Affective Tissue Injury Paper

681 Words3 Pages

Primary diagnosis: Late effects of musculoskeletal and connective tissue injuries (Amputation).

Secondary diagnosis: Affective/mood disorders.
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The claimant was a 34-year-old man.
Alleged disability: Bipolar disorder, amputation of the left arm, and sleep apnea.
He reported that he wore a prosthetic left arm most days. He had difficulty lifting objects and using the left upper extremity; he had a hook instead of hands and fingers. He also had difficulty concentrating because of anxiety.

Education: Associates degree in power plant (2012). Vocational rehabilitation, attended practice interviews and job search at a State College (2015).
Work experience: Cook, construction, material handler, delivery truck …show more content…

Medical records (2015-2016) indicated that the claimant had a history of thyroid disease, obesity (360 pounds), benign hypertension, and severe sleep apnea. His medical issues, including sleep apnea were under control; he was fitted for a new prosthetic arm. He reported that was working 15-18 hours a day.

Per mental health records (2015-2016), the claimant reported that he was doing well, was taking his psychotropic medications with positive result and no adverse side effects. He denied symptoms of depression, suicidal ideation, or others, with the exception of anxiety that he controlled with medication. He had a job at a fast food place, worked there approximately 50 hours a week, and started a part time job at a large hardware store.

Per work questionnaires (09/2016), the general manager and the supervisor of a fast food place indicated that the claimant was able to perform his duties as assigned, had a good appearance and good personal hygiene, rarely called in sick and was always on time. He was able to perform his job without supervision; he understood instructions and responded well to changes in the work