Personal Documentation of Injury or Condition

The information that you note in your personal injury/condition documentation may include, but is not limited to the following:

• Date of injury or onset of the condition
• The precise location of injury or condition
• The activity you were doing prior to or during the onset of the injury or condition
• Documentation of other medical treatment you received with regard to this injury or condition
• Home remedy treatments you have tried
• Description of pain

The following words are helpful in properly diagnosing the cause of your pain:

• Aching
• Sharp
• Dull
• Penetrating
• Throbbing
• Tender
• Nagging
• Shooting
• Burning
• Stabbing
• Exhausting
• Numb
• Gnawing
• Tiring
• Unbearable
• Occasional
• Continuous

Note the time(s) of day that your pain is usually at its worst, and rate your pain on a scale of 0 – 10.
(0=No Pain and 10=Unbearable Pain)

Note the time(s) of day that your pain is usually at its least, and rate your pain on a scale of 0 – 10.
(0=No Pain and 10=Unbearable Pain)

Rate your level of pain on a scale of 0 – 10 when you do one or more of the following activities:

• Laying down
• Sitting
• Standing
• Walking
• Running
• Lifting
• Bending over
• Pulling
• Pushing
• Driving

Note any other activities you do that make you feel better or worse.

Note any side effects or symptoms you are having caused by your injury or condition.

The following are examples of common side effects caused by pain:

• Nausea
• Vomiting
• Constipation
• Loss of appetite
• Fatigue
• Sweating
• Difficulty concentrating