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Home Court filings USA v. Adrienne Ponzo Exhibit — USA v. ADRIENNE PONZO (Dkt. 23.4)

Court filing

Exhibit — USA v. ADRIENNE PONZO (Dkt. 23.4)

Filed April 6, 2026 in USA v. ADRIENNE PONZO; one of 7 filings from this case.

Record facts

CourtU.S. District Court for the District of New Jersey
Filed2026-04-06

U.S. District Court for the District of New Jersey · No. 1:23-mj-02053-AMD · Doc. 23-4 · 2026-04-06 · Docket on CourtListener

Full text

Case 1:23-mj-02053-AMD Document 23-4 Filed 04/06/26 Page 1 of 2 PagelD: 83

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INITIAL Vestry ONLY
worker's descriptive pf scoters tagary

WORK RELATED MEDICAL DIAGNOSIS (Es) Muscle spam of hackiMn? 4)
TREATMENT PLAN
Diagnostic

Tests

Procedures
Theragry Rise PT
Moedicatiogs

Lin per day palicnican work: = _#+ 4 6 4 2 xa
D.O.T Csssification of Work

Sodesmry Exon 18 Ihe. of fe Sondaterally aad've « negligible anmnal ol bere irogenste WW, caery. pea, pel cx etherwine maven chfextn
ra icing he a ay Semiay nn sg met eine het wf aaah cence hr ep
Light Fey ee) Rit rer armemtanalt: entice op > 90a of force aman andr acuveant of etree
= acal Demand roqairemens are in excess iif thowe fur Sodentary Work

Medium Using 20 80 Bf cea 10625 gm moe en gh we es
= ohlects, Physical Dersand requirements eeecenn 1a theme for fe

mane 30 te: BOs asf Seas gcd wedior 25 te 56 Ia: of ts daiadie ano 16 ts Sd Ios ef ee ad aes rec iaone

Ayer Demand eveqvirements ar¢ in eacens of thove Sor Malieas Week.
id ve naancd pene sega Lp vomarbashe ie para) 2 sy Vong, CPB OER NPP aR
Sl aod seo Ptrysical Demand royatternents are at aces o€ thone for Horry Work

a more«

dmon cxinte up te 1/5 of he eee

ee scan or condition exes es ptaipe naire rh
: 1 condition exits fom 2) or mere
Convtantiy: etry

rived the putient’s sbvdotice Lam fer the fothewan
Comment a appropriate i the pace pe

‘Siuing

_ YES (Seat Date

Date 03262026 Next Appotemment
AL Cotified Provider X YES NO "Refersces the Hewlthcare Pract:

Wo the 19 Deb. §2322,A)°

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