June 10, 2005

ABC INSURANCE COMPANY
7 Park Ave
Anytown, USA
Attn: Jane Adjuster

CLAIMANT: Mary Claimant
INSURED : G. Hilltop
CLAIM # : 20041115
D.O.I. : 11/13/01
ERI # : RDD102768

Dear Ms. Adjuster:

I have reviewed cervical spine MRI obtained on 12/12/04 and lumbar spine MRI obtained on 12/20/04. The following is my interpretation of those exams.

Cervical spine MRI 12/12/04: The exam is of relatively poor quality. There is straightening of the normal cervical curve. Vertebral body height, marrow signal and alignment appear normal. The cervical cord grossly appears normal. Axial images to the C2-T1 level demonstrate no evidence of disc herniation, neural foraminal encroachment, central canal stenosis or other significant abnormality.

CONCLUSION: C-spine straightening.


Lumbar spine MRI 12/20/04: This study is of relatively poor quality. Vertebral body height, marrow signal and alignment appear normal. The tip of the conus appear normal. Axial images to L1-S1 demonstrate no evidence of disc herniation, neural foraminal encroachment, central canal stenosis or other abnormality.

CONCLUSION: Normal lumbar spine MRI.

I certify that I am a licensed physician in the Commonwealth of Massachusetts and have reached the above conclusion to a reasonable degree of medical certainty.

Subscribed and sworn this ____ day of ______ in the year _____ under the pains and penalty of perjury.


Sincerely,

Sample
______________________________
Radiology Reviewer, M.D.