Medical Diagnosis Letter Template

Date: 1 November 2025 To Whom It May Concern, This letter confirms that John Doe (Date of Birth: 15 March 1980) was evaluated at our clinic on 1 November 2024. John Doe has been diagnosed with lumbar disc herniation, as evidenced by MRI findings and clinical assessment demonstrating lower back pain and radiculopathy. John Doe's condition significantly restricts his ability to sit or stand for prolonged periods, lift heavy objects, or maintain static postures comfortably. These limitations directly impact his capacity to fulfill typical workplace tasks without adjustments. To support John Doe’s health and workplace effectiveness, I recommend the following accommodations: - Ergonomic seating and adjustable standing workstation - Flexibility to take frequent brief breaks (5-10 minutes per hour) to reduce pain and stiffness - Limitation on heavy lifting tasks (maximum of 5 kg) - Modified work schedule allowing partial remote working when symptoms intensify These recommendations should be implemented for a period of 6 months, with reassessment scheduled by 1 May 2025. This document is provided with John Doe’s consent and meets relevant privacy and medical documentation guidelines. Should you require additional details, please contact my office. Sincerely, Dr. Thomas Kelly, MD Orthopaedic Surgeon License Number: 123456 Orthopaedic Care Clinic 123 Health St, London, UK Phone: 020 7946 0958 | Email: drkelly@orthocareclinic.com