Diagnosis

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September 13, 2001


STATE OF CALIFORNIA

Department of Human Services

P.O. Box 694



RE: Way, Gerard

CASE: 4536229

DOB: 04/09/91

AGE: 24 years, 1 month

DOS: 05/13/15

HEIGHT: 5′ 9″    WEIGHT: 155 pounds


Dear Examiner:


REASON FOR REFERRAL: Adult mental exam of 24 years old and the mental status examination.


EVALUATION INSTRUMENTS: Mental status exam, WISC-IV, review of records.


CLINICAL INTERVIEW: The claimant is a 24 year, 1 month old, Caucasian male who was seen per your request.


DIAGNOSIS:

AXIS I: Dissociative Identity Disorder 300.6

AXIS II: None.

AXIS III: Self-Inflicted pain/ upper legs and lower arms

AXIS IV: Inadequate social support, drug and alcohol abuse, death of grandma

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