDMAN, M.D. 18 Taken by the Plaintiff 19 2:00 p.m., July 29, 1997 9 Pursuant to Notice of Taking Deposition, 10 and further pursuant to the Florida Rules of Civil 11 Procedure, the deposition of STEPHEN L. GOLDMAN, 12 M.D., was taken before Carolyn S. Fowler, a Notary 13 Public in and for the State of Florida at Large; 14 commencing at approximately 2:00 p.m., on July 29, 15 1997, at the offices of CSX Transportation, Inc., 16 500 Water Street, Jacksonville, Florida; and as 17 reported by Carolyn S. Fowler, RPR. A P P E A R A N C E S 2 3 EDDIE WILSON, ESQUIRE 4 of the law firm Wilson, Hajek & Shapiro 5 1294 Diamond Springs Road Virginia Beach, Virginia 6 Attorney for Plaintiff 7 GREGORY F. HOLLAND, ESQUIRE 8 of the law firm Mays & Valentine 9 P. 0. Box 1122 Richmond, Virginia 23218-1122 10 Attorneys for Defendant T A B L E 0 F C 0 N T E N T S 2 WITNESS PAGE 3 4 STEPHEN L. GOLDMAN, M.D. 5 DIRECT EXAMINATION 6 by Mr. Wilson.............................. 5 7 8 E X H I B I T S 9 Plaintiff's Nos. I and 2....................... 27 10 Plaintiff's Nos. 3 and 4....................... 45 Plaintiff's No. 5.............................. 58 S T I P U L A T I 0 N 2 It was stipulated and agreed by and 3 between counsel for the respective parties and by 4 the witness that the reading and signing of the 5 deposition by the witness was waived. 6 - - - 7 STEPHEN L. GOLDMAN, M.D., 8 having been produced and first duly sworn as a 9 witness, then testified as follows: 10 DIRECT EXAMINATION 11 BY MR. WILSON: 12 Q Dr. Goldman, state your full name and your 13 home address, please. 14 A Stephen Louis Goldman, M.D., 7565 15 Founder's Way, Ponte Vedra Beach, Florida 32082. 16 Q You have a stack of documents in front of 17 you. I would like to run through those with you and 18 ask you when you received those documents. 19 The first is a Metropolitan Medical 20 Evaluation Center, Dr. Michael Kyles. When did you 21 receive that, please? 22 A I received that yesterday. 23 Q Who did you receive it from? 24 A Scott Marshall. 25 Q You had never looked at this before 6 1 yesterday? 2 A No. I was briefed by Scott as to the 3 contents of it. 4 Q Yesterday? 5 A No, prior to that. 6 Q When had you been briefed by Scott 7 Marshall? 8 A I don't remember the exact date. 9 Q This month? 10 A Yes. It was prior to him writing the 11 letter to Mr. Downs. 12 Q Before July 16th? 13 A The date of the letter escapes me. The 14 date of the letter is July 16th. It was probably a 15 day or two prior to that. 16 Q The next item is the HealthSouth 17 functional capacity evaluation. When did you first 18 receive that? 19 A Same thing; same story. 20 Q Is that true for all these records? 21 A Yes. 22 Q Let me run through what they are. mcv, 22 James Wade psychological evaluation. You got this 24 -- all these documents from Mr. Marshall yesterday? 25 A No. I got them from Linda Shafer who is 7 1 one of the administrative assistants here. 2 Q Yesterday? 3 A Yesterday. 4 Q And you had never reviewed any of the 5 documents before yesterday? 6 A That is correct. 7 Q The next is a PFCE from Healthsouth, two 8 pages. 9 A Same story. 10 Q Abdullah Bandax records, looks to be maybe 11 thirty pages, paper clipped together. Same thing? 12 A Yes. 13 Q You need to speak out as opposed to 14 nodding your head. is Patient progress and treatment record, 16 Boyce Downs, Andrew Blumberg, same thing? 17 A Same thing. 18 Q Okay. And that is about -- I'm not good 19 at this -- seventy pages, my guess. 20 A document with a yellow stickee on it, 21 John Barsanti, and the first page of that is a 22 medical of Abdullah Bandax. Same thing? 23 A Same thing. 24 Q Institute for Chronic Pain Management, it 25 looks like maybe a hundred pages, Michael Decker's 8 1 records, same thing? 2 A Same thing. 3 Q Drs. Decker and Carr, Stoney Point. Whose 4 handwriting is that, please? 5 A I do not know. 6 Q You received those yesterday also? 7 A Correct. 8 Q And I guess this is the second portion to 9 that under the pink part, HealthSouth. 10 Documents of William Moore, M.D., about a 11 hundred pages again, handwritten notes. Same thing? 12 A Same thing. 13 Q The deposition of Boyce Downs. You 14 believe that this came from Scott Marshall 15 through -- 16 A That was given to me by Mr. Greg Holland 17 yesterday. 18 Q At what time yesterday. 19 A Sometime midafternoon. 20 Q Okay. Who do you understand Mr. Holland 21 to be in this case? What is his role? 22 A My understanding is that Mr. Holland 23 represent CSX Transportation in this. 24 Q He is the lawyer for CSX? 25 A That is my understanding. 9 1 Q Have you read Mr. Downs' deposition? 2 A I have read parts of Mr. Downs' 3 deposition. 4 Q Can you tell me what parts you have read 5 and what parts you haven't read? 6 A Not offhand, no. 7 Q Okay. How much time have you spent 8 reading the documents that you received yesterday? 9 A Probably about six hours. 10 Q Okay. Did you do that this morning? 11 A I did that mostly yesterday and last night 12 and some this morning. 13 Q And then we have the deposition of William 14 Moore dated June 19, 1997. Mr. Holland gave you 15 this -- 16 A Correct. 17 Q -- yesterday afternoon? 18 A Correct. 19 Q The deposition of Dr. Michael Decker taken 20 July 8th, 1997. Let's see which one this is. This 21 is the one that I took of Dr. Decker dated July the 22 Bth. Have you reviewed that? 22 A I reviewed that document. I quite 24 honestly do not remember who the attorneys were or 25 who the plaintiff was at that particular time. 1 0 1 Q Did you review the exhibits that were a 2 part of this deposition? 3 A I only read the deposition. 4 Q Do you know what the exhibits are? 5 A No, I do not remember offhand. 6 Q And you got that yesterday afternoon from 7 Mr. Holland also? 8 A Right. 9 Q Same for the deposition of Dr. James Carr 10 dated July 2nd, got that yesterday afternoon? 11 A Correct. 12 Q Okay. Physical therapy plan and care, 13 HealthSouth Physical Therapy Department. When did 14 you get that? 15 A Yesterday. 16 Q Did you get all of these yesterday? 17 A Yes. 18 Q Okay. You just got it from different 19 sources? 20 A Yes. 21 Q Then apparently we have some -- an 22 operative note of Dr. Decker dated 3 -- I'm sorry, 23 lJ22/97. Same thing? 24 A Same thing. 25 Q Who did you get that from? 1 A I believe that was in this stack from 2 Linda Shafer. 3 Q And then we have from the Circuit Court of 4 the City of Richmond records of -- is this Louis 5 Wright, I believe, maybe a hundred, hundred and 6 fifty pages? 7 A Received that yesterday. 8 Q okay. From Mr. Holland? 9 A From Linda Shafer. 10 Q Who is she again now, the administrative 11 assistant? 12 A She is to administrative assistant to 13 Dr. Cook. 14 Q All right. Well, do you know how long she 15 has had these records? 16 A No, I don't. 17 Q It says a received date of February the 18 6th, 1997. Is that a received date for your 19 department? 20 A No, that is not our stamp. 21 Q Is there a stamp on any of these documents 22 that you looked at that would show what date they 2@ were received in the medical department? 24 A No, not that I see. 25 Q So Dr. Cook would be the one that knows 1 2 1 when they were received? 2 A I can't speculate on that, but I dc)ubt 3 that he would know that. 4 Q For all you know, the records could have 5 been here since they were issued and they could have 6 been mailed the next day. They could have been here 7 for months as far as you know? 8 A I do not know when they arrived. 9 Q You certainly don't want to speculate on 10 that, do you? 11 A That is correct. 12 Q And this appears to be some records from 13 Dr. Maurice Schwartz. They're dated -- they've got 14 a date on them of 4/10/97. I guess that is a 15 subpoena date written up in the corner or do you 16 know what it is? 17 A You would know better than I. 18 Q You received these from who yesterday? 19 A Linda Shafer. 20 Q The same with the Sheltering Arms Physical 21 Rehabilitation Hospital records? 22 A Same thing. 2@ Q Same for Dr. Giordano's records? 24 A Same thing. 25 Q Same for the Richmond cardiology 1 3 1 Associates records? 2 A Same thing. 3 Q Same for Ralph Hagen, neurosurgical 4 records? 5 A Yes, sir. 6 Q How about this record from Dr. Decker 7 dated March 10th, 1997, when did you receive that, 8 do you know? 9 A Same thing. 10 Q Just don't know. Got it yesterday but you 11 don't know when your office received it? 12 A That is correct. 13 Q The same for Kennedy Daniels? 14 A Same thing. is Q I think we have already seen this one. 16 It's the functional capacity evaluation from 17 HealthSouth. 18 A Yes, sir. That is a repeat. 19 Q Okay. And then I have a paper handed 20 group of records from the Medical College of 21 Virginia Hospital which appear to he from 22 Dr. Bandak, operative records, emergency department 23 records, hospital treatment records in relation to 24 the 7/5/96 incident. Same thing for these? 25 A Same thing. 1 4 1 Q You also have a medical file in front of 2 you which I have looked at. Do you know when those 3 records came in? 4 A You would have to be more specific as to 5 which records you are talking about because a 6 medical file is a dynamic living thing and obviously 7 it's throughout the lifetime of a patient's 8 employment with the company. 9 Q Why don't you look through it and tell me 10 then. I want to know if you can tell -- just start 11 looking through the letters and tell me if you can 12 tell when any of those came into your department.) 13 A Anything that has a stamp with a circular 14 stamp saying "Received Medical Department," that's 15 stamped when it comes in. 16 Q And if that is not on there, you have no 17 way of knowing except it was probably after the date 18 that is written on the letter? 19 A That is correct. 20 Q All right. That's fair enough. You don't 21 need to look through all of them. I'm just trying 22 to get some identifying mark in case I ran across it 21 again. 24 A The circular mark saying "Received Medical 25 Department." 1 5 1 Q What is your job title? 2 A Chief medical officer. 3 Q What is your job description? 4 A I plan and coordinate all the activities 5 of the medical department. That includes industrial 6 hygiene, employee assistance program, ergonomics, 7 occupational health nursing, substance abuse 8 testing, coordination of testing and compliance with 9 the federal regulations, including DOT regulations 10 and OSHA regulations where applicable. 11 Q You would be Dr. Cook's supervisor? 12 A Yes. 13 Q How do your duties differ from his? 14 A Dr. Cook is -- devotes most of his time to 15 disability management. 16 Q Injured employees? 17 A Injured employees or ill employees. And 18 he runs the disability management process for the 19 company. And I do most of the other occupational 20 medicine responsibilities for the department. 21 Q When did you first become involved in the 22 case of Boyce Downs? 23 A Probably several days before Scott 24 Marshall's letter went out. 25 Q So that would be sometime in July? 1 6 1 A July 14th or 15th, something around there. 2 Q And before that, you had not reviewed any 3 portions of Mr. Downs, file? 4 A That is correct. 5 Q You had not reviewed any medical records? 6 A That is correct. 7 Q And you had not offered any opinions 8 concerning Mr. Downs or his ability to perform 9 certain jobs? 10 A That is correct. 11 Q Do you know why the railroad would have 12 told me on June the 23rd of 1997 that you might be 13 an expert witness who would be called at the trial 14 in this case to testify about the joh requirements is applicable to a locomotive engineer and other 16 railroad crafts in which Mr. Downs may be capable of 17 working? 18 MR. HOLLAND: Be fair with the 19 question. It lists either Dr. Goldman or 20 Dr. Cook, I believe. 21 THE WITNESS: I think I can speak to 22 that question with some authority. 2@ BY MR. WILSON: 24 Q All right, go ahead. 25 A I think I just answered it. I think I can 1 7 1 speak to that question with some authority. 2 Q Had you formed any opinions by then about 3 the job requirements applicable to a locomotive 4 engineer and other railroad crafts in which 5 Mr. Downs may be capable of working? 6 A I deal with that issue day in and day out. 7 Q How about with Mr. Downs, had you dealt 8 with the issue with him as of June of 1997? 9 A No. 10 Q Okay. And they also said that you may be 11 an expert witness as to the nature and extent of 12 Mr. Downs' medical condition. And they told me that 13 on June the 27th and you hadn't even seen his file 14 as of June 27th, had you? 15 A That is correct. 16 Q And you hadn't reviewed any medical 17 records as to his medical condition, had you? 18 A That is correct. 19 MR. HOLLAND: Again, I'll object 20 because those aren't specific opinions. 21 BY MR. WILSON: 22 Q And they also stated that you might 23 discugg his medical condition and how that may 24 relate to Mr. Downs' ability to return to work in 25 any capacity. And on June the 27th, you didn't have 1 8 1 any opinions about that, did you? 2 A No. I have those opinions now. 3 Q And you have formed those opinions within 4 the last twenty-four hours based on information that 5 the railway company lawyer brought to you from 6 Virginia and the records that were given to you by 7 an administrative assistant yesterday? 8 A Those are the sources of my information, 9 yes, sir. 10 Q Now, on June 27th, did you have any 11 opinions as to what jobs could be offered Mr. Downs 12 as well as medical rehab employment and additional 13 services and supports that Mr. Downs could receive 14 from CSX? 15 A Could you repeat that? 16 Q Yes, sir. I am trying to find out if on 17 June the 27th, did you have any opinions or 18 information about jobs that could be offered 19 Mr. Downs? 20 A That could be offered Mr. Downs? 21 Q Yes, sir. 22 A Had we had -- had I had any medical 22 information, I would have had a significant amount 24 of opinions as to what kind of jobs could be offered 25 Mr. Downs. Having had no medical information at 1 9 1 that time, I think it's a moot question. 2 Q I agree, you could not. 3 A Correct. 4 Q Would you he able to testify on June the 5 27th that Mr. Downs had declined to become involved 6 in the vocational rehabilitation program for CSX? 7 A I think the answer to those questions are 6 obvious. On June 27th, I had not read Mr. Downs' 9 file nor was involved with his case. 10 Q Is the answer no? 11 A The answer is no. 12 Q Are you able to offer that opinion today? 13 A I can venture some opinions today yes, 14 sir. is Q That particular opinion, Mr. Downs has 16 declined to become involved in the vocational 17 rehabilitation program? 18 A Mr. Downs' representative has recently, 19 quite recently offered to become involved in the 20 vocational rehabilitation program. 21 Q So what is your answer? 22 A My answer is that as of today, Mr. Downs 23 has availed himself of the rehabilitation program. 24 Q What involvement have you had in this case 25 to this point today? 2 0 1 A Prior to Mr. Marshall sending the letter 2 that offered involvement in vocational 3 rehabilitation, into the interactive process of 4 vocational rehabilitation, Mr. Marshall reviewed 5 with me the salient points of this man's medical 6 condition. 7 Q Okay. Tell me what salient points he 8 reviewed with you. 9 A He reviewed with me the functional 10 capacities evaluation from HealthSouth and the 11 independent medical examination. 12 Q How many hours a day did the functional 13 capacity evaluation show that Mr. Downs could work? 14 A The functional capacity evaluation did not 15 specify that. 16 Q Did you look at the PFCE or did Mr. -- 17 Excuse me, or did Mr. Marshall discuss that with 18 you? 19 A No. I saw that yesterday. 20 Q Based on the PFCE filled out by the 21 treating physician, Dr. Michael Decker, and by 22 Mr. Scarupa the gentleman who did the FCE, do you @2 have an opinion as to whether or not Mr. Downs can 24 work eight hours a day? 25 A This department relies on objective 2 1 1 medical information that is developed by the 2 treating physician. I thought the functional 3 capacities evaluation was well done. Beyond the 4 functional capacities evaluation, everything else 5 was subjective. 6 The specific evaluation that you are 7 talking about went beyond the functional capacities 8 evaluation and opined that he could not work more 9 than four hours a day. 10 Q Do you discount that? 11 A I could not find any objective medical 12 information backing that up. 13 Q Okay. Do you discount that? 14 A I take that into consideration. 15 Q Okay. Do you have an opinion as -- based 16 on your review of the PPCE, the FCE and the other 17 medical information as whether or not Mr. Downs can 18 work eight hours a day? 19 A I think it is still something that is open 20 for discussion. 21 Q Have you personally ever done or 22 participated in any job analyses of any job 23 positions for CSX Railway Company? 24 A Would you define job analyses for me? 25 Q Well, I know that is a tough word. Have 2 2 1 you ever gone out to the railroad yard and done the 2 job of a locomotive engineer or observed someone 3 else doing the job of a locomotive engineer? 4 A Yes. 5 Q Okay. What locations have you done that? 6 A I have been with the company three years 7 and I have observed the job of a locomotive engineer 8 on several occasions. It would be difficult for me 9 to pinpoint those locations. Some of them were on 10 line of road and so there is no location. 11 Q Can you tell me what state? 12 A It was either Georgia or Alabama, the one 13 incident I am thinking about. 14 Q So from that I'm going to assume -- I is normally don't like to assume because of the obvious 16 connotation -- that you haven't observed a 17 locomotive engineer's duties of a locomotive 18 engineer working out of Richmond Virginia? 19 A That is correct, I have not. 20 Q Have you ever observed on-the-job 21 yardmasters at work for CSX? 22 A Yes. 21 Q Okay. Where have you done that? 24 A I have done that at multiple locations 2S around the system. 2 3 1 Q In Virginia? 2 A I believe I have done that in Virginia. I 3 am sorry, I can't remember. 4 Q Have you ever been to Richmond, Virginia? 5 A I have been to Richmond. 6 Q Have you ever made any observations of the 7 CSX Acka Yard in Richmond, Virginia, in connection 8 with your job? 9 A I feel fairly certain I have been to Acka 10 Yard, but we have so many yards that I can't quite 11 place it. I'm sorry. 12 Q Can you tell me -- can you give me a 13 description of the physical structure in which a 14 yardmaster works at Acka Yard? 15 A No, I cannot offhand. 16 Q Can you give me a physical description of 17 the yard as to its size, its car capacity, its 18 length, anything of that nature? 19 A No, sir. 20 Q Do you have any notes or are there any 21 products such as writings that you have generated as 22 a result of your visits to job sites on CSX? 23 A No, sir. 24 Q Have you looked at the job description of 25 a locomotive engineer and the job description of a 2 4 1 yardmaster? 2 A No, sir. 3 Q You have not? 4 A No, sir. 5 Q And I am talking about these two in 6 particular. Let me show you -- just so we are not 7 confused. They are the ones that I have marked as 8 Plaintiff's No. 1 in Mr. Marshall's deposition, job 9 title, locomotive engineer. Have you looked at that 10 or seen that before? 11 A I have seen it but -- and I have probably 12 read it at some point, but I certainly couldn't 13 quote from it. 14 Q You didn't review it in regards to this 15 case? 16 A No. 17 Q Okay. And the job of yardmaster, did you 18 review that -- that is the one I think is marked 19 Exhibit No. 2 -- in regards to this case? 20 A I have seen it and sent it out, but, 21 again, am not totally 100 percent conversant with 2 2 it. 23 Q Is it fair to say that you are dealing 24 with the medical aspects of this case as opposed to 25 the vocational aspects of this case? 2 5 1 A No, I deal with both aspects of this case. 2 Q Okay. Have you reviewed any type of job 3 description that relates specifically to job duties 4 of jobs in Richmond, Virginia? 5 A State that again. 6 Q well, as I understand it, this is a 7 generic description that's entitled, as a matter of 8 fact, general description of job for yardmaster and 9 engineer. 10 A Correct. 11 Q Then at specific locations, as I 12 understand it, on the railway company, there may be 13 specific physical requirements for a locomotive 14 engineer that may encompass all or part of this 15 general job description. 16 A That is correct. 17 Q And the same for the yardmaster's 18 description? 19 A That is correct. 20 Q So what I am trying to find out is, have 21 you looked at any specific description of the job 22 duties at Richmond so that you could then look at 23 this general job description and say, well, that is 24 something that Mr. Downs would have to do at 2S Richmond as an engineer so he can or cannot do 2 6 1 that? Have you done that? 2 A We look at -- we have gotten some 3 information on the specifics of the requirements of 4 a locomotive engineer in the Richmond area, yes. 5 Q From who? 6 A However not the yardmaster position. 7 Q Okay. From who? 8 A From Scott Marshall. And that is who 9 would supply that information to me. 10 Q Okay. So you would rely on Mr. Marshall 11 and the information that he has about that specific 12 job requirement in Richmond to form your opinions? 13 A Correct. 14 Q And the same for the yardmaster's job? 15 A That is correct. I have a good working 16 knowledge of what each position requires in 17 generality. And, of course, we have to get 18 specifics for each location. 19 Q Right. Did Mr. Holland furnish you with 20 the deposition of Leon Stockwell, a railroad 21 locomotive engineer from Richmond, wherein 22 Mr. Stockwell describes the duties that he performs 23 as a locomotive engineer? 24 A No, sir. 25 Q The same for Mr. Glasser, he didn't supply 2 7 1 you with that either? 2 A No, sir. 3 Q And you have not talked with anyone from 4 Richmond Yard, like a supervisor or something like 5 that, to find out what the specific requirements are 6 for either yardmaster or engineer? 7 A No, sir. 8 MR. WILSON: Can we agree that 9 Marshall 1 and 2 will be made a 10 deposition exhibit to Dr. Goldman 1 and 11 2, we'll just have it copied and use them 12 interchangeably, I guess, to keep from 13 doing it again? 14 MR. HOLLAND: Yes. 15 (Thereupon, the documents last 16 above-referred to were received and marked as 17 Plaintiff's Exhibit Nos. 1 and 2 for is identification.) 19 BY MR. WILSON: 20 Q Do you consider the job of a locomotive 21 engineer on CSX to be one that creates mental 22 stress? 23 A I find that to be a rather interesting but 24 quite ill-defined question, and I really have no 25 idea how to answer it. I think all jobs create a 2 8 1 certain amount of mental stress, and it's more 2 dependent on the person than it is the job. 3 Q Well, would it be fair -- I agree with you 4 that each individual handles stress differently. Is 5 that what you are saying? 6 A Correct. 7 Q And are you also saying that each job may 8 differ as to the amount of stress that it impacts on 9 a particular individual? 10 A Correct. Without a doubt, the position of 11 locomotive engineer is one of significant 12 responsibility. 13 Q Would the same be true for the job of 14 yardmaster? is A Yes. 16 Q And would you agree that as the more 17 responsibility that you're assigned in a job, 18 generally the more stress that is associated with 19 the job? 20 A That is also an interesting question, 21 since recent studies show that the more 22 responsibility and judgment that you can bring to 23 your job, the less stressful it is. That is the 24 study out of England. 25 Q So you believe that President of the 2 9 1 United States would be less stressful, say, than 2 your job? 3 A I don't know that you can make individual 4 considerations like that. We are in a theoretical 5 discussion now. I don't know how to quantify 6 stress. There are no measurements for that. 7 Q Well, one of your job descriptions talks 8 about stress. It says the yardmaster's job, as an 9 example, works in a stressful environment. What 10 does that mean? 11 A I don't know. I didn't write that. 12 Q Okay. It's something that you send out 13 you said, right? 14 A Correct. 15 Q Well, you don't generally send out 16 documents that have things on them that you don't 17 understand what they mean, do you? 18 A i didn't write that, Mr. Wilson. 19 Q I understand you didn't write it, but I'm 20 trying to find out do you understand what they mean 21 by the statement works in a stressful environment? 22 A I am not totally sure what they are 23 implying. 24 Q Okay. As to the job positions that are 25 mentioned in the letter of Scott Marshall, in 3 0 1 determining whether or not they currently exist or 2 are simply job positions that may exist, should I 3 ask him about that or ask you about that? 4 A He would be the best to ask. 5 Q Do you know the answer to it? 6 A I know we have jobs that come up on a 7 fairly regular basis, some of which have vacancies 8 now, some of which we anticipate will have vacancies 9 or opportunities soon. And that is something that 10 is a very dynamic process, and I am not totally 11 conversant with it at this minute or at any given 12 point in time. 13 Q Do you think it unreasonable for an 14 employee not to be willing to relocate four or five is states to take another job? 16 A Do I think it's unreasonable? 17 Q Yes, sir. 18 A I think it is unreasonable, yes. I 19 relocated from Pennsylvania to take this job. 20 Q Do you like it here? 21 A Yes, I do. 22 Q If they told you tomorrow you had to 21 return to Pennsylvania, would you go? 24 A Yes. 25 Q Why is that? 3 1 1 A I liked Pennsylvania, too. 2 Q So you like where you go? 3 A I like certain places. I'm certain that 4 I'm probably the same as everybody else. I like 5 some places more than others. Also I like to earn a 6 living. 7 Q So you think it is unreasonable for people 8 not to want to transfer five states to take another 9 job? 10 A I can't say what's reasonable and 11 unreasonable for people to want to do. That is 12 something that is of their own likes and dislikes. 13 Q You believe they should do that? 14 A I believe that people should go where work is is offered, yes. 16 Q Do you know whether or not a person has to 17 qualify for any of the jobs that were offered in the 18 Jacksonville area by Mr. Marshall? 19 A Somebody has to qualify for each and every 20 job on the railroad. 21 Q Same for yardmaster? 22 A Yes. 21 Q When did you first see the letter 24 Mr. Melberg wrote to CSX on behalf of Mr. Downs? 25 A I cannot recollect when I saw that. I do 3 2 1 not remember whether that was part of the package 2 that Scott Marshall shared with me or came after 3 that. I'm sorry, I don't remember. 4 Q Have you ever made the request of a 5 defense lawyer who is working for the railroad, such 6 as Mr. Holland, or from Mr. Holland's firm, to 7 furnish Your Honor you medical information that he 8 may have gathered from CSX in an injury case? 9 A No, I have not. 10 Q Has Dr. Cook ever done that, do you know? 11 A I do not. 12 Q Is that something that is forbidden within 13 the medical department, asking the railroad lawyer 14 to furnish you medical information? 15 A I don't know that anything is forbidden. 16 Q So you could do that? 17 A I do not know what Dr. Cook's practice 18 is. In fact, I know that Dr. Cook's practice is to 19 ask the employee for it. I don't know whether 20 Dr. Cook also asks the attorneys for it. 21 Q Okay. How about you? 22 A I have not been in that role to ask the 23 attorneys for it, no, Sir. 24 Q Is that something Dr. Cook generally takes 25 care of, gathering the medical information? 3 3 1 A That's correct. 2 Q And particularly when it's involved with 3 an injured railroad employee? 4 A That is correct. 5 Q As I understand it, you talked with 6 Mr. Marshall concerning Boyce Downs. Have you also 7 discussed Boyce Downs with Dr. Cook? 8 A No, sir. 9 Q Have you discussed Boyce Downs with 10 Beverly Jackson? 11 A Yes. 12 Q When did you do that? 13 A Today. 14 Q I would like you to tell me exactly what 15 your understandings are of the physical and mental 16 restrictions that have been placed on Mr. Downs 17 currently by all doctors. And we can start -- you 18 can either do it in general or you can break it down 19 doctor by doctor. 20 A That is a rather lengthy question. 21 Q It is. 22 A Let me organize my thoughts. The 21 restrictions placed on Mr. Downs by Dr. Decker 24 include, if I remember correctly, lifting of 25 approximately twenty-one pounds, sitting limited to 3 4 1 four hours per day, limited overhead work, no 2 crouching or squatting if I remember correctly. 3 MR. HOLLAND: Are you asking him to 4 recite this to you without him referring 5 to the records or may he refer to the 6 records? 7 MR. WILSON: It's not a memory 8 contest, if that is what he is asking. 9 BY MR. WILSON: 10 Q You can refer to anything that you want 11 to. I want your specific understanding of what 12 restrictions? 13 A Placed by each physician? 14 Q Placed by each physician. 15 A Give me a few minutes to find that. 16 Q Sure. Take your time. 17 A The restrictions placed on Mr. Downs by 18 Dr. Decker including -- include sitting for forty 19 minutes per hour, five hours per day; standing for 20 fifteen minutes per hour, one hour per day; walking 21 for five minutes, thirty minutes total per day. 22 would you like the breakdown of all the lifting 23 restrictions? 24 Q No. I think the twenty-one pounds -- are 25 you talking about in No. 3? You are reading from 3 5 1 the PFCE now, right? 2 A Yes, I am reading from the PFCE. 3 Q Do you understand what he means by number 4 D, thirty inch to thirty inch lift and carry? 5 A I believe that is a carry statistic. 6 Q Ten pounds? 7 A Oh, I'm sorry, D? Yes, greater than ten 8 pounds one to four times per hour. That is to hold 9 and carry. 10 Q okay. 11 A I'm sorry, there are two Ds under lifting. 12 Q Oh, there sure are, aren't there? 13 A Yes. 14 Q Are those the only restrictions that you 15 understand he's placed on? 16 A Would you like me to read further on 17 this? 18 Q Sure. 19 A That he may never couch. He may 20 occasionally twist at waist. He may occasionally 21 crawl, climb stairs. May never climb ladders. May 22 occasionally kneel. May static push or pull, 22 twenty-five push, thirty-two pounds pull. That he 24 may occasionally use his head and neck in a static 25 position in flexion, extension and rotation. That 3 6 1 he can use his hands for simple grasping, firm 2 grasping and fine manipulation on a frequent basis. 3 That there are considerations for work activity, 4 including unprotected heights, temperature changes, 5 dust, fumes, vibration and jarring. That -- well, 6 that is not a restriction. 7 Q No. 9 you are talking about is not a 8 restriction? 9 A Is not a restriction. 10 Q Okay. 11 A Nor is number -- yeah, that's correct. 12 Q And it's your understanding that these 13 restrictions are permanent? 14 A That is what's marked on No. 11, yes. is Q Now, are there any of those that you agree 16 or disagree with based on your review of the medical 17 records? 18 A My review of these compared to the 19 functional capacity evaluation, found them to be 20 somewhat more restrictive and some of them were not 21 noted within the functional capacity evaluation. 22 Q Using the restrictions on the PFCE form, 23 would any of these restrictions prevent Mr. Downs 24 from being a locomotive engineer using the general 25 job description of a locomotive engineer? 3 7 1 A Yes 2 Q Which one? 3 A The no work of more than four hours per 4 day would be something which could not be 5 accommodated within the workplace. The sitting, 6 standing, walking guidelines would be problematic 7 but not entirely unworkable. That is really about a it. 9 Q How about the vibration and jarring? 10 A There is really very little vibration on 11 most of our locomotives. 12 Q How about jarring? 13 A Jarring is only occasional, depending on 14 what kind of run you are on. 15 Q What causes the jarring? 16 A Jarring may occur when picking up cars. 17 Q Have you ever heard of the term slack 18 action? 19 A Yes. 20 Q Is that what you are talking about? 21 A Yes. 22 Q Is slack action magnified by the number of 22 cars in atrain? 24 A Generally. 25 Q Is slack action magnified by the abrupt 3 8 1 starting and stopping of the locomotive? 2 A Yes. It has a good deal to do with the 3 ability of the locomotive engineer to deal with it. 4 Q Have you ever been on a locomotive that 5 has been involved in a switching operation in the 6 yard? 7 A No. 8 Q Do you know what a switching operation is 9 like in the yard? 10 A I have some idea, yes. 11 Q Would you describe to me what your 12 understanding is of a switching operation in the 13 yard? 14 A A switching operation is where a switching is locomotive will pick up cars and move them around to 16 different tracks trying to create blocks of cars for 17 later movement out in trains, trying to form a 1 8 consist. 19 Q Have you ever observed a CSX rail yard 20 crew switching cars by picking up a string of cars, 21 bringing them to a stop, then propelling the cars 22 ahead at speeds up to ten miles an hour and abruptly 21 stopping the locomotive and a portion of the cars to 24 allow certain cars to detach and free roll into 25 tracks? 3 9 1 A I have not seen that operation, no, sir. 2 Q Do you kriow whether or not it takes place? 3 A I do not. 4 Q Okay. And the other restrictions are the 5 functional capacity evaluation of Mr. Scarupa? 6 A Correct. 7 Q And you took all of that into 8 consideration in forming the opinions that you are 9 going to offer today? 10 A Correct. 11 Q Now, what is your understanding of what, 12 if any, restrictions have been placed on Mr. Downs 13 by any other doctors? 14 A I look at the independent medical exam by is Dr. Kyles. Allow me a minute to find the salient 16 parts. 17 I'm sorry it's taking me so long. 18 Q Take your time. It's a lengthy report. 19 A I read a section on Page 11 where 20 Dr. Kyles states from his review of the case and 21 reviewing the physical demands of an engineer, he 22 does not feel that he is incapable of working as an 21 engineer. 24 Q All right, Sir. But you are reading 25 Dr. Kyles, opinion. what I am trying to find out is 4 0 1 what are his restrictions. 2 A And that is what I am trying to see 3 whether I have found them in here. I'm sorry, I 4 don't see any particular restrictions from Dr. Kyles 5 in here. 6 Q Okay. Are there any mental restrictions 7 that anyone has placed on Mr. Downs? 8 A I have not seen any mental restrictions 9 anywhere. 10 Q Do you have any opinions or comments that 11 you are going to make in connection with your 12 evaluation concerning any mental restrictions or 13 mental problems that Mr. Downs may have? 14 A No, I have no comments about his mental is ability. I have seen no restriction on his mental 16 abilities. The only information I have received and 17 have reviewed is that of Dr. Wade who appears to say 18 that this gentleman appears to go cognitively 19 intact . 20 MR. HOLLAND: Can we take a break 21 just a minute? 22 (Off the record) 23 BY MR. WILSON: 24 Q We have discussed that the four-hour 25 restrictions by Dr. Decker would prevent Mr. Downs 4 1 1 from being a locomotive engineer. Would that also 2 prevent him from working as a yardmaster? 3 A That would prevent Mr. Downs from doing 4 any kind of full-time employment. If he could only 5 work a total of four hours per day, considering 6 there are seven days in a week, that only adds up to 7 twenty-eight hours. 8 Q And I guess that is what I am getting at. 9 There is no part-time employment on the railroad? 10 A Not that I know of. 11 Q Can you tell me whether or not you know of 12 or you have participated in in any studies that have 13 been done by CSX that address stress on the job for 14 any job position? 15 A I know of no studies and I have not 16 participated in any studies. 17 Q Are you aware of any studies that have 18 been conducted by any national rail organizations 19 concerning stress on employees who are kept on duty 20 over eight hours? 21 A No. 22 Q Getting back to the restrictions that you 23 understand to have heen placed on Mr. Downs by 24 Dr. Decker, did you read his deposition to refine 25 exactly what he meant by the restrictions in the 4 2 1 PFCE? 2 A I read his deposition to try to get more 3 insight as to what he was talking about. I don't 4 remember seeing a discussion in there that refined 5 it further. I may have missed that. 6 Q Did you read any portion of his deposition 7 that you recall concerning Mr. Downs, ability to 8 mount, dismount and climb a railroad locomotive 9 ladder? 10 A No, I do not remember that. 11 Q Okay. And do you have any recollection of 12 Dr. Decker's opinion as to whether Mr. Downs would 13 be released from his care to become a locomotive 14 engineer? is A It is my understanding that Dr. Decker 16 feels that this man cannot become a locomotive 17 engineer. 18 Q And at nowhere in Dr. Decker's record nor 19 in his deposition did you see anyplace that he had 20 released Mr. Downs to perform the job duties of a 21 locomotive engineer, did you? 22 A No. That is correct. 22 Q Are you required to be familiar with the 24 rules that govern medications that employees can 25 take while they are working as a locomotive 4 3 engineer? 2 A Yes. 3 Q Is there a list of medications that is 4 published or defined as medications that should not s be used by employees while working as a locomotive 6 engineer? 7 A No. B Q Do you know -- can you tell me today what 9 type of medication should not be used by a person 10 while they are working as a locomotive engineer? 11 A An employee -- any employee should not use 12 any medication that alters their cognition, 13 coordination, judgment or gait while working, 14 whether as a locomotive engineer or any other kind 15 of position. 16 Q I have some rules, if I can find them here 17 in my many documents, that I would like you to take 18 a look at. The first is a rule under substance 19 abuse, CSX Safeway 5-1-97. That is the book that it 20 came from. Do you recognize that rule? 21 A (Witness taking and reviewing document) 2 2 Yes. 23 Q And does that rule govern the subject that 24 we are talking about now, employees not using any 25 type of drug that might alter their behavior while 4 4 1 they're on duty? 2 A Correct. 3 Q And would that include not only illegal 4 substances but prescription drugs also? 5 A Correct. 6 Q Are you required to be familiar with the 7 Federal Railroad Administration standards from the 8 code of federal regulations concerning substances 9 that can or cannot be used by employees on duty? 10 A I would think so, although I am not sure 11 exactly what you are referring to. 12 Q Okay. Are you familiar with the Subpart 13 B, Prohibitions, alcohol and drug use prohibited, 14 that applies to railroad employees? You are welcome is to take a look at it. If you are not, just tell me 16 and we will move on. 17 A Yes, I am familiar with this. 18 Q All right, sir. And is that a federal 19 statute applicable to railroad locomotives, 20 including CSX locomotive engineers that prohibit 21 them from using any type of drugs, including 22 prescription drugs, that would alter their 21 performance on the job? 24 A That's correct. 25 Q Or inhibit their performance on the job 4 5 1 also? 2 A Correct. 3 MR. WILSON: All right, sir. Let's 4 mark these two rules. First the CSX rule 5 and then the CFR rule. And that would be 6 3 and 4. 7 (Thereupon, the documents last 8 above-referred to were received and marked as 9 Plaintiff's Exhibit Nos. 3 and 4 for 10 identification.) 11 BY MR. WILSON: 12 Q Dr. Goldman, as I understand it, you are a 13 medical practitioner who has attended medical school 14 and you are licensed to practice medicine in certain 15 states? 16 A Correct. 17 Q What states are you licensed to practice? 18 A Pennsylvania, South Carolina and Florida. 19 Q Do you retain a familiarity in your job or 20 keep up with certain drugs that may be prescribed by 21 doctors to railroad employees? 22 A I make every attempt to. 23 0 Do you know what prescription drug am 24 going to have to spell it, V-a-s-e-r-e-t-i-C, I 25 think it's Vaseretic? 4 6 1 A Vaseretic. I'm very familiar with 2 Vaseretic. 3 Q What is that drug, please? 4 A It's a combination ACE inhibitor and 5 hydrochlorothiazide. It is used for a step two 6 control of hypertension. 7 Q And is there any prohibition or would you 8 prevent a railroad employee from taking that drug 9 while he is operating as a locomotive engineer? 10 A No, sir. 11 Q Tetracycline? 12 A Very familiar with Tetracycline. It's an 13 antibiotic. 14 Q Any restrictions or prohibitions against a 15 railroad employee from using that prescription while 16 working as a locomotive engineer? 17 A No, sir. 18 Q Amitriptyline? 19 A Amitriptyline is the generic name for what 20 is more a commonly known brand name of Elavil. It's 21 an anti-depressant. 22 Q Yes, sir. Any restrictions against an 23 employee using Blavil while operating as a 24 locomotive engineer? 25 A None as long as the employee does not get 4 7 1 side affects from the Elavil. 2 Q As an example, if he is drowsy from the 3 Elavil, you would not want him to be a locomotive 4 engineer? 5 A If he gets drowsy from the Elavil, I would 6 expect him to not report for work in a drowsy state, 7 correct. 8 Q Are you familiar with the warnings from 9 the Physician's Desk Reference for use of the drug 10 Amitriptyline? 11 A Not offhand, no. 12 Q What is your understanding of the general 13 side affects that may result to a person using 14 Amitriptyline? is A Drowsiness, dry mouth and constipation. 16 Q Okay. Are there any warnings that you 17 know of about that person using care when operating 18 heavy machinery? 19 A I do not know. Elavil, Amitriptyline is a 20 drug that has been around for a long time. We have 21 a great deal of experience with Amitriptyline. The 22 vast majority of people do not have any problems 22 operating equipment on Amitriptyline. 24 However, having said that, especially in 25 the beginning of therapy, there are some people who 4 8 1 have some difficulty. For those people, they should 2 not he operating heavy equipment. 3 Q Daypro? 4 A Daypro is a nonsteroidal anti-inflammatory 5 drug. 6 Q Any restrictions? 7 A No, sir. 8 Q Zoloft, Z-0-1-0-f-t? 9 A Zoloft is a serotonin reuptake inhibitor. 10 No restrictions. Consideration needs to be given if 11 side affects occur. 12 Q All right, sir. You don't believe that 13 Zoloft comes with a warning from the drugstore that 14 says it may impair ability to drive or operate 15 machinery? 16 A A lot of drugs do that. I think one needs 17 to take into account their own personal experiences 18 with the drugs. 19 Q So it would be up to the individual, if 20 he, himself, experienced some impairment of his 21 ability, to notify the railway company of that or to 22 take off from work? 23 A That is precisely what it is. 24 Q Roxicet? 25 A Roxicet is a mixture of acetaminophen and 4 9 1 oxycodone. It's the same warning, if you have any 2 difficulty with this, including drowsiness, you 3 should not be reporting for work. 4 Q What is Roxicet used for? 5 A Pain. 6 Q Did you read in Dr. Decker's deposition as 7 to whether or not Mr. Downs required pain 8 medication? 9 A I found the need for pain medication to be 10 extremely variable. The last thing I saw about 11 Mr. Downs' use of pain medication showed that he was 12 taking it only on an as-needed basis. 13 Q Do you know how often he takes the 14 Roxicet? 15 A No, I do not. However, it is not 16 prescribed at this point, as far as I could find 17 from the medical records, on a continuing basis. 18 Q Did you read Dr. Decker's opinion as to 19 whether or not Mr. Downs will require pain 20 medication into the future? 21 A No, I don't remember pinpointing that 22 aspect of it. 21 Q Would you want someone taking Vaseretic, 24 Tetracycline, Amitriptyline, Daypro Zoloft and 25 Roxicet to be operating a railroad locomotive engine 5 0 1 for CSX? 2 A I would have no problem having someone 3 with those medications operating a locomotive as 4 long as they were not taking the Roxicet on a 5 permanent continuous basis and that they suffered no 6 side affects from it. 7 Things like Zoloft and Amitriptyline are 8 some of the most common drugs in the country. If we 9 eliminated everybody from the work force who took 10 those drugs, we'd have no one left on the work 11 force. 12 Q Well, you don't take them, do you? 13 A No, I don't take them. 14 Q Well, I don't take them. 15 A They are extremely common. If you look at 16 the list of the most common drugs in the country and 17 how many people take them, they are among the top 18 drugs. 19 Q Are railroad employees required to notify 20 the CSX Railway Company if they take Amitriptyline? 21 A No. 22 Q Are they required to notify the railway 23 company if they take Zoloft? 24 A No. 25 Q Are they required to notify the railway 5 1 I company if they take Roxicet? 2 A No. 3 Q Are they subject to dismissal if they are 4 involved in an accident and they are tested and they 5 have these drugs in their bloodstream and have 6 failed to notify the railroad they're taking them? 7 A Not that I know of. 8 Q Do you place any requirements on any 9 employees or does CSX place any requirements on any 10 employees that you know of that they must report 11 medications that they are taking orally if such 12 medication may interfere with their operation of 13 machinery? 14 A That has not been a regulation as far as I 15 know. However, there is a prohibition, as you are 16 looking at, that requires people to not take that 17 medication. They have no requirement to notify us 18 if they are taking it. 19 Q well, and that is what I was getting at. 20 The CSX Safeway rule, which is Plaintiff's Exhibit 21 No. 3 for Dr. Goldman says, "Employees shall neither 22 report for duty nor perform service while under the 23 influence of nor use while on duty or CSXT property 24 any drug, medication or other substance, including 25 prescribed medication, that will in any way 5 2 1 adversely affect the employee's alertness, 2 coordination, reaction, response or safety." 3 So if the person is taking Roxicet and it 4 affects their alertness, coordination, reaction, 5 response or safety, they should not be working for 6 CSX; is that correct? 7 A They should not report to duty as long as 8 they are under the influence of an exogenous 9 substance. That's common sense and true for really 10 any job. 11 Q They're not even supposed to possess that 12 while they're on duty, are they? 13 A They are not supposed to drive a car while 14 they're under the influence of a substance. 15 Q All right, sir. But I am talking about 16 the CSX Safeway rule now. They're not even supposed 17 to possess Roxicet and have it with them while 18 they're on duty, are they? 19 A That is correct. 20 Q Would the same be true for the job of 21 yardmaster, you would not want a person working that 22 job who was not alert, coordinated, had good 23 reaction, good response and was cognizant of the 24 safety of other employees? 25 A I wouldn't want him to be yardmaster. I 5 3 1 wouldn't want him to be your taxi driver either. I 2 think that's fairly obvious. 3 Q That is what I am getting at. It is 4 pretty obvious if Roxicet affects you, you shouldn't 5 be out there as a locomotive engineer? 6 A If Ibuprofen affects you, you shouldn't be 7 out there as a locomotive engineer. 8 Q All right, sir. I understand that. But 9 my question is -- 10 A If any substance affects you. 11 Q okay. And that is good way of putting 12 it. If you are taking a prescription drug which 13 affects you and those abilities that we just talked 14 about in this rule, you should not be working as a is locomotive engineer? 16 A Correct. I mean, there are some 17 anti-hypertensives that can potentially affect you, 18 especially the first-dose phenomenon of Hydergine. 19 Some people pass out the first time they take a dose 20 of it. You should not take your first dose of 21 Hydergine on duty. 22 Q Is there any national standard that 23 addresses a particular group of drugs that should 24 not be taken by employees other than the Code of 25 Federal Regulations and the CSX? 5 4 1 A No. And the FRA gives very little 2 guidance to this question in their regulations. So 3 generally occupational medicine physicians take 4 their guidance from some of the Federal Highway 5 Administration regulations and guidance. 6 Q Is there an agreement between operating 7 unions and the CSX as to certain groups of drugs 8 that will not be used by employees while on duty? 9 A I have no knowledge of such an agreement. 10 Q Does Roxicet contain a narcotic? 11 A oxycodone is a narcotic. 12 Q Is that the same as Percocet? 13 A Similar, very similar. 14 Q I would like you to look at a medical 15 file, if you will, back near the bottom, 1991, and 16 in that there is some reference to a form called an 17 MD3 form. Do you know what that form is, MD3? 18 A Yes, sir. 19 Q Is that a form that is still used on the 20 CSX Railway Company? 21 A Yes, it is. 22 Q Who fills out the MD3 employee form? 21 A The employee's physician. 24 Q The treating physician? 25 A Correct. Hopefully so. 5 5 1 Q Back in 1991, Mr. Downs underwent a 2 surgical excision of a disk and I believe then made 3 an attempt to return to work at the railway 4 company. Is that reflected in his file? 5 A Yes. 6 Q And have you reviewed that portion of his 7 f i 1 e ? 8 A Yes, I have. 9 Q And is it true that CSX would not allow 10 him to return to work until Dr. Wright, his treating 11 physician, had released him to work as a locomotive 12 engineer? 13 A That is the first step in the process, 14 correct. 15 Q And that is the general process that is 16 followed with employees, isn't it, when they attempt 17 to return to work? 18 A Yes. 19 Q And you would agree that based on your 20 review of the medical records, Mr. Downs' treating 21 physician has not released him in this case to 22 return to work as a locomotive engineer? 23 A That is correct. 24 Q I would like to offer those particular 25 documents in your file, and maybe I can pick out 5 6 1 which ones I want if you don't mind me reaching 2 over. Is this the MD3 form that you have? 3 A That is correct. Included in there is a 4 discharge summary, I believe, on the last page. 5 MR. WILSON: I'd like to offer those 6 four pages. I don't have a complete copy 7 of them. maybe use these. Could you get 8 a copy made for us right here? 9 THE WITNESS: I can get a copy 10 made. Do you want me to do it right 11 now? 12 MR. WILSON: No, we can do it at the 13 end. 14 MR. HOLLAND: I reserve the right to 15 object to your discretion in that. 16 BY MR. WILSON: 17 Q Let me ask you some more about questions 18 about these pages, Dr. Goldman. Are these records 19 that are kept in Mr. Downs' CSX medical records file 20 here at the medical department? 21 A Yes. 22 Q And are these records that are kept in the 22 ordinary and customary business of CSX Railway 24 Company? 25 A Yes, but that is not our name. 5 7 1 Q CSXT? 2 A CSX Transportation. 3 Q All right, sir. But you agree they are 4 records that are ordinarily kept in the course of 5 business? 6 A Yes. 7 Q And you rely upon these records when 8 you're making evaluations of employees, don't you? 9 A Yes. 10 Q Let's set these over here. Do you want to 11 keep them in order and maybe mark them or -- 12 A I am afraid this chart is no longer in 13 order. 14 Q okay. Why don't we just set them over 15 here. The same would be true for these two other 16 records, one dated December 20th, 1991, to Mr. Downs 17 from Joseph Thomasino who then was the chief medical 18 officer? 19 A Correct. 20 Q And it looks like a computer printout 21 below that dated 12/20/91 to G.L. Gibson from Joseph 22 Thomasino from Joe. Is that a record that is 23 contained within Mr. Downs, file here at CSXT? 2 4 A It is. 25 Q And also the physician's examination 5 8 1 report, invoice No. 333009, the same for that, 2 that's an examination of Mr. Downs kept within the 3 CSXT medical department file? 4 A Correct. 5 Q And that is two pages? 6 A Correct. The report is one page and the 7 invoice is one page. 8 Q All right, sir. 9 (Thereupon, the document last 10 above-referred to was received and marked as 11 Plaintiff's Exhibit No. 5 for 12 identification.) 13 BY MR. WILSON: 14 Q Have you talked with Dr. Kyles at all? 15 A No, sir. 16 Q Dr. Decker or any of the other doctors 17 involved in this case? 18 A No, sir. 19 Q You told me you became chief medical 20 officer of CSX about three years ago. I am trying 21 to find out if your job is an administrative type 22 position in the medical field in general or whether 23 or not you treat patients, generally trying to make 24 some differentiation if I can. 25 A My job is very much administrative. 5 9 1 Occasionally clinical contact, not much. 2 Q You don't see patients on a regular basis 3 or have a practice outside of the administrative 4 job? 5 A No, sir. 6 Q Did you ever do that? 7 A Yes, sir. a Q When did you do that? 9 A I did that for twelve years starting in 10 1978 until 1990. 11 Q In Pennsylvania? 12 A Yes. 13 Q Have you ever practiced in Virginia? 14 A No. 15 Q Did you go to school there? 16 A No. 17 Q Where did you go to school? 18 A Temple University Medical School in 19 Philadelphia. 20 Q Okay. So the three years since you left 21 Pennsylvania, you have gone to an administrative 22 type job? 23 A That is correct. 24 Q Now, when you were a practicing physician, 25 did you have any specialty? 6 0 1 A Family practice. 2 Q Did you have any certification as a 3 specialist in the field of family practice? 4 A Yes. 5 Q And that requires a board certification to 6 do that? 7 A Correct. 8 Q You don't have any in the field of 9 orthopedics or anything else in medicine? 10 A No. I'm also certified hy the American 11 Board of Preventive medicine and Occupational 12 Medicine. So I have two boards certifications. 13 Q Okay. When did you get the second one.> 14 A February 1997. 15 Q That has to do with your job concerning 16 Occupational illnesses here at CSXT? 17 A It has to do with a wide range of 18 occupational medicine and is a subboard of the Board 19 of Preventive Medicine. So it is a board 20 certification in that is both a board certification 21 in preventative medicine and occupational medicine. 22 I know it,s confusing. 22 Q I just let those slide by. You are right. 24 Okay. When you practiced, I assume you 25 prescribed medications and examined persons? 6 1 1 A Quite a bit. 2 Q Okay. Did you do surgery of any kind? 3 A Minor office surgery. 4 Q Like what? 5 A Removal of skin lesions, incision and 6 draining of abscesses, treatment of paronychia. 7 General office minor surgery. 8 Q Okay. As an example, if I had a cold or 9 something or a headache or backache or whatever, I 10 might come to you as a general practitioner? 11 A I would hope that you would. 12 Q Okay. And you have never examined 13 Mr. Downs? 14 A No, sir. is Q Have you seen his x-rays? 16 A No. 17 Q You did read x-rays in your practice for 18 the, what was it, twelve or thirteen years in 19 Pennsylvania? 20 A Yes. 21 Q Have you read the x-ray reports in this 22 case? 21 A Yes. 24 Q Have you relied upon them in forming your 25 opinions? 6 2 1 A Yes 2 Q Do you think you have an understanding of 3 the injuries that Mr. Downs suffered as a result of 4 the train wreck of July 5, 1996? 5 A I think I have an understanding of them. 6 Q Describe to me what your understanding is, 7 please. 8 A My understanding is that he suffered some 9 facial bone fractures on the right side, that he had 10 a crush injury to his, if I am correct, his left 11 arm, causing the partial laceration of some tendons 12 and muscles, that he had a hemopneumothorax 13 secondary to, I believe, four rib fractures. 14 Q That is a punctured lung? is A Yes, with buildup of blood within the 16 thoracic cavity. That he had a fracture of the 17 spinous processes of perhaps one or maybe even two 18 thoracic vertebrae. That was the major extent of 19 his injuries. 20 Q Do you have any understanding from your 21 review of the records as to whether or not he 22 suffered any injury at all or any aggravation of any 23 in3ury to his lower back? 24 A That I found to be a little bit difficult 25 to pick apart in the medical record because there 6 3 1 doesn't appear to be much mention of it during the 2 hospitalization and only three or four weeks later 3 do I find it mentioned. 4 Q Did you read the Tuckahoe rescue squad 5 report? 6 A I did not see that, no. 7 Q It's always a pretty critical element when 8 a person -- element when a person is injured as to 9 what they first report to someone, isn't it? 10 A I find that in the criticality of the 11 moment, a lot of inaccuracies are possible and that 12 that is not a particularly good indicator of what 13 comes after that. That is my experience. And I 14 have worked in a lot of emergency rooms. 15 Q People sometimes overlook their 16 complaints? 17 A I think people sometimes misinterpret a 18 lot of things that go on in the excitement of the 19 moment. 20 Q Do you know what position he was found in 21 after the cars struck the locomotive? 22 A No, sir, I don't. 21 0 Do you know what a supine position is? 24 A Sure. 25 Q Describe that for me, please. 6 4 1 A Lying on your back. 2 Q Do you know whether or not he was trapped 3 in the locomotive for any period of time? 4 A My understanding was that he was 5 unconscious for several minutes in the locomotive. 6 Q Do you know whether he was able to leave 7 the locomotive under his own power or not? 8 A That, I don't know. 9 Q Do you know whether or not he required the 10 stopping of blood flow on the site of the accident? 11 A That, I don't know. 12 Q Has Mr. Holland shown you or anyone else 13 shown you any pictures of Mr. Downs following the 14 injury? 15 A I thought I saw a quick glimpse of some 16 photographs but nothing that I actually sat down and 17 looked at, no. 18 Q Has Mr. Holland or anyone else shown you 19 the pictures of the locomotives on which Mr. Downs 20 was riding, the pictures taken by William E. Price, 21 a supervisor for CSX? 22 A No, sir. 23 Q Are those type things that would be 24 helpful to you in understanding the impact that 25 Mr. Downs underwent on July Sth, 1996? 6 5 1 A I think they are only minor elements in my 2 understanding of the case. The force with which the 3 accident occurs is not -- you don't need to totally 4 understand that in order to understand his injuries, 5 which were significant. 6 Q Okay. As I understand it, you have not 7 read the deposition of Mr. Leon Stockwell, a 8 locomotive engineer in Richmond, wherein he 9 described the actual duties of an engineer at Acka 10 Yard? 11 A No, sir. 12 Q Nor Mr. Glasser, Chuck Glasser? 1 3 A No, sir. 14 Q Do you know whether or not a locomotive 15 engineer in Richmond, Virginia, has to link 16 electrical cables from one locomotive to another? 17 A That is a standard duty of a locomotive 18 engineer. It occurs infrequently, hut at this point 19 it's a standard duty. It may be a duty that is 20 modifiable. 21 Q In other words, you might be able to get 22 someone to agree to do that for him? 23 A That is right. 24 Q Okay. They used to have a job in Richmond 25 called an independent engineer's job where the 6 6 1 engineer worked by himself and no one was around. 2 Are there any other positions like that on CSX? 3 A That is rare. I do not know whether there 4 are other positions like that. I have not heard of 5 it. 6 Q Is there anything you know of that 7 prevents the railway company from negotiating an 8 agreement or instituting that type job in Richmond? 9 A The FRA has a ban on single-crew 10 locomotives at this point is my understanding. 11 Q Are there any crews operating out of 12 Richmond that only have two employees, a conductor 13 and an engineer? 14 A I think that is rapidly becoming the norm. 15 Q Let me know the exact weight you believe 16 Mr. Downs can work with at shoulder to eye level, 17 I'm talking about in this foot and a half area, and 18 how long he can work with his arms at shoulder to 19 eye level. 20 A That is not something that is included 21 within the physical functional capacities 22 evaluation. This is -- the only information in here 23 is sustained overhead lifting. 24 Q All right, sir. What is the sustained 25 overhead lifting limitation? 6 7 1 A Overhead lifting iS three minutes, two 2 pounds. 3 Q In cases -- I'm sorry, let me start over 4 on that. 5 Do you, in all cases, require the MD3 from 6 the treating physician before you'll put an employee 7 back to work? 8 A No. 9 Q Under what conditions do you not require 10 an MD3? 11 A If we feel we have enough medical 12 information within our records. 13 Q If a treating physician who is continuing 14 to treat the person, the employee, opines that that 15 person cannot return to work at a particular job 16 requiring certain force, would you overrule that 17 treating physician and put the person back to work 18 anyway? 19 A Well, we give the treating physician's 20 opinion great weight without a doubt, but we'll look 21 at the objective medical information that was used 22 to formulate that opinion. 23 We do not force people back to work. We 24 give people the opportunity to work. 25 Q Define accommodation for me, will you, 6 8 1 please? 2 A Accommodation is the act of modifying the 3 job such that it will meet the restrictions of 4 someone, meet their functional capacity limitations. 5 Q If a person has certain restrictions 6 placed on them, an accommodation would be you 7 changing a job to meet those restrictions where the 8 person could do that job? 9 A It's potentially possible. 10 Q And is that the same definition you,d use 11 for accommodations under the American Disabilities 12 Act? 13 A Same process. 14 Q Have you made any accommodations for any is locomotive engineers under the American Disabilities 16 Act? 17 A Yes. 18 Q Okay. How many? 19 A I cannot answer that. 20 Q Have you done any this year? 21 A Yes. 22 Q Where? 22 A I can't answer that. 24 Q Can you tell me how many this year? 25 A No, I don't keep count of those. That 6 9 1 count is kept generally in our computer system and 2 by the vocational rehabilitation people. 3 Q Do you have to file documents with the 4 government to make accommodations under the American 5 Disabilities Act? I mean, do you have to let anyone 6 know that you have done that? 7 A No. 8 Q There is no reporting system for that? 9 A You are an attorney, right? 10 Q Yes, sir, I am. That's why I asked the 11 question. Because there is a reporting required. 12 A Not that I am aware of. 13 Q Okay. Has anyone filed a claim against 14 CSX under the American Disabilities Act of which you is are aware? 16 A Yes. 17 Q All right. A locomotive engineer? 18 A Not that I am aware of. 19 Q Well, why would you make accommodations 20 under the American Disabilities Act if no one has 21 made a claim under that that's a locomotive 22 engineer? 22 A The fact that somebody has not accused us 24 of violating their civil rights doesn't stop me from 25 trying to uphold their civil rights. 7 0 1 Q So you are saying that you have made 2 accommodations but not particularly accommodations 3 that were brought about by someone forcing you to do 4 that under the American Disabilities Act? 5 A We do that because it's our obligation. 6 Q It's an obligation that CSX has for its 7 employees? 8 A It's our moral obligation as well as our 9 obligation under the Americans with Disabilities 10 Act. 11 Q And you would apply this same 12 accommodation to persons who were off or a heart 13 attack, who were off for a stroke, who were off for 14 whatever reason. They don't just have to be an 15 injured employee with a claim? 16 A We offer the same potential 17 accommodations. 18 Q Well, there is difference between offering 19 the same potential accommodations. Do you offer the 20 same accommodations and will you in the future offer 21 the same accommodations to persons that are off for 22 heart attacks and strokes that you offer to injured 2@ employees? 24 A The answer is an emphatic yes. 25 Q Now, as an example, if an employee has a 7 1 1 heart attack and his doctor opines that he is not 2 able to walk over uneven surfaces such as ballast, 3 would you make an accommodation for him in that 4 instance? 5 A We treat every case on an individual 6 basis. We need to look at his exposures. we need 7 to look at his seniority. We need to look at his a particular job and his ability to get to potential 9 jobs which may accommodate his restrictions. So I 10 cannot predict because each one is looked at on an 11 individual basis as per the instructions of the ADA. 12 Q So being that you have not looked at the 13 particular functions and aspects of Mr. Downs, job 14 requirements in Richmond, you are not able to offer 15 the opinion today that you can make accommodations 16 so he can work, are you? 17 A We are prepared to offer that we are 18 willing to go through that process with Mr. Downs. 19 Q That wasn't my question, sir. My question 20 is, being that you do not know the specific duties 21 that are required of a locomotive engineer in 22 Richmond Acka Yard, such as would be required of 23 Mr. Downs, you are not able to offer the opinion 24 today that you can make accommodations for him to be 25 able to work that job, are you? 7 2 1 A can say that we are -- that at first 2 blush he looks like he may be able to become 3 qualified as a locomotive engineer. I cannot 4 predict at this point in time that that will 5 ultimately become successful, if that answers your 6 question. 7 Q All right, sir. Do you know how much 8 force it takes to operate a railroad switch? 9 A A railroad switch is somewhere around 10 forty pounds. 11 Q And do you know how much force it takes to 12 tie a hand brake on a railroad locomotive? 13 A That, I do not have off the top of my 14 head. is Q All right, sir. Do you get any 16 publications from the American Association of 17 Railroads concerning studies that they have done as 18 to the pull-push force capacities required to 19 operate hand brakes? 20 A No. 21 Q You have never seen those? 22 A No. 23 0 You have never seen them in relation to 24 operating a railroad switch either? 2S A We do our own measurements. 7 3 1 Q All right, sir. Who does your 2 measurements? 3 A Mr. Todd Brown, Dr. Todd Brown. 4 Q And have you looked at those measurements? 5 A Not recently. 6 Q Is the forty pounds something that you 7 recall from having looked at the measurements in 8 relation to the railroad switch? 9 A Correct. 10 Q As I understand your opinions today, 11 Dr. Goldman, what you are able to tell me is that 12 CSX is willing to try and make accommodations for 13 Mr. Downs? 14 A That is correct. is Q You are not able to tell me today nor 16 offer an opinion that you will be able to make 17 accommodations which will allow him to work as a 18 locomotive engineer in Richmond? 19 A That is correct. 20 MR. WILSON: That is all the 21 questions I have. You can answer 22 Mr. Holland's questions. 2@ MR. HOLLAND: I don't have any 24 questions. 25 MR. WILSON: All right, sir. Would 7 4 1 you like to waive or would you like to 2 read this thing and sign it? 3 THE WITNESS: Oh, I don't want to 4 read it now. 5 MR. WILSON: We do need to make a 6 copy of these documents, if you don't 7 mind. 8 THE WITNESS: Certainly, certainly. 9 (Witness excused.) 10 (Thereupon, the deposition was concluded 11 at approximately 3:55 o'clock p.m.) 12 - - - 1 3 1 4 is 16 17 18 19 2 0 21 2 2 22 2 4 2 5 7 S C E R T I F I C A T E 0 F 0 A T H 2 STATE OF FLORIDA COUNTY OF DUVAL 3 4 5 I, the undersigned authority, certify that 6 DR. STEPHEN L. GOLDMAN, M.D. Personally appeared 7 before me and was duly sworn. 8 9 WITNESS my hand and official seal this 7th 10 day of August 1997. 11 12 13 14 ------------ 15 otary Public, State at Large 16 17 18 19 2 0 21 2 2 23 2 4 2 5 7 6 C E R T I F I C A T E 2 STATE OF FLORIDA) 3 COUNTY OF DUVAL) 4 I, CAROLYN S. FOWLER, Registered Professional 5 Reporter, certify that I was authorized to and did 6 stenographically report the deposition of DR. 7 STEPHEN L. GOLDMAN, M.D.; that a review of the 8 transcript was not requested; and that the 9 transcript is a true and complete record of my 10 stenographic notes. 11 I further certify that I am not a relative, 12 employee, attorney or counsel of any of the parties, 13 nor am I a relative or employee of any of the 14 parties' attorneys or counsel connected with the 15 action, nor am I financially interested in the 16 action. 17 WITNESS my hand and official seal at 16 Jacksonville, Duval County, Florida, this 7th day of 19 August 1997. 2 0 21 2 2 22 CAROL R, R.P.R. 24 Notary Public, S ge 2 S My Commission ex JOB TITLE: @HQTIVE ENGINEER Generic (X) Specific N@ : LOCATION: (If Specific) ,RITTEN BY. Brenda E. NortQn TITLE: ER Sr)ecialist DATE: APPROVED BYs W. J. LockwoQd TITLZ:AVP Transportation DATEI APPROVED BY: @..Marke TITLE:Dir, Risk Manaaement DATE: 03108/93 APPROVED BY: omasino TITLZ:Chief Medical Officer DATEI 12/18/92 APPROVED BY: TITLE:SR. AVP ER DATE: 03/08/93 APPROVED BY: Hall TITLZ:Counsel DATE: 7/6/93 .16 A. OMMRILL DZSCRIPTION OF JOB The Locomotive Engineer operates electric, diesel-electric, or gas turbing- electric locomotives; interprets train orders, train signalm, and railroad rules and regulations to transport freight or passengers in a safe and satisfactory manner. D. spscrric JOB ACTIVITIES PERFORMED 1. Operate controls such as throttle, train brakes, safety appliance, and electrical owitches, etc. as required to operate locomotives and control the operation of trains. 2. Recelve and review written Instructions and info=ation such an bulletins, train messages, general orderm and special instructions for train movement prior to run. 3. Participate in job briefing with crew members to become conversant with track warrants, train bulletins, timet&blo schadulam, speed restrictions, and classification of trains. 4. Perform 'hogtlerl function by operating locomotive between various shop locations, service tracks, and switching areas. 5. Inspect locomotive for operational readiness beforqk run by performing tentm and verifying quantity of fuel, sand, water, flagging equipment and other supplies, as required. 6. Supervise the handling and movement of train when operated by trainee. 7. Monitor the position of switches aligne-d by crew. S. Honitor track to detect obstructions and to anticipate operating problemo as required. 9. Prepare failure description@, inspection reports and/or unusual occurrence reports for reference by others. 10. Inspect locomotive during or after run to detect changed or defective equiprnent, prepare engine work report, and advise designated personnel an required. ii. Review train consist giving physical make-up of train including weights, lengths, location of loads and emptiem, and cars requiring special handling. This description is intended to be a general description only. it in subject to modification on a position by position basis. At some locations, some of the specific job duties listod in this job description May b* performed by someone with a different job title. indicates tho function is not essential an defined by the ADA. 'VCRV OXM Iq POUT;*P 89 TV74assg* 4cu ST nOT40vn; sq4 284NOTPul VW 'T'4T'4 qOr '4u*-I@;;TP 9 R4Tml UOGUO@ lq PsluO;-206 Oq IVE aCT-4dT-x*NGP qoF 87t['4 WT Pe-45TT NOT'4nP qcf OT;T*Ods DR-4 ;c Duos 'IUOT'49**T emos -4y 'BTSvq UOT'4TSOd Lq UOT'4Tsod v UO UOT.4uOT;Tpou 0'4 '4"rqrts sT '41 ',ETUO uo'F@dTXox@P TV-2*uefi v aq o-4 popue-4uT ST UOT,4d7.xosep ttqz '-Isuuvm 420'40w;874*8 PUN G;vs w UT UTv34 Dlwx*dO sslmz&440 04 Puv 9Twu6Ts 5uluJvm PDqT2O98zd MAT6 04 JBPJO UT 'bUTE6023 8Pv36 Puv ODAJnz 'NDPVAB 'uTvJ204 bulpnTOuT IA204TI394 ;O 86POlmO@ ATddY ICE 'BulVZ4 buTwODUO U3v,% 04 POaTnbea ueqm utmal ;O xva2 644 UT PUT ;O 4UOJ; UT bUT66911 OPTAoid saeqwaw majo qvqq eansua IC ;BANTDP go lodole PaTnpeqosun ls:tusp-roov uTwIdme o:t e-4.xc>dex eivdexd pu 88T'4Tjoq-4nu Todo.Td A;T40H loc ' .4usmeAom U'TT.7'4 DT4'4 15uT'4D*;;w 9-70:t'4vm BuTu.703UOD nuoT-4onz'4*uT OATOODI .70 UOT-4vuuO;UT e@75 o-4 uni fiu7.7np uoT,4v-4a loj:tuoo puw 2o-4onpuoo tt-47m O:tVDTunwmoo '6Z -sonvaq ;o 6uTqqeo .xodo.7d pus SPNOT OPTA ;O buTTPUNg asdo.2d o.Tnsue 04 gOaXOldwa GOTAiedns lez '600uv4gumDJTD 20 NUOT4TPUOD Tvnsnun 04 A104VT3doiddi puc>deaj O:t 3OP-TO UT *B8u7PVOJ ;O 0'4v:49 V UTv'4uTvm Puv '4-TGTN AI'4uv'4BuO3 U'FwwOll 'LE 'POJTnbea SW WDIBAB f)UTIC>00 MOZ; asivt4 utwaa 19E -venvaq puwq sevelea puv Alddv lsz 'A2vs89O9u us4m 28qD4TAs XOV24 u6TIV 'VZ 'OuOT47PuOD 9;voun ol sasqqo lawly 'EC 'o;e 195wlllds 6uTxoolq &ATloe;ep 'BPROI P04;Tqs 20; 6uTPvT 'Nulvzl 6uTgovd 'Avft-;O-4qbTA pvoallva oazeoqo 'Cc ,pejtnbei U94M BOT47AT40V BUTOTA.109 puw O.Ilvde.T IOUTW uuo;.iod Puv EuOT,4oun;lww -IOUTM A;T:TUSPI 'TZ ' SOTN-I R-4Tm DzuvTTdwOD aineow 0'4 UTN-7'4 buTAOw ;o poods xo-4Tuom .7o ouTM30-40a loz lmvi sitvjq jamod Iviope; Aq POJTNBOJ SW o4oe4 exviq peqtaooead mio;aed '6T ,suo74TJOdO OBOTesooqvo jo; IuDwdTnbO Ailmmlel siviedo 'ST -uoTlv4ojd2*4uT UT 03OZ29 PTOAV 04 6UTUNGM ;O uOT4vDT;TJGA 20; GzOqwsw MDJD 0:1 lsuuwm DTqTpnv puw avelo v uT BTVU679 spigaim sivolunmwoo 'LT -Aosinoov 92noew oq sjeqwem i4e.23 ti,4TI4 PUT (.Tetlz'4wdsTp .70) 3(0010 P-IVPUV'49 T4'4Tm 4@-49m OxTuo.7tiouAS '9T 'BONvzq 2TV ;O UOT4vDTlddv Aoue6asius IvuOl4us4uTun 04 Pu@Od 'ST 'BUOTITPUO3 isglvem PUT UTT2394 0'4 PUN NOT'49T-10'40VJWIID UTT-7-4 Puv OA7'4@OOT 0-4 UOT-4vzDPTBUOD 6UVAT5 suoT,4w.xodo UOT-4v-'DlDDDN ao 03(vaq 64glITuT o4 mr4 e4w7ado3ddv OuTuL'040U 'tT 's2oqoo4ep 4oo;ep puw s5wl; Ineopedio4 '91VU575 '4t(bll UOT'4Tsod 'DTVU61E :4t[671 20100 'sTvuf)TO otpvi 15ulpnlouT 'slwu6Ts qvo OA7;000*OT PUT OTNUBT eplnavm uc>dn 4ow puv 0'4 Puodself 'ET '*Tnpeqoo mq4 PUT SUOT-4vi@.7 A-40;98 bulmOTTO; .70uuvw '4u*TOT;;* UV uT *A-T-4OmOoOl 0-4w.'OdO 04 9&Tnl PRO21TV2 PUT '@Twu678 'SUOT4onalouT 4uO"AOw UTWZI 4ITM Aldwoo 'ET tz"lpn ,m eq4 Iq peut;op ON TNT4u*gsb Zan sT uoT4otm; sq4 9*4w*Tpul ,01,4T,4 qor '40*29;iTP v R'47^ Ouoomos Iq punzo;jod eq lvu UOT'4dTiosep qog gTq-4 UT PO-49TT seT,4np qor *T;Tmsds sq-4 ;o @on 'OUCT49*OT @g 4V 'O'Ffvq UOT'4TOOd Iq uoT,4yood w uo uoT,4woT;-Fpou 04 40ofqns sT 41 -ITUO VOT-4dT.222*P Tv.2*usl 9 aq o-4 POPUS-49T ST UOT'4dTAOSOP E-Tta uOT4v3T;T4203 VUA saxvlaialiuao cxv SZSNNolri cl -notinp qo@ 6u-ruuO;20d DTlt4i4 -4u9WTnb* Puv loxvddv A-4e;ws 2vem o-4 po,71nbe-d .8 ,seowtd pavm%mv jo posoloug 'POuT;uOD 'POdwvgD UT 3(JOI4 'L 'DAvPTTOq JO 8PUOI(60A '04;T4$ 4qbTu 4uouvwjod '@2nO4 TITO -UO '@WT:POAO 1-4;-F4s alqvT.TVA apnlout Avm tlzttim m2noti pawpuv.4@-uou I(;roi4 .9 '4U&MdTnb* BUTAOM ;o A41kwTxoad sq4 uT BOT4TAT40V XJOM UUO;20d s 'SAV42 146JU38AO o3TrLboa Avm 4*74m UOT4wDOT i(.7om AjvtwT.Td oti-4 uvq4 26q4O suOT4wDOT 04 TOAT24 ATM .11 'BuOT40TJIBTP Auwm q4Tm lUaWUOZTAUG UN UT 3(3014 c -uoTloo4oad BUTZTDII oe.TTnbas 4vt4,4 A,4Tsua:tuT UV ;O STOAOT 99TOU SATOAUT AvH z -surT4 sq4 ;o monm eaoop4no xaom 'T smol3val xx@oo UOLI 9Z 'St 'OT 'S 't 'I tr Tmvjo/43no'D/TODuX/(pueg) dools EC lgz lsz Itz 161 ST 10T Is It IT TDDA/20buTi/sTPUVH/qDVB'd ZE 'LT 'El 'ZT sAvIdela 1 sToqwAS TwngTA 5uTPuv4g3ePun TE 'SZ 'LZ 'VZ 'ZZ 'OZ 8T 'LT '9T 'OT 'TT '01 'S 'L '9 'S 't 'T buTNOwAX/uOlloedoui/A41nov ImnOTA LZ 'ZZ 'ET A;Inoy A.ToiTpny ZE 'SZ 'LZ 'CZ 'ZZ '61 'ST 'ET 'ZT 'S 'L NOTNU A49;vS ;O 95POTmOuX EE 'SZ 'SZ 'tZ 'TZ 'OT 't 'T uOTsuetle.Tdwoo ImOTuvqOGH TZ 'OZ 'ST 'tT 'S bull(ON uOT8TD9(l Pug buTATOS wDTqO,7d 9T buTzTuvbzO Pum Buluuvll EC SC 19 uollonalsuj f)UTPT-%03d ZE 'TE DE '6Z 'El 'LT '9T 'ST 'ZT 'OT '6 '9 'C 'Z uOT-4vDTunuxuOO uO-4'4T.'M/Tv-70 6T 'ET 'TT 'E 'Z (IwOTuL[DOL 13 IvJ*uOD) uOTsuetloidtuo:) f)utpveii axy Tirms 'goornomm a -A-204TJ.10'4 4'47^ 'vTlTwv;un 2T m*23 uDI414 93TO 204304OP-TIN-7 073-400TO-100OTP .70 mu7wa4 ;o uoT-4v2edo asTAiedno 20 '40ITd 'CE JOB TLTLR- Yordm4ster Generic (X) Specific NAMES( LOCATION- (If Specific) WRITTEN EYs- no TITLE: ER - Spec-iali@t DATET APPROVED BY: W J. Lockwood TITLE- T @@n atio DATEs APPROVED BY: Marks TITLE: ir. Ili DATE: 03108/93 j@m -. , "PROVED BY: @A..ZPomasino TITLEtChief Medical Officer DATET 12117192 APPROVED BY: iletti TITLE:SR. AV ER DATEI 03/08/93 i I", C M) APPROVED BYt E. Hall TlTLEi ounse DATET 07/06/93 @!. .1 A. GEHLPRAL DESCRIPTION OF JOB The purpos* of this position is to insure the overall safe, efficient operation of the yards. Supervises yard and road crown and inovement of trains into and out of the yard; and oversees and directo switching and proper wake-up of outbound trains for on-time departur*. supervision over employs@@ directly engaged in the swttching, blocking, classifying and handling of carv and trains and duties and other employees performing work with in the yard. S. SPECIFIC JOB ACTIVITIES PE"ORHED I Supervioes, directs and coordinates actinities of workers engaged in makeup and breakup of trains and switching inbound and outbound traffic of railroad yard. 2 Keeps abreast of physical characteristics vixjrrounding opecific mileposts, switches, and other pertinent locations. 3 Learns the restrictions on assigned tracks or territory. 4 Prioritize conflicting demands or needs for work to be performed and performs most important work first. 5 Determines the overall job approach, time required an appropriate personnel to perform work. 6 Assigns work to employees ouch as yard crews, mechanical, T & E, maintenance of way, hostler, at the beginning of the shift to cover all critical jobs. 7 Usen information from coworkers, supervisors and other company personnel to help decide how to approach a job. I Adjusts schedule as the day goes by to react to new events. 9 Reviewe ansignments at beginning of shift and decide what must be done on the shift. 10 Reviews train schedulee and switching orders, and observes traffic movement in yard to determine which trmckis can be made available to accommodate inbound and outbound traffic. 11 Directs routing of inbound and outbound trnffic to specific tracks. This description is intended to be a general description only. it is @ject to modification an a position by position basis. At gone locations some of the specific job activities listed in this job description way be performed by someone with a differ*nt job title. ** indicates this fujactian is not essential as o@fin@4 by the "A. Yardmauttz 34 Known tho lengrth of sidings, classification tracke, leads, etc.. 35 Provides suggestion@ to a supervisor or other personnel to help resolve work-related problems. 36 Roviews waybills or other shipping records indicating material to be loaded or unloaded, tonnage of cargo, type of carrier, and planned routes. 37 Provides instruction concerning switching of cars, makeup and breakup of trains, and routing of @ound and outbound traffic to ensure safe and efficient conduct of yard activities. 38 Issues work orders, switch list, double overm, etc.. 39 EKpodits the movement of all fright as quickly and safely an possible. 40 Disciplines employees demonstrating unsafe practices. 41 Assesses volume of traffic and requests extra trains as needed. 42 Maintain an accurate inventory of all cars in the yard. 43 Validates yard job payroll, monitors overtime and other payroll related cost. 44 Monitors multiple machines, equipment, processes, or operations simultaneously. 45 Work way involve mounting and dismounting locomotives in order to monitor crown at work. 46 Coordinates motive power with Power Bureau. C. MO@, SKILL AND ABILITY RZQUX@S Reading Comprehension (gen. & tech.) 9, 10, 11, 13, 14, 15, 16, 17, 18, 19, 22, 26, 32, 36, 41, 42, 43, 44, 46 Oral/Written Communication 1, 6, 7, 9, 10, 11, 12, 13, 14, 15, 16, 18, 20, 21, 24, 33, 35, 36, 37, 38, 39, 40, 41, 42, 43, 46 Learning & MeiDory (Procedure@) 2, 3, 4, 8, 15, 17, 19, 32, 34, 44 Analytical (Problem solving , analyzing, planning) 1, 4, 5, 6, 7, 9, 9, 10, 12, 21, 23, 24, 26, 35, 37, 39, 41, 42, 44, 46 Numerical 1, St 10, 11, 20, 21, 23, 30, 31, 32, 33, 34, 36, 37, 38, 41, 42, 43, 46 TILis description is intended to be a goneral description only. It is @ject to modification on a position by position b-agin. At some locations gong of the psciflc @ activitl*s listed in this job description way be performed by :Omoone with a different job title. ** IndLcates this functlon is not *msential as defijil-d by the ADA. Substance Abuse 21. Employees reportin-. for duty, on duty, on CSXT properiv, or occup),ing facilities pro% ided by CSXT are prohibiied from having in their possession, using, or bein-. under the influence of alcoholic beverao.es or intoxicants EniploNlees shall neilher report for duty nor perform s@'Ice, %,,hile under the influeng,, of. nor use while on dutv or on CSXT propertv. anv dru@. medication, or niedication that wiil olh'er @ubstance. ncludin@ prescrib in anv way adversely affect the emplovees' alertness. coord'ination. re3ciion. re@ponse. or safeiv iii@@al use an(tor possession of a drug, narcotic, or other substance that affecls alertness, coordination, ted while on or off reaction. response, or safety is prohibi duty. 5 v I , r /-t ri L -94 Edifion) F&deral Railroad Administrahon, DOT 219. 1 01 ith the no- otisly described a3 being based on Inde- (ii) Having .04 or more &Icohol con- j(dxl) and pendent authority. centration in the breath or blood; or 'Ployees of (54 FR 53259. Dec. 27. 1%9: 55 FR 22M. June (iii) Under the influence of or im- which they 4, 1990. m @ended at 59 FR 7458, Feb. 15, paired by any controlled sub3tance. 19941 (3) No employee may use alcobol for .der which it EFFECTIVE DATE Non: At 59 FR 7458, Feb. whichever is the lesser of the following uested under 15,1994, 1219.23 was amended by revisint th, periods: mct4on heading and pamgmdhs (a) Lnd (b). (i) Within four hours of reporting for will be used and by adding P&rLgraPhS (d) @ugh (f) ef- covered se@ice: or &Icohol and fective January 1. 1995. For the convenience (ii) After receiving notice to report tect the em- of the u.%er. the superseded text Is set forth for covered service. If the testing be]OW. (4) No employee tested under the pro- a.lidity c)f @ 1219M Notice to employ@ visions of this part whose test result hat thOrA rl- (a) Whenever a brnth or body fluid test is indicates an alcohol concentration of e correct e@ mqulmd of an employee under this @. the .02 or greater but less thiln .04 shall milroad shall provide cle@ "d unequivocal perform or continue to P-erform covered ,at a COV" written notice to the employ" that the test -service functions for a rlilroad. nor @hol and drog is be@ mquired under Fedemi Railroad Ad- .I EL railroild pern-iit the employee to -ordance with minigtxation reirulations. Cle@ annotation sn&l of Lbe drug testing custody and control fom perform or continue to I>erform covered )f what ('@n for t"t") with the letten "FRA" gervice, until the stlrt of the employ- ,it to an LIC& pria m provjdlng a copy to the emplOYee ee's ne,t regularly acheduled duty pe- atilfles the requirement of tblis paragraph. riod. but not less than eight hours fol- @tt,ndant Rather than providing wittan notice for lowing adniintatmtion of the test. uch Individual te8t. a company that m- 1. ) Controlled substance. "Controlled 3 for covero quim breath andor body fluid tests only (D e viol&ted I& under the authority of EbJs part for , cl,@ly isub@nce" is defined by 1219.5 of this dellneilted portjon of Ito employees niay sat- DLrt. Controlled substlnoes Lre iluding ths m WY thla requirement by publisting tW, f,,t grouped as follows: M@ijuana, narcot- aployee bO In a mamer that provides effective notice to ics (such a3 heroin and codeine). atimu- n Covered @ mch employ,,. IELnt3 (such as cocaine Lnd amphet- .inder 1219.1$'L (b) Whonever a brelth or body fluld test I es for POV "quimd of " employee under this mm, th: Lmines), depresmnts (such gz b@bitu- ave an ga@w -@ shall pmvide cle@. unequiv@ rates and minor tranquilizers), and gre&ter but 10 "ituu nouce of the basis or bases upon hiLlIucinogens (such as the drugs known as PCP and LSD). Controlled -ern'ng th substances include Illicit drugs (Sched- a on an iU;:l ule I), drugs that are required to be dis. tributed only by a medical practition- er's prescription or other authorization (Schedules II through IV. and some drugs on Schedule V). and certean prep- &rations for which distribution Is through documei3t&d over the colinter Subport B- sales (Schedule V only). (c) Railroad rules. Nothing in this sec- "'S-101 Alcoh,l m tion restricts a rajlroad form Imposing i@ iLn absolute prohibition on the preaence nt pro 1%) of alcohol or any drug in the body @.1 P'Ohibitions. Ei M- fluids of pemons in ita eml)loy. whether in furtherance of the ptlri)ose of this Part or for other puposes. (d) ConsMxtion. This section shall not be construed to prohibit the pres- report for cov- ence of an unopened cont4Liner of an &l- ain on duty In coholic beverage in a private motor ve- hicle that is not subject to use in the e of or impaired business of the r&ilroad; nor aball it be )e cl ys const@ed to restrict a railroad from 135 A 49 CFR Ch. 11 (10- Fsdorcil Railroad Administrcdio 5219-102 t does no dent (or conduct directly relat ii ire5en,, under it5 (b) to), but the presiding oM I)rokLibiting sllc discr Ingke Bep&rate findings as to ,wn rules. 59 reQUi Ince with 219 101 elnd 219.IV, WI. 1989. mended at road @t. [54 Fl' priol ' (2) 'rhe hearing shall be VR ,.% 15"'Ig"l e action- @i,.hin the period specified in t FFF 219.104 @Po"' cable collective bargaining ag 15. IS (s) itemoval In the absence of an agreeme si@n, the employee may dem. the bearing be convened withj the C nd&r days of the suspension ( text ase of iLn employee who is un ,i "d dmg pmbibi@ due to lnjury, illness, or otl J219.101 Al@b' clent cause, within 10 days of (&) : * * Lhe employee becomes avai (2)) U:@.W o4 prcent or @ore alcOhOl 'n he@ng. (is th, blwd; or es to pr (3) A Dost-suspension procee forming to the requirements b or & plicable collective bargainir ib,t,on on abuse of co,,, Dles when re, ment.together with the prov der a mOl Ldjustment of disputes under Ile no eM- of the Railway Labor Act. On and service d 11 deemed to satisfy the proce ployee v at any s M Quirements of thi.9 paxagraph. rnay uBe duty, ex- (4) Nothing in this part t,irne, wi of this doeb not glpply to deemed to abridge any addit ceduml rights or remedies r cept Ls @tent wlth this p@t that subpext. over-the- Lble to the employee under a Pres,,ibed and "&ining agreement, the wu3ater drup- t thec LLbor Act, or (with respect t (a) This (on ment at will) at common la, r^t to the removal or oth use of a olledI Kzion taken as a consequ Schedule 1 orized substancp posses- @tive test result In a test by E, rnec in w required by this part. (5) Nothing in thir part sh, .i,, incid titioner wbo refusc (1) The e rall- yrnent tesl discretion of the railroa or a Phy test Nv 42 tmployee's denial of pro road ha3 an 0.10( @l or dmg use a, a wal With not r greater Wrilege the employee woul@ duties ELI rolled 511 '"Y Lo have such prohibit 't dmg use treated as a n- rnedic&l or uPOn I " matter or to have disc stALnce I Tn coveri Lbeyance. scribed the r@i '41 Return to covered servi consiste rsson @" who haz been deta the emi the dos- nolated 219.101 or 121@ (2) TI and @ to cooperate in a ELge Pre ee i5 being Iluid test under this (3) In oll rttumed to covered treatee Sul ee titione ar ty for uated by a pre.ctil nal to deter niedici cted by a ps and b Dendence on rnedic 0 c a] dii Ontrolled Bu I>erfOl date( ntiflable an (and w arisi tl stric in corr oftb me 136 I I F I -- H T E F I I T -.- I IE E, . [,E r' T F E TRANSPORTA3'[ON FORM mo.@ARm IF? \ I REV. i2@6 COMPANY: I Departmerit CSX SPORTATlb'K" PHONE A: VI,er Street ALIFIED I/e. Florida 32202 FROM. I PAGES: C/ C PHONE #:-I VERIFY (YfN) t) 3.59-1500 TY INJURY OR ILLNE -@IEDIC@ DRP TMRI ys\ NT SuP@rvisor will cOmPlOtO top portion of form And give to employee for completion by his personal ph Ca Ifollowing an absence fmm @ork due to illness or otf cluty injury. Q CSX RAIL TFKANSPORT CSX [)ISTRIBUTION SERVICEs F] rSX EQUIPMENT MPL YGE LAST NAME, FIRST NAME, MIL)DLE IN(TIAL EMPLOYEE AT)DRESS Do;xn- . - - I - NUMBER AND STREET CITY AND STATE ZIP CODE 1.459 Shady OAKS Trail, @taidens, Vs 23102 DEPARTMENT L rich Engineer Transp. Richiuond, Va RMPLOYING @ICER RESP CODE SOC. SECURITY NO. - I.D NUMBER J . s . Bake r 1 8 6 1 1 11 375-50-009() 400675 The above omployee has reported that he has t)een under your professional cars. To enable me to give consideration to his return to @rk, pleasc complele the remaining portion of this reporl in entirety. Any charge for your report will be the personal responsibility of you, pati@t Pleaso call me collecl it any clarification or discussion is desir@. Pleage return the compleled form and all attachments to me at the address shown above. All intormation will @e treated confidentially. J. A. Thomasino. M.D. Chief Medical Officer I History Pain in back and right lower leg silice May 1991. 2. Physimi Findings (Plewe include B/P. visual acuity. blood sugar. x-ray findings. etc.. when apprOpriate.): R--'ght side '@4-5 lateral disc with lateral recess stenosis L4-5 right 3. Diagnosis: Ruptured intervertcbrtil disc with lateral recess stenosis, L4-5 riglit (Forcerlaindiagnoses,i.e.,hearldisease,diabotesmollitus.seizuredisorders.ordisturbancesofconsciousness.substanceabuse. or it the employee has been hospitalized or instrutionalized, specific addilional information is reqvired. Please see following pages.) Next Page PlOase I 1- H I L k f 1 1 - I I E L- E F T F H. E 'Cl@ 4d. If employee is suffering from seizure disorder or disturbance of consciousness: frequency. nature and severity ot any seizures or di*tlirbances of conrciousness in past one year; results of recent neurological examination; results of any specialized laboratory tests (e.g., Er=G, brain scan, b@ levels of medications, etc ) that may have been performed; state of employse's compliance wilh treatment regimen; frequency of employee's visits lo you for monitoring. If employee is sutforing from substance abuse@ copy of reStilt,5 of any recent blood alcohol determinations and urine drug screening: dclails of rehabilitation and recovery plan: nature. extent and severity of any complications of substance abuse. 6 Treatmeni (please include dosage and frequency of any medication) N/A 5a Will any modicati(>n employee is taking adverscqy affect alertness. coordination. judgement, vision or gait? X_ Not on any Me(3iCatiOn. NO YES (Please check one) If yos, please expiain 6. Duration of Care: From 9 / 1 9/ 9 1 To May return to work 12/28/91 Next Page PIG8Se .II @ I -- H 1 E @ II II E L@ L-E F I F H 7. Progrvosis: -IMPROVED S. In your opinion is this employee qualified to safely return to his regular assignment? NO - Yes X If Yes. date released for retum to work. 1 2/2 8/9 1 (Please check one) Ba. If NiD, is employee quadi@ to safely work with restriclions? NO YES Spoc@ any recommended restrictions 9. Adcltional comments Cif any) Copy of Discharge Surnmary enclosed. 2 a Fe/Wnal Phyg@ R. Lewis Wriaht-- M n Print w Type Addrm, aM Telephone 4 9 0 8 Monument Ave. . s Number m Pe@nal Physlclm B"sth hii @nature Ric:hmond, VA 23230 1 F I f i H I I lE L.. :.E E RICHMOND ?FEMOR@ HOSPITA.L 1300 Westwood Avenue Richmond, Virginia 2 322 7 Name: DOWNS, BOYCE T. Admitted: 09-26-91 Record 567978 Discharged: 09-29-91 Accountf; 00101830420 Physician: R. L. WRIGHT, M.D. DOB: 03-29-1949 Location: 5S--513-02 Age: 42 HISTORY OF PRESENT ILLNESS: rhis 42 year old male returned at this for leminectomy and the treacmenc of lumbar disk disease. He was previously hospitalized here on September 20-21, 1991, for myelogram followed by CT scan. This showed evidence of a large ruptu-ed disk with lateral recessed stenosis at L4-5 on the right. In addition there was an equivocal smaller disk protrusion at L5-SI on the right. He waa admitted at this time for surgery. There had been no Lnterval change in his history of neurological findings. BOSPITAL COURSE: On the morning of admission he underwent partial hemilaminectomy and foraminotomy at L4-5 on the righc for removal of the large disk herniation, with two free fragments impacted beneath the nerve root. Exploration at L5-SI was not remarkable. This slowly improved, although he concinued to have some intermittent pain in che right calf. DISPOSITION: He was discharged on the third postoperalive day, to return to my office in several days for removal of sutures. He w2s to rescrict all strenuous activities. He was given a prescription for Percodan, I tablet every 4 hrs prn pain. FINAL DIAGNOSIS: 1. Ruptured intravereebral disk with lateral recess&V stenosis L4-5 righc. 2. Erythrocytosis. 3. iiypertension. PROCEDURE: 1. P2rrial 'nemilaminectomy and foraminotomy L4-5 right and removal of ruptured disk; exploration of L5-Sl right. RLW/mt54 D: 09-29-91 T: 10-10-91 DISCHAITGE SUKKA.RY t. t T-)TAL P@-.iE . Of,14 t I CSX IRARL TRANSPOR'R CSX EQUIPMEIFT HE' 691 INVOICE No.333009 CSX DIST'RIBUTION SERVICES REPORT FOR MEDKAL EXALVKATION TO: OTHER NAME AND ADDRESS OF BMINING PHYSICIAN NAME OF ADD STAEET i4i@ SOCLAL SECUR ZIP CODE 4iT A. TYPE MINA PRE@EME APPLICANT SPECIAL INJURY El FUFILOLX*F 0 PER@ TRANSFER INibRY ri LEAVE OF A13SENCE C-1 OTHER OFFICER El El El INVOICE CODING FORM FEE FOFT SERVKNES: $16 @-S*N@A fl@EOF@ DA-TE 4-ACCOUNTING DEPT.-ACCOUNTS PAYABLE TRAMPORTANON CU RAIL TRANSPORT P.O. Box 40586 8%efohm,A. Thamosino, M.D. 500 Water Street dical Officer Jacksonville, Fl. 32203-0586 MIS G Com, RD. (904@ 359-1513 T' r Omni Fax No. An*ociato'Chli'FM&dical Officer (904) 359-3757 December 20, 1991 D. T. DOWNS 2459 SHADY OAKS TRAIL MAIDENS, VA 23102 ID: 400675 Upon review of recently received medical information I now find you medically qualified to perform railway service without restrictions, effective 12/28/91. If you have not returned to work, please contact your supervisor if he has not already contacted you. Joseph A. Thomasino, M.D. Chief medical officer cc 0. L. Gibson FC0025 PHY51CIAN !5 kzYAMINA I lUN HLKIUH I (;SX RAIL TRANSPORT F-I CSX EC)UIPMENT NVOICE NO.333009 CLX OISThl[3UTION SERVICES RT FOR MEDICAL EXAMINATION TO: OTHER AND ADDRESS OF E)(AMINING PHYSICIAN ILA T P"E, FIRST NAME MIDDLE INITIAL OF EXAMINING PHYSICIAN Do L) /L),) 5@. ADDRESS NUM I AND STATE T ADDRESS jy@d? 5@,qi2-Y ;-X-AJ @ t, I ; SMIAL SECURI@ NUMBER I D. NU Ti N WHICH EXAMINED CIT-Y STATE ZIP CODE 4/,O MENT UAlt @OYVAG OFFICE R SUPERMM NAME PHONE NUMBE IA. TYPE EXAMINA RESUMING WORK AFRER PRE-PLACEMENT APPLICANT SPECIAL n ON DUTY INJURY Fl FURLOUGH PERIODIC TRANSFER n OFF DUTY INJURY El LEAVE OF ABSENCE THER El OFFICER 0 ILLNESS REINSTATEMENT 2. PFRTTWNT ONJURIES. OPE@TIONS. ILLNESSES @Oh 'm T NEAR 10DO L) SUGAR CER@7@ SIO@RURI BACK EXTREMITIES 12. HERIYIA CSX @SPORL, 13 CHEST & LUNGS QUALIFIED 14. CARDIOVASCULAR MEN rAL STATUS At4D AT!NTUDE FURTHER EXAMINATION NOT REGUH%ED FOR PERM ED BY HISTORY. SK*4 COMPLETE REMAINING ITEMS FOR ALL OTHER EXAMINAT10fiS. 17. HEAD& NECK EYES.EARS NOSE& THROAT A@EN GENITALIA 2i. NFLMOGIC ROLLOWING ITEMS FOR SPECI (SEE SL EXAMS, AS DIRECTED BY MEDICAL DEPARTMENT 22. ADDITKML EXAMINATION OR TEST RESULTS ATRACHED: El LL*AAAR SPINE X-FIAY CHEST X-RAY PULMONARY FUNCTION TEST El BLOOD CHEMISTRY n ELF-;CTROCARDIOGP.AM F] CBC 24. SPECtAL@-EXAMINATION. IF NECES@RY, AS FOLLOWS: (MEDICAL DEPT. USE ONLY) FEE FOR SERVICES: 12 MONTHS 6 MONTHS 1 MONTH OTHER s/o@. COMMENTS IA SMATURE OF EXAMINEE Tu D@TE @&@zq 2- ORIGINAL RETURN TO CHIEF MED R DA@ @@jtj1. i.IIF: 1. y I j 1.t