Medicaid Documentation Guidelines for Rehabilitative Services: Assessment

Module Four

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• Introduction*
• Diagnostic Assessment*
• Crisis Assessment *
• Functional Assessment*
• Interpretive Summary*
• Challenge*

Interpretive Summary for Marcus

Marcus is a 34-year-old, married father of two.   He is diagnosed with Major Depression and Obsessive Compulsive Disorder (OCD).  The dominant symptoms include ruminating thoughts that he is not doing his work completely.   As a result, he re-checks his work for completion over and over.   In the evenings, he dwells on his work and experiences restless periods of sleep or no sleep at all.  This leads to lowered work productivity and loss of energy, a sense of worthlessness, and increased levels of distraction, irritation, and restlessness.