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Health-Status Report Sample

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The Health Status Report was completed by the applicant’s Physician who has known the applicant for 27 years and seen him between 0 and 5 times in the last year. ALCOHOL ABUSE For this condition, the Physician indicates on page 3 of the Health Status Report (HSR) as impairments “Poor social, personal, financial decision making”. There is no current prescribed treatment for Alcohol abuse. On page 6 of the Health Status Report, the Physician notes that the applicant “had tried different Psychotherapy / Counselling programs in the past. None currently”. It is not clear for which of his conditions (Alcohol abuse or Depression / Anxiety) the applicant was treated. However, further details (i.e. duration, progression and efficacy of the Psychotherapy…show more content…
Lack of sleep. Poor focus” and for Depression is “Loss of pleasure. Depressed mood. Poor concentration. Sleep disturbance. Lack of insight” (page 3 of the Health Status Report). In the Health Status Report Page 5 is noted that the applicant has “No medications at present time”. As shown above, on page 6 of the Health Status Report, the Physician notes that the applicant “had tried different Psychotherapy / Counselling programs in the past. None currently” and is not clear if the applicant was treated for “Anxiety / Depression” or for “Alcohol abuse”. There is no report to indicate the type of therapy, the duration or the outcome. Additionally, while the applicant endorses a 5 years history of depression and worries in his Self-Report (page7), details regarding the clinical history (i.e., onset, frequency, episodes of remission and/or relapse, treatment) are not offered within the medical information. On IEWS (Intellectual and Emotional Wellness Scale) the Physician marked one index on the Moderate scale: “Motivation” (depressive avolitional problems). Further, the IEWS indicates that the applicant has Minimal symptoms on “Emotion” (affect, mood, anxiety and other emotions), “Impulse control” (difficulty with behavioural control), “Perception” and other eight
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