is -I: self -harm - Organized Mobbing

3ATE OF ADMSSSION: 01/0E/OR
DATE OF DISCIYLRGE: 01./11 ./38
- PSYCRIATRIC DIgCRARGE SUMMARY
KISTORY OF THE PRESEm ,ILLNESS: 'I'hc patient is a >'/-yeii~.'-uld Akrican--
A[ner.ican f ernale br-ouyh[ i1;t.o the hospital a?l..r.r xecellt ly al i eyedly cuttir-y
her wrists bilaterall;,- and tkcn L.iikinc a hos~ alci dLt;ac.hiilg it t~; ller. rJar
exha!~sl. anri taping it ro ho~' wiridow and was fo~lild unconscious by security
car. in her cntn~>lcx. Tile patient at th i ;q t1rr.e very dcprci-z~sd for s lorly klre
and thi F: L.~.III~ just felt ovcl.-w>;eln~ed and clid not care about d'ylrlg. kt thi~
I-. i at. patier-t meet:: l ilgm;ient. crite-ri a ne(:ondar;~ to ila [:?*I. tc self cj~le to
mental 7 1 [less with litt.1 r. i i::c: the conncqilcs:ices of her a::!..iurls. ??!~c!n I
r;pnke aboct why s h ~ is -I: the il3~~'1:T..dL Y~LE just fi?..dt...d, "I'll hr:, [i~i~, I'li
:i~-~st i~cs ho~o. " I stated abo'ut. :;iedizatian foi. itepr~ssinn wllicfl she i,er.l:
crl arrtidrgres~arl~. ~nedicatio~l I;c!l'i>rr and very y~.iar.ded abcllt. tier st+r.?chr..s 11;
her lire an well ns hcr 1 ife in gea?ral. At tnis t-j:ne. patient_ ~l;r::(:.:L.s
:i f~patient critcri 3 a?cc~~ry to darlgsr ta pel f due to rr.enre 1 illness.
KEDICATIQNS: Ativan I. 7r.y per day as well as a~ather- meciicinc which oh^.
(:loex cot remamber. -LntLcieprt;!,c:sa_1+, and h-Aeral mainly For. blood pveenure
MEDICAL ELSTORY:
H':,.l;~r.r.':ensio~:
MWAL STATUS EXAMINATIDN: kf f ecL : Somewllat flat . She Icok.~ her sr,ll..ec', a?;e
wixh fair. elre contsc~ . She is ozitnte~? timen thuGa with .I dr?pressec! ;nocsd.
M~rl'liir.:~ : Fai:: . Specr:!il: IJor-;nsl rat;c, rlormal aulglitudc . 11;t.elliuencc : .&varacye.
Tr:~ight : Lilni l.e:.l insinht i n!..o her currC:rtl_ p~ychoLog l cal condit. i v11. Tho.dgh(.
conkeat: "T kr~u:.~ I put I : . h huse to t-hc window. A. l..riuw I war-: -ur:conscio~ia i r ~
rl-ir car.. " T!lo-~ght. processes t Nc:) delusions but sornevrha L. bizarrc Lhought
p r.ucesf. ;J~lfiyn;erit : Pgor . Perceptual d i t.urbclncr:~ ~ : There i :; self -harm
sit~~i1t.i on, rncect a l.!-amnt, no llcs1nicid~t1 icicdtixt. 2'her.e asr 1-10 auditory
hal.lucination~. 1Ju ~rina,ll Fallucinzti ofis.
AXIS II NO32 ,
AXIS 111
AXIS IV
!IYPEIC'l'h:NS~Oj4.
F'CYCIIOSOC~XA'I t
ST?XESSOR.L; : XUUZPATE TG SEVERE,
AXIS V GTOSllL hC'Sh':;CMENT OF' . ~ ~ ~ C ' TAT I ~ THE N l 'TTME ~ ~ QF mMISSIoN\rl 75,
G;CDfiL A:iSGI;SMZ>T" Oh' FTJNCTIONING I1i TXE PAST YEAL : 73.
HOSPITAL COURSE: Trlitit~l 5i;iqrlusis v?aw aajvr dc:plession. 3etox proto,zg~
per rncd.1 cal dsctor . ~~icide pr rcautions in niac!e due to depressi V?
~p~pi.o~r~at~l~g.i. Zcjlcft :!!J tllg p.0. CI ?.8; 3C ti;.rr;ke to c! .inicr~~ .C:ymptaac.
Page I
COLLEGE HQSPYTAL
PATIENT NAME : GPACiA, DSNIELLX
CEWITOS HOSPITAL NUMBER: '1: 136
PSYCHIATRYC DISCHARGE, AGE : 3 7 SEX : b'cnlalc
SVKMARY
ATTENDING PBYSICIFN: Lralg W~oncki, D.O.

irll>i? Vivtaril because of lailk of ecficacy ar.d then rr:s:.nr.tecl brcnuse
of some anxiety, and starr.ed it q 8 hcurs p.i7.n, anxiety. The pati!:!nc did
well with rnedicati.on tiErat1c.n to I-1inir.n. sy.;ptorne., iacresr;~ in ir?slqht
Into her illness but wa: di.sc-.:haegcd % court on 1 /! 1 j38 and at th,>t. I.. i roc+
did IX-~I.. war! t the medication. No otFcl:. madicizc was give?^ aild foliowup r:art:!
will be on the out.pati(::-t:. f:auis. Ile will he. d'sc::harged h2* cnurt ar:~fi that
happened (311 1 /J ;/08. The patie:lt tn fol low up with ourr;it-!cr providers. T::r.
pa Lierlt prefers tzi arrn?lyc? 8 f bercare with Cia~3.0H I(agar? and she za.ic3. she
will do rh;: by he~:.aal.f.
~istcor.~~..
LABOKATORY : SiQ"i- 25, CEi' an? thy'r'0ir.3. f.uctio11 vrcxq within 11orly.al 1 .i n1i.t~
H&H a little low ale 10.3 and 31.3. Bcta HCG negative. Qr.i rre drug screcn
positivc for, benzodiazepines .
--
KISTORY AND PBYSTCAL EXAMINATION! Hist.wr)~ arlrl pl~fsical c;irnir:zt iol wa::
dole by TI' . r,!elchor .?.~xi zhi>~?A t;yp2~+-~11~i~:l, !:,!VITO;I~C h~-adachc, l.il.cesatia11
IcFl-. forearm, . sacunda~-~v r.o r:a,r.i>c:)r~ rrlon3xide 2Ci.i ?:::cling.
AXIS I1
AXIS v
:DISCHARGE PUB: '1-lie patierit ~rc~ttssd ally nicdication at t;ili;-i time, b:,?j.~l~es to
~LIGL. do holis=ic~l!y on the cst:l.gatlent basis. Was discha~yed by cou.:..::
T.il:>uyl'~. At r.hi..c: L.i~qcr I .;lad sp:>kari wit3 thc: ~!iotl-ler abol~t.. need Tvr succni
sl-~~purr. well as il:c!rv?asin(? fupprsr L on the olll.~,atient baw i a. Mother 1 ives
out 0.F Late, starcs t'.:~? underst.c~c,ci this. ':hc pat Fent is 1.1gt o~lic:j gal,
homicidal, or. gsyc5otlc at. 1.Fia time of d.i.scharqe ac::ording to l,Ilc court drld
wan di.c;c:harged and p;i::i =nt. not wi.:;hi~ly to okay .ji~lwtaz-j.l y.
-. .-
Craig i+Jrorski , D. 9.
C!W/crn d: 01/%3jOa t: C'L./25/08 doh t CC462iG
--
lJagr: Z
COLLEGE HOSPITAL
PATIENT NAME: CARCIA, D;iPI TELLE
CERRITOS HOSPITAL NUMBER: "12175
PSYCHTATRIC DISCHARGE AGE : 3 7 SEX: Female
SUMMARY ATTENDING PHYSICIAN: Craig lh'r.uilski, D. 0.

PSYCB'TATR'IC AND MENTAL STATUS EYAMINATION --
DATE QF ADMISSION;
01/08/C8
HISTORY OF THE PRESENT ILLNES!. The pa1.i e ~t. in a 3?-\;f!a~.-olci Africnnhlnerican
female brnughr inko the hospital af~.cr recently allc~gadly curting
her wrists b3.laterall:j and tk~en 'caking a haze ai~d el-t-aching it to ?J,:?T. car
exl.-au9 !, arid tapillq it to he:r ihl i nciurv and v!as f ounA ~.~~icnnscious hy H B C U ~ ~ ~ Y
car in her coc~lplnx. The patient at Ckl..i~ time veq ddepreaaad for a lcmy tinie
aria rl~ia Lint! just fclt oirervht:ln~ed and did ~:ct csre about Cying. Rt: this
L.inia patient meets 'i a;>?tierit criteria ~ccoridary :o d;irgcr Lo elf due fn
mental Llll~i':;?~ 'with little ii:.to r.h~: ~orlae-ensrs af wctions. l W : ~ ~ ~
:;~:c.)habo:lt wily she is I r1 1.1.1a hcspita; shr:: just stated, ''1' 11 be fii:~, 1, 7 7.
just qo hnmc." I stated 3bcv.t mcdic2Liun for bepressicn vrhicn shs was very
t.t:!a~ I.Lil i:.!le~ I tail~cd abo~t her 19 .jca.r. (>id daugl1:er. Tfle patien? ?1;i(.3 heell
on s n r i c i o ~ rlledicat ~ i ion bcl;orc: arld ..rery guarded about hi:^: alzetches

MEDICBL
-
HISI'ORY AND PHYSICAL EXAMINATION
DATE OF ADMISSION:
ol/oa/os
CHIEF COMPLAINT: "P.?..c~mpt.ed sLiciQe. "
BRIEF HISTORY OF TRE PRESENT ILLNESS: Tile patierlt ie a 37-year-nld Af r:! car.(-
.z;\ne.r,i.car~ feir~alr, who at.tenpted -Lo commit suicide by eai.horl ~rirj.ncr:.;ide
poisoning in he- car. The pa5ic.n~ Lad tvxic ezczphalopath as a
col:aequcm!i:. T~c: pl,ie:~L WRB adnlitted at Wozt Pnahein~ i"lcdica7. Center on
3./'5!CE1. She also made laceratioils x two ancl silt :~uge.r~ficial cut in the lcft.
f oresl-n~ with LL kxif @. 'l'hc l.&ccr-at.ioriz wex'e suture? and these wt::yc irila(:,r,,
'J.'hc gal.ienld iier~ieu any pair1 f rorn her lecLonn . Shc: i s co~,:plsil-~:~:; of chronic
l?ead:~che, ~I:JVJ it is 11c~r: a:; bad, 5/1.0, aching, fronrral, :~or~-xarj.i 31.. i.115. .She
riurlizs ariy cb-x-qe in vision or aeui-clog? c F:)??gl:.orua,
PAST MEDICAL HISTORY: Hyye~ l.e:leion, cr.sential trr:rro:*s, i:!br.(;r~ii: headache
fforkcp was newt ive . She was j u:;t. l>l aced or propra;loloi ;~ncl At..ivar~.
PAST SURGICAL HISTORY:
Ucremarkable
PAST CHILDHOOD ILLNESSES2
Chickrnp.jx.
OB/GYN HISTORY: G 1, P 1. N o miscarriagcs
MAJOP. INJOR3ES : ;done .
ALLERGIES: No know^ rlril'g a1 1.e rgiss .
MEDICATIONS
Ativar, propranolcl.
sOCIAL HISTORY: ~h4 pa~ient li.ren wf th :let daughter on and c~ff, she dc:ni c:s
arT: drug use. Sht-: :;molt c:; three zigaret ;es a day j ~1st recently, ~1:e rJrir~~
..in:[,:s a week, sbcut 1-2 b~cr's i)ar sesrio:~.
2 . .-
.
FAMILY HTSTORY:
Iln.r'c:~~rd r.kablr?.
AEVLEW OF SYSTEMS: GENEML: The patient rlc?riieu aq suddcr: i~i~igilt. loss,
i.iri.gI-:r_ gain, 3vnco~al e:+sodes, n\alaisr, ~FT-er, ~ r . c;~s of sppet-ir.c. HEENT:
1 CARDIORESPIFA'I'ORY: patient. :ic:rli.as any chest pa i ~ i ,.hc>rtnec:;
of breath, gi~ 01- whe ?zing. GA9TROINTESTINA.L : ':he pi; ti.ent denies ar.:y
ahdon:inal pain, -nailsea, vorr.itillcj, diarrhea, or conr;;ipa!-:ior?. The paticr~i,
does not have any me:!ex.3. or h:matrmcsi.s. GENITOURINARY: The pltient d~!iiies
fiysuria, rIrqrllcy, f reyl.~~ncy, :nasitancy, &r,d herr.at,uria cr flank pain.
EXTREMITIES: The patl.or.c:. dent.2~ any ankle ywelli~g or joi~it pin.
NEUROLOGICAL: The patie,.lt delllee SIIY dizzf ~les.c;, weakness, or. :iumhness of
3i:Y extremities . SKIN: Sae IIPI .
PHYSICAL EXAMINATION:
-
COLLEGE HOSPITAL PATIENT N-ME ; GIirtCIA,
Pqe 1
UA1;ITELLC
CERRITDS ROSPITAL NUMBER: /2:36
XeDICAL HISTORY AND AGE : 2 ' I SEX: bctn-lle
PfIYSICAL EXAMINATION ATTENDING PWSLCLAN: C. Aro~lsX~, D.O.

VITAL GIGNS ... : Tetllperat~rre: 98.2, Blood prengure: 14D,/$i. pulse : 65
Respi cator-f rate: 30, Height 5' SN, weiqht 13 R pounds.
Slc.lN: Tll~ patientpi.. :%kin iz warm Ar16 intact. The patient. has no raa!st:kt.
Pr..esence of 1 aceratiuns, 5 cm Cn the proxiinai left. f(:>r-earm anc? 2.5 cm mi
the disl:el left forc:a?-111 with zuturea, clean, dr-y, intacr., nn2 inonrcr~[lnr to
p.ilpa!.-iuE. In addi:::iorl there is a sup~rf ici a1 cut z.So~lT. 0 . 5 cm n?i l:.kie left.
Eurearn~.
-4EEP:T; Iiracl is ~'~oznoc:egl~al~.r: and atracn~atic. Eyes! Ftigils a-rc! eq;~al,
-
ṙ c~urid, a~lri :t:.eactive tcr 1 iyllc . Extraocular movcnlerl:. s a:-e i ntact . Sc? erne
anir,t ,.r.r
-.. .- I.(.!. Earn! 3xLes-nal audi.l.ory ca~mis iire patect'.. Ty?maaic rrtenbranes
i :~l:.azt. Mosi! : Normal rLasd.1 passagca . ?Joutll s~?d thrcat : Huccal mllcor;a is
pink and moist . De:~r. i L.ivn ; Fair. TmqLe is pin^ 2nd i.r:. tte miciline . Nn
ph;l r'yrlgeal exvdaLes.
ED3.T: Regular rat-~: ?rid rhyth~~n. 51 and S2 rlvrmal. Nu nlurmurg, 1-ubs, a:
gal 3 r.ip5.
I.-. \E~CIV:E~I : Ssf t a?ld 7orlt erdez- . 3ewel so~inde are pr-caext rt:-.c! rlcrrnoact.ivc.
E~~XAST/PELV~S.'/RECTAL:
. lhc! examinstjcri was deferred sct:!vndarl; t:r: the
patient's x'afusal, She had a. Pap smear 3rd breasd axax dor'ie in 9/07 which
we-ce i;c.)l.F~ ~?cjr-malimi Ls .
k:XTF.:,LMITI k:S ;
-
Nn clubbirlq, c\r.anosis, =IX sdcma . Hjll railqc uf moti 011 all
t.hro~lg.:j:~ut .
NPIJROT,~GICZAL
- EXP,MI>lA'II':jK: 'She patic!rir, is awske, .~lc:r.l;, z1ld c:lsiei:ted >: 3.
P. .. --
iruar~ial nerve I: Sot axamined. Cranial ?:crve I:: 1ilurrr.al viouai 1:~elds to
cnntxnn!.:ation. P'llniiu,~~~:~pi?l ezaminatior is hor~ign. I:::,-tinial ncsrves LIT, Ii.;,
'JI: Pupils are cqual, round, and :'cacti-.re Co light, . Extraaculsr :nosrene::t.a
are intact. and frill. T?re par.ii.rit doe..: not rep3c.t. anif r>y~taqmus. Cr;lri.ial
nerve V: Sensory exam rc gi-r~rick a112 corncal reflcxes arc e?r.etricsl.
il'xaui.al Iservc! VIi; No 'I ORS of riafi~labial fold. Xc! ptosis. Bil,~t.r.!r.~.lly
syrnrr.etr5 cal wrLnkl. ing ';t tf?e f orencad. Crani.nl nerve ~111: ,fl~,2rill~ i,~
illt2cb. Craliia.1 rien7cs XX, X: C&G retier. is inract. LTvula elev;t.c!s in t.l.le
m:j dline . Pharynqeal se>:satio:rts are in tact . Cranial nctve XI I :?o wea It mess r?~
atrophy uf trancsi~s 01: alernoclf:'~.ilomast~id muscle,, Gono shoulder shrug.
i:.c*rlial xcr ve XI1 ! 'ror~:.n~e proLr.udes i. ti the n1.i dlire . No inotor or se~~s:,ry
3- Lic:.i,,,
L c- , Reflcxes arc :?+ 'uiia;erally ir I~tit!~ uppc?r and lower ~txt:.cemitica.
Cter.sbellar%: Piilger k:o-ilose [.tr?8t is iritac", Rapid ali-arnatinq mo-~encrit.5 ar?.
alsc! inl.act. Cai :. is norir~ai.
PAIN -
ABSk;SSKENT: .- See IIPI.
-,. -
Pirg- 2
COLLEGE EIOSPITAL PATIENT NAME;; G-XqC'lA, DXYTZLTE
CERRITOS HQSPLTAL NUMBER: 72196
MEDICAL HISTORY AND AGE : 'J 7 SEX: Fenale
PHYSICAL EXAMINATION ATTENDING PHYSICTAN: C. Nronsk.;. 13.0.

LABOFATORY STUDIES: L,>h:: are still pendi~ig at of dictation. ?T scan
nf the head dorie. at th? hnspit.al 1/6/09 was negative.
ASSESSMENT:
I. LACERRYIONS O'J TI-IE LEFT POREAPJ4
PLAN:
- - ~diui t; pal ... i enl. L.c.l:i t.k:e ur~it -;r;_d~r tl:~ r~z-e of 137- . Wr'uiwki who will
1.3rrf :jrm a rnental status exacin~~ion, pr;yr:!h .i.al.r.iu evalaation,
m~aagcmcilt on83 LrPa l.~rrw 1.lla patient nr a medi.ca1 i>ani:3 and aidress
EI ny "I:)r":)~~1'fi1 1.abs .
?hark yori for. al:ow.i;'ig
ma to participate in t.hc c.:*-r.e 2f this n;ttie:ir.
F!~/rnIi d; 01/09/C9 t: 21/39/08 Juh 4 DD266i.9
-
Rosemarie Melchor, M .D.
.-
COLLEGE HOSPITAL PATIENT NAME : G.WCI3,
Page 3
3>1JIEsi,4:
CERRITOS HOSPITAL NUMBER : '/ 2 1 96
MEDICAL HISTORY AND AGE: 3 7 SEX: Female
PHYSICAL EXAMINATION ATTENDING PHYSICIAN: C. Wro:~~ki, D.O.

03, i 3 finr~~nni
US1 1 I U'73VUVI UI
j:.
.,
..,.
Licensed
? ,
., ,
':'$
-:. :
Daniel Brown, M.A.
Clinical Mental Health Counselor
3 Main St., Suite 2 16 75 Fairfield St.
i"
;$ Burlington, VT 05401 St. Albans, VT 05478
.:.;I (802) 65 1-75 15 (802) 524-2002
-.:I
State of Vermont
Disability determination services
93 Pilgrim Park Rd., Suite 6
Waterbury, VT 05676
October 1,20 1 1
Dear disability services,
This letter is in response to your request for information concerning Ms. Danielle
Garcia's application for disability services (case #: 0 1 508 19). Ms. Garcia entered into
counseling with me on 8/21 I and we have continued meeting for sessions once a week.
A total of eight sessions have occurred to date.
Ms. Garcia is a single 41 year old woman who presently lives in a homeless shelter in
Burlington, VT. She reports that she has felt "very shaky" since 1995-96 or so. Her
childhood years involved serious chaos, including sexual exploitation, and she had a
daughter at age 17. She describes her family as "not good people" and presently is cut
off from them with no contact. Her present symptoms are consistent with PTSD (309.81)
and involve serious impairment in the ability to trust anybody. She also describes being
harassed and persecuted in a series of different job settings which she refers to as
"workplace mobbing". Needless to say these experiences have made matters
considerably more overwhelming for her. Looking for a safer place to live has led her to
Sweden and she ha. sought asylum in Cuba. None of these attempts worked out.
I have not done any psychological testing with Ms. Garcia and have not received any
reports of testing from anybody else. She presents normal in regards to memory and
shows some impairment in regards to concentratiodattention. Her affect and mood
present as anxious and depressed. Her insight and judgment, stemming from her trauma,
present as having been compromised. Her ability to trust and relate with others is
significantly impaired. Ms. Garcia does not drink or smoke, presents herself in an
articulate and appropriate manner and has been very conscientious in keeping all of her
scheduled appointments. In my opinion in her present condition she is not capable of
holding down a job. I do not see that changing in the near term. The long term prognosis
for Ms. Garcia is not known at this point. I hope this report is useful to you as you
consider her request for disability services.
Sincerely,
?&*/I 4w--,
Daniel Brown, LCMHC
Vermont Lic. #: 068-0000090
*c,y/tc

FROM :CERRITOS PSYCHTJLOGICRL CENTER FRX NO. :562 860 1154 Nov. 03 2011 08: 53PM P2
Cerrltos Psychological Center
1721 5 Studebskar Road Suite 119
Cerritos, Califorr.ia 90703
1582) 860-2219 Vcica Mall 3
Fax (562) 860-1 ? 54
Lester A. Mindus, Ph,C
CCI-Dlrectar
November 3,2011
State of Vermont
Disability Determination Sewices
93 Pilgrim Park Rd. Ste 6
Waterbury, VT 05676
Re: Danielle Garcla
Case # 0150819
DOB 7/30/1970
Brlef Narrative Report
Danlelle Garcia was in individual psychotherapy with me for 9 visits on 6/15,7/6,7/13,7/23,8/3,8/10,
8/17,8/31, and 9/7/10.
Her diagnosis was 296.33, major depression recurrent, severe with persistent features of persecution.
In my opinion she was unable to tolerate work related pressures and relationships and was probably too
severely impaired to work.
~?jAf?f~~fld/&f
Lester A. Mindu Ph,D,
Clinical ~s~cho(o~ist #PSY5564

VERMONT DISABILITY DETERMINATION SERVICES
TELEDICT.4TION
CONSUI>TATIVE EXLAM
PSYCHOLOGICAL REPORT
PROVIDER'S NAME/ADDRESS:
Benjamin Skolnik, Psy .D.
RE: Danielle Garcia
2 C.hurcl~ Street, Suite 2B CLAIM$: 0150819
Burlington, VT 05401
DATE OF BIRTH: 07:'30/1970
DATE ESL4IMINED: 1 lR3/2011
D14TE DICTATED: 1 li30!2011
DIStU3ILITY ES.4,b11NER: Bryan Civalier
GENERAL OBSERVATIOT\I:S:
Danielle Garcia is a 41-year-old fernale \ T~O presents to this examiner as part of her
application for disability benefits. She states that she walked to my office today for her
appointtnent from a shelter. which is only a few blocks away. She states that shr: has a
driver's license but no vehicle. Ms. Garcia dates that she is presently staying in a
hollieless shelter and has bee11 doi~lg so since June of this year. She states that she has
been homeless since March of 2010 and that she has been in the Burlington area since
June of this year. Most recently, prior to moving here, she lived in California.
Ms. Garcia przsentsd as a casually but neatly dressed woman who appeared
approximately her stated age. Her affect was flat and her mood appeared irritable, but she
was agreeable and forthcorning througho~lthe interview. There was nothing notably
~rnusual about her posture, gait or nlotor behavior.
INFORMAIT:
Information for this report was gathered from the itlterview with Ms. Garcia as well as
from some ~s~edical and psychological notes forwarded to this exanliner. The first of these
notes dated 01/11i2008 related to a psychiatric hospitalization followitlg a self-reported
suicide attempt. The report explained that Ms. Garcia was discharged by the court likely
because she was in the hospital against her will and that she refi~sed medications upotl
discharge. It appears that the duration of her stay was 3 days. The second note was dated
10/0112011 and was by psychotherapist Daniel Brown. Mr. Bronin's note consisted ofa
letter in support of Ms. Garcia's disability application and described Ms. Garcia as
meeting the criteria for posttraumatic stress disorder. The note also reported that Mr.
Brown felt that Ms. Garcia was not in a position to function well in the workplace. The
final note was dated 11!03:'2011 and was an evaluation by a Dr. Lester Mingus, a clinical
psychologist, I believe, in California. This no indicated that Ms. Garcia met criteria for
ma-lor depressive disorder, recurrent and severe with "persistent fantasies of persecution."
It is interesting lo note that nons of the notes forwarded to ths exanliner indicated the
possibility that Ms. Garcia met criteria for a psychotic disorder.
It appeared to this examiner that Ms. Garcia was answering ques?ions honestly and to the
best of her ability. There was no evidence gathered today that ~varranted questioning the
possibility of intentional falsehood, malingering, exaggeration or mninimizaliotl. The only
Page 1 of 7

Claimant: Danielle Garcia
Claim #: 01 50819
puzzling thing was that Ms. Garcia's presentation appeared quite acutely del~~sional and
none of the medical notes forwarded to this examiner indicated that R~ls. Garcia had rnet
criteria for delusional disorder or for any other psychotic disorder. While there Lyas no
evidence that Slfs. Garcia was malingering, there was some discrepancy betwleal this
examiner's observation and the apparent observations of these previous notes. The only
hint in previous notes of this specific sort of difl>culty \vas the report by Dr. bIingis that
Ms. Garcia experienced persistent fantasies of persecution.
CHIEF COMPLAINT:
M'hen asked what it is that caused her to appllr for disability. hls. Garcia stated, ".A
nunibzr of factors, mostly on that nrebsite." The website she was referring to was a
website she had IcA me a. message a few days prior to the interview to check out and is
one of her own creations. The website; ktiown as organizedn~ohbing.co~~i was not clearly
pronounced in her message, so this examiner did not have a chance to read the website
until R few mitl~ltes prior to the inter\:ic\v when I revieived her medical records which
also referenced the website. From lvhat this examiner saw ofthe website it was a general
treatise on Ms. Garcia's belizf system about the way tliat she and other people have been
the victims of w11at she described as "government disintegration." Ms. Garcia explained
to this examiner that there were other parts of the uiebsite that were more autobiographical
in nature though this examiner did not have a chance to check these parts out.
Garcia veti it on lo slaborate that the reason she was applying for disability was because of
this "gowt-timent disinteyation?' and stated that '7hrough government disintegration you
have an ~nlraveling of your life." She then referenced "COINTELPRO." When this
examiner asked what this was she looked at hitn somewhat cluizzically surprised that he
did not how that she was referring to counter intelligsnce progamning. She s-tates that
this is the agent or the disintegration and that it is brought about by the government.
When asked to elaborate, she slates that she believes the government is causing her to
lose jobs and is otkerwise trying to ilnravel her life and in her words "disintegrate" her.
She states emphatically that she does not believe tliat this is the case "I ktlo\v that this is
tlic case."
I-IISTOKY OF PRESENT ILLNESS:
Ms. Garcia reports that she grew up in Rochester, New York with both parents. She states
that she was an only child and that she suf'fered an extremely diff~cult childhood. She
states that licr fathcr was hostile and physically abusive to her mother frequently and to
her, herself, occasionally. She states that she \vitncssed ller father's abuse to her mother
on multiple occasions and that tthere was generally an atmosphere of fear and hostility in
the home. She states that she had to walk around "tiptoeing." Slle states that her father
was not an alcoholic.
.At some point around the ,zgc of 14 or 15. hls. Garcia reports that she became "connected
to the wrong individual and became a child prostitute." She states that she left home
around the same age and dropped o~lt of ~cliool and began living with the person that
appears. essentially. to have beet1 pimping her. She states that her dropping out of school
Page 2 of 7

Claimant: Danielle Garcia
Claitn #: 0150819
was the wlnter of 1 lth grade. She states that she stayed there for a year and that it mas an
extsemely abusive and difficult environment. Approximately 1 year later, she was able to
get out, lived down the street for a ~vhile and then went to stay with her grandmother She
states that she returned to school at this tixne and managed to graduate with her previous
classmates by consolidating her junlor and senior year into I year. She states that she was
very successful acadenlically when she wanted to be and that she never had trouble with
conlprehenslon or with academic performancs. She also states that she was an athlete,
playing softball. She denies any history of si gnificant itlvolven~ent with alcohol or drugs.
She states that during this period of her life she felt socially coriilected and comfortable,
though she does feel there was a lot of racism in the school that she went to. Ms. Garcia
is African-hericar~ and she stiites that she went to a mostly Caucasian school.
Ms. Garcia does recall intense periods of sadness during her adolescence including 3
suicide anetnpts. She states that these attempts each consisted of her cutting her wrists,
though she states that she did not lalovi~ how to do so effectiti~:ely. She states that she still
wishes that she had been successful in killing herself either during these episodes or in
episodes that occursed later. In spite of the abuse that she was experiencing, Ms. Garcia
denied ally histon; of nightnlares at the time. She states that she actually had dreams and
a sense of optimism when slle was not in one of her acute periods of sadness. After
finishing high school, Ms. Ciarcia states that she went to community college then
transfersed to the State University of h'ew York \arith one of the cainpuses near Rochester.
She states that she got her bachelor's of science in English.
h4s. Garcia states that. she believes that at some point during her undergraduate or
graduate school career that she believes that she began being a target of the govermnent
disintegration described above. She states that she is uncertain why this is the case and
that she is frequently persecuted by a desire to unders$and. She states that she believes?
perhaps. that she has been targeted for being anti-Semitic, although she denies tlis being
the case. She relates a couple of stories ~~lhere people saw things that she had beer1
doodling and referred lo them as swastikas or other anti-Semitic slogans even though Ms.
Garcia dznies that this is the case. She states that she believes that these are the kinds of
mind gallles that people play with you when you are a target of govelntnent
disintegration, trying to tnake you feel like you are crazy. She states that in the years
since college she has had a great deal oftrouble holding down jobs or relationships arid
that she has moved a numbsr of times in an attempt to escape the government
disintegration. She also states that until recently she did not really have a sense of what
was happening to her, and it is only in the last couple of years that she states that she has
scad thir~gs and gathered information that she has become very clear about the nature of
her persecution. She does state that she has moved around a number of times in an
attempt to escape it even though she was not entirely certain what it was and relates one
story where she feels that she came close to doing so in a foreign countsy but that they
ca~~ght up to her. She states that everybody in hzr life, including her family, are 01.1 board
with the government disintegration. She went so fhr as to report a. sensz of surety that
even this examiner was involved with the govemnlent disintegration and that the whole
Page 3 of 7

Claitnant: Danielle Garcia
Claim &: 01 50819
process is simply one that has managed to either it~doctritiate everyone in her life or get
them to look the other way. She states that as a result, "I'm totally isolated.''
Ms. Garcia's system of very bizan-e thinking appears very tight and impenetrable. She
appears entirely convinced of the reality of her situation and appears to zxperience
ambiguous situations as filrther cotfirmation tl~athe government is trying to unnerve
her. She also feels that she has been dniggsd and surveilled by helicopters. She denies
any fatnil? history of schizoplrenia or other psychotic disorders. She denies
hallucinations or other bizarre saisot-y espesiences. She does report that she feels so
hopeless about hat is being done to her that she has attempted to kill hersclf on 4
separate occasions. She states that the most recent of tl~ese was an attelllpt at carbon
monoxide poisoning which led to her hospitalization in 2008, referenced in the note
described in the beginning of this report.
It \tias .very clear to this esaminer at the time of the intenrie~v that it4s. Garcia was acutely
delusional. It was itllpossiblc to assess, given a one-time intervie\v and the absence of any
longitudinal information, the e~qent to which this perception comes and goes. Ms. Garcia
was asked about this and states that she is always clear at ths point about what is
happening to her, but she also states that this clarity has onlv arisen in the last ycar or
two. Because ofths it is difficult to ktlo\v whetha Ms. Garcia goes in and out of these
bizarre delusiotlal periods or \vhether it is a persistent esperience for her. There is also a
vet?.; slim chance, as it should be noted. that Ms. Garcia was exaggerating or fabricating
her presentation hr this cxaminds benefit. Again, there n7as no evidence of this effect,
but the contrast between this exanliner's observation and that of the previous people rvho
have known Ms. Garcia in a clinical context \was striking.
Ms. Garcia reports that she has not ~rorkcd since Sovember 2010. Prior to that, she
worked for approximately 3 years as an eligibility worker for welfare benefits in Los
-4ngeles County in California. She states that she left that job because she began to
pcrceive "workplace mobbing." basically a sense of the in\:olvement of her co~vorkers
and supervisors in the go~~ernment disintegration. It was very difficult to get a sense from
S~ls. Garcia of e-mctly what was occurring interpersonally between she and her coworkers
and employers as her tight delusional system made her perceive every&hing as people
persecutitlg her and tqing to make Iier feel she was crazy. Prior to this job- Ms. Garcia
states that she has done a number of dif'fcrent things over the ycars gctierally \vorking in
jobs for 3 or 4 years before the government disintegration and the workplace mobbing
within it catch up to her arid make her have to leave.
13s. Garcia reports that she receives primary care services from a Dr. Miller at Fletcher
,Allen Health Care. She states that she recently saw therapist Dan Brown but after reading
the note that he sent to the disability people did not tn~st him anymore. She states that the
note in its absence of reference to the workpla.ce mohbing or go.r~nment disinteg a t' lot1
itidicated to her that TvIr. Rro\vtl was hitnself attempting to obscure the reality of what she
is going through.
Page 4 of 7

Claimant: Danielle Garcia
Claim if: 01 5081 9
She hopes to connect with a new therapist probably through Fletcher ,Ulen.
.4t the present time, Ms. Garcia reports that the only medication that she takes is
lo raze pan^ for anxiety. She states that she did take Risperdal, an antipsychotic, at some
point in the late 90s though has not taken any antipsychotics other than this. It does
appear to this examiner that antipsychotic medication may be of great benefit to her but
she is likely at this point to be mistrustfi~l of anybody that trizs to prescribe it,
14s. Garcia reports that she has been psychiatrically hospitalized on 3 occasions. The
tnost recent of these was in 2008 following thc carbon monoxide poisoning. She reports
that she tvishes she had succeeded but that she was found unconscious by a security
guard. She states that she was hospitalized at Cerritos Com~minity I-Iospital in California.
Slie appea.rs to have left on cout-t order without accepting any medication prescriptions.
Prior to this, she reports that she was hospitalized 2 times in 1996. She states that onz of
these was for 24-hour evaluation follo~ving a referral from jail, where she had been
arrested and incarcerated briefly for some sort of bizarre behavior which she statzs did
not result in criminal charges. Following the 24-hour evaluation, she was transfetred to
another unit at Lindemann Hospital in Boston. She states that she was there for
approximately 1 month. Slie is unable to remember the specific circumstances that lcd to
these hospitalizations except to say that sotnething occurred vilule she was in jail that led
her to be referred for psychiatric evaluation and hospitalizatioti.
Ms. Garcia rcports no major impair~nent with activities of daily living. Socially. she
reports that she is extremely isolated because she believes that everybody in her life is
involved in the government disintegration.
LIFE HISTORY:
As mentioned previously. Ms. Ciarcia grew up in Rochester, New York. She states that
her parents are still living and that "hly mother has nly things and I'm tqing to get tthetn
away Srom her." :.Zs tnentioned abo\:e? shc has corne to believe that her mother is
in\:olved in thz government disintegration so s112 feels that she cannot rely on her for
support. She did not have any siblings.
Ms. Garcia reports that she has a bachelor's of science in English fioru the State
IJnivzrsity of Nev 1-ork. She states she began but never completed a mastcr's program in
library science.
h,ledically, Garcia reports that she suffers wit11 neuropathy, ~rhich she describes as a
feeling of pressure in her head which is not entirely painful but is somewhat unpleasant.
She states that it has been diagnosed as neuropathy at the present time though it is unclear
what exactly is happening medically hzre. Ms. Garcia denied arly history of ~xinlinal
charges. She states that she has never been in the military. She has been married 1 time
and has 2 childrn~, a 17-year-old boy and a 22-year-old girl. Ms. Garcia reports that she
is estranged from both of her children and that her 17-year-old was gven up at the age of
Page 5 of 7

Claimant: Da~iielle Garcia
Claim #: 0150819
2 for adoption. She states that this was voluntar> but she felt coerced into doing it and in
retrospect feels that this was yet another eesarilple of her being persecuted.
11s. Garcia reports that she likes to dl-itik alcohol but that she catuiot afford to buy it and
that it is against the reg~~lations of the homeless sheller wherc slis lives. Shs denies any
significant history with alcohol abuse or with any other recreational drugs. She denies the
present use of any other recreational dn~gs.
\,IENTAT, STATUS:
>Is. Garcia presented as a casually but neatly dressed woman who appeared
approximately her stated age. Her affect was somewhat flat and her mood was generally
irritable and extremely suspicious. She was fidly oriented to time. person and place.
though she had sotne disorientation related to sinlation, related. 1 think, to her delusional
system. She evidetlced significant thought disturbance, specifically ideas of reference and
persecutory delusions. There was no evidence of perceptual disturbance. Judgment and
insight appeared poor rclatulg to the acuity of her delusional disorder and, given thls,
there is some reason to question her capacity to capably handle her own finances.
14s. Garcia was admiriistered the Mini-Mental State Esatn and received 29 out of a
possible 30 points. This would indicate tlo overt disturbance with atte~~tiotl.
concentration. immediate or short-term memory.
DIAGNOSES:
Asis I: DIFFERENTIATE BET\.'i'EEN:
297.1 Delusional disorder.
295.30 Schizophrenia. paranoid type.
Axis TI: 799.9 Deferred.
ibis 111: No diagnosis.
Avis TV: Homelessnzss, occupational pt-ohlems, ecotiomic problzms.
Avis V: GAF 50.
Page 6 of 7

Claimant: Danielle Garcia
Claim fi: 015081 9
FOR;LlUI.,ATION:
It seemed very clear fiom Ms. Garcia's presentation today that she is acutely psychotic,
specifically extremely delusional. She does not appear to evidence any history of
hallucinations though it is hard to ktlow for sure. Additionally, it is hard to know the
duration or pattern of her delusional thinking which tnakes it difficult to diflerentiate
between a delusional disorder and more full blown schizophrenia. It is also, as mentioned
2 times previously, pilzzling to this examiner that tlo~lz of her previous treatment
providers have described her as meeting criteria for a psychotic disorder. It is at this point
an unknowable contrast but does appear to warrant fi~rther consideration.
Benjamin D. Skolnk, Psy.D.
Yern~ont Psychologist $9 12
BSlczeitls
nn: 12!01!2011
DT: 11,'30!2011
10-02575293
LC: 129
Page 7 of 7

Disability Determination Explanation
CLAIMANT INFOFth4ATION
This Disability Determination Explanation is for the Dm claim at the In itid level.
CLAIh3ANT INFORMATION
Name: Claniillle S Gari:ia
SSN.
Phone Number 802-683-1 138
Secondary Phone Number
.Address:
Claimant Gender: F
Self Reported Height: 65 inches
Self Reported Weight. 140.01bs
Special Indications: None.
RELEVANT DATES
Below table represents the Relevant Dates
Date of Birth Current Age BOD Age at AOD DFI DL1
41 years 4 40 :real's 3
Age at
DLI
person)
person)
Does the individual have an attorney lappointed representative? Yes
Representative's name, address and phone number:
Craig Anthony jarvis
353 STONE CUTTERS WAY
MONTFELIER., VT 05602
802-229-5146
ALLEGATIONS OF IMPAIRMENTS
The individual filed for Initial claim for disability on 05/29/201I due to the following illnesses, injuries,
or conditions:
Fast-tfaurnatic stress
Post T1'3umatic Stress
FJeusopathg
The individual alleges inability to function andlor work as of
11 / 1512010
TECHNICAL ISSUES

Is the individual working?
No
Prior Electronic Filing
There are no prior electronic filings.
Alleged Onset Date:
llj15(201C)
Has the individual performed work after the Alleged Onset Date(.4OD)?
No
Has any period(s1 of work been determined to be an Unsuccessful 'Mrork Attempt, S~~bsidizedlSheltered
Work or involved Impairment-Related Work Fxpenses, or other technical issue?
No
The following initial evidence has been received
EVIDENCE OF RECORD

The following evidence has been requested:
Source of Evidence
DR. GREENEUR-G; UCL4
-
.-cnr,rr~~ nr~rrunru~n n~r r~hr-ror,. A rr r cc-rcn nsrh~r~rrc
EF Request Date
loj07/20ll
i rT,
1~,713r,i i
Level
IPJ
T ~ T

~~nn.1 I 'JJ r A ILI IV I I LL~LL-.~ L LLIY I ~;n> r.1 I LLA I Ln LVIIIVUUJ
DR GREEMRURG; UCLA
CERRITQS PSYCHOTHERAPY CENTER; P.TT LESTER MIMDUS
ICIJLJI (LLJIL
09/23/2011
09/23/2011
11'4
I P.J
IN
CLAIM COMFlUNICATIONS
No Clam Cofmunications 1-lave been created.
Is a Cqs) required?
Yes
CONSULTATIVE EX4MINATION(S) (CE)
Select the reason(s) for which a CE(s) is required:
c--
~~~~cialized ~r~edical e~idence that is needed is not available from the individual's treating or other
medical sources.
Was the beating source(s) contacted to perform the CE(s)?
No
Indicate which of the following apply:
Specific exa,m neerfed
Were all of the CE(s) kept?
T?
r es
Analysis
dib 11115110-dlif
FINDINGS OF FACT AND ANALYSIS OF EVIDENCE
Neuopathy :
"Neuropathy" vms used as a dia.gflosis regarding the clairnarit in 1989 to explairl a reactior~ to Elavil which
involved a sense of pressure within her head, twitching dovm her spine and jerking ml.).lverrlents of her a,rm
and legs. These sympto~~
have gradually refitted spontaneously, and clairm.nt does not consider them to
present any irrlpairnlent.
Neurological CE dated 12 101 11 1 included a norma,l neurological exarmnation aad the conclusion that "This
patient has no neurologic irnpairr-nent."
Rerriew of the Func. Rprt. corlfirrns that clairnent is not alleging any physical inipairfnent. Nu, MDI
Mental:
41 jrr old fe~mle with 4 years college alleges PTSD. She has history of administrative jobs, leavif~g last job as
eligibility worker due to ~n,~orkpla.ce reorganization, fnobbing, harrass~nent, discrirr~ination and disparate
treatrlerlt.
She rem.rks that she was vrongfully terminated. JSQ from 06-07 notes rlo ciifficulties, and further sta.tes she
vos good viorker and pleasure to ha.77~ on staff Clrr~t had 4 day ps:;ch hospitalization in 2006 fi~ll~~i~firig
serious suicide atternpt by cutting wrists and carbon n-lo~loxide poisonif~g. Diagnosis %as Major Depressiof~
and discharge GAF ~ ms 70. She was discharged by court, refused meds Clrr~t seen for 9 outpatient
psychotherapy appointments from 6110-91 10.. with diagnosis of hlDD, reimrrer~t, severe, with persistent
features of persecution Treating source opined that clmt vm.s unable to tolerate work-related pressures and
rhras probably too severely impaired to vark. This opinion is appreciated af~d given significa~it weight as source
is specialty and treating. Letter frorn tr~ating counselor dated If31 11 notes clmt seen at that point for 8
sessions since Ej 11. He reports she is presently homeless, has a, history of sexual exploitation, and currently
resides in a shelter. Current symptoms are ~loted to be consistent with PTSD. She has serious impairment in
ability to trust anybody. She reports being harrassed at rrlultiple jobs, and has sought safer places to live,
including Sweden and seelung asplunl in Cuba. Affect and ~nood are anxious and depressed. Insight and
judgment are compromised, ability to relate and trust others is severely impaired. Memory is norrnal,
attentionjconcentration ShOm sofne impairment. Treating Source opines that in current condition, dmt is not
capable of holdi~ig dmm a job now in the near tern1 Long term prognosis is unkno~m~. This opinion is
appreciated and given appropriate {eight, but not contr-olling weight as source is not program-acceptable. At
PCP to establish care, clmt had normal speech, full affect, thought appeared to be goal-directed. She r~po~ted
hdnm d;=nnn.?crA r~"+h DTCPt ;r1 3nl-IQ Cha ra-n+tc h;.?tnr,r ,-,$ r~nsclrnl

past 10 years, ~fi.qtl1 recent a.ttempt to seek asyli-~rn in Sn~den. Her only rned was lorazeparn, used infrequent1;r.
kt neuro1og:i CE, she reported that disabiling condition is PT SD. MSE vias norrnal. There r~~ias no neurologic
irnpairrnent. At psych (3E in 11 ( 11, clmt reported being prostitluted as teen. She reports 3 suicide attempts by
cutting during her adolescence. She reported that during undergra.d school, she becarne target of "gorrrmrrlrnt
disintegration" and discussed counter intelligence programming. She has a :~,~bsite that further explains these
issues. She has had difficulty holding jobs and has moved a number of tin-~es in order to escape government
progranming. She reported that her family and everyone in her life, including examining psychologist, mere
invl2lued with this government disintegration. Diagnosis u.as Delusiona.1 Disorder, noted to be extensive and
impenetrable. It was unclear to psychologist whether this vms co~ltinuous v@rsus episodic condition. GAf T~a.s
50. Psychologist noted tha.t there vn.s no diagnosis of this from other- providers, but did note remark by one
treating source about "persecution fanta.siesU. MSE noted that affect v,ms some7,vhat fat, mood was generally
irritable arid extreme1:~ suspicious. She ?QIT~S generally oriented, although somevihat disoriented to situation,
rela.ted to delusional system. She had significant thought disturbance, specifically ideas of reference and
persecutory delusions. There TOL~S 110 evidence of perceptual disturbance. Judgment a1x1 insight appeared poor
due to acuity of delusional disorder, thus raising question about capability. MMSE of 29/30 does not indicate
frank cognitive irnpairrnent. Psychologist noted that clrnt h8.d read treating counselor's note to disa.bility, no
longer trusted him, and had dropped out of counseliag. Per function report, clrnt resides in shelter, avoids
people in order to avoid "rnclbbing". She reports she tries to stay al$m.ke tto keep an eye on the people in the
shelter clue to concerns ahout rnobbing. She reports she ~fi,vuld not be able to trust refrigerator, does not
prepare meals, But feels she could. She reports she uses public t~'ansporta.tion, shops, marlages finances. She
reports difficulty with memory, concentration, getting a.long with others, but states she can follow instructions
r~rell. She does not do ?$Ell with authority figures. She reports her fears are justified, people are up to things.
The total evide~lce suggests a lengthy rie11ta.l health history, with at least one documented serious suidde
a.tternpt and refusal to participate in rrledication treatrrler~t in 200%. Clmt briefly participated in outpatient
psychotherapy just prior to A13L in 2010, with diagnosis of MDi3 nith persistent feature of persecution and
opinion tha.t she 5hms probably too irr~paired to ~mmrk. She apparently traveled to Swden and then relocated ts
Ver~nont follo7,ving this. More r'ecently, she participated in brief episclde of outpatlent psychothera.py, wth
counselor noting she is unable to trust anybodv. Clmt discussed "rnobblng" there as well, and ~zounselor
offered opinion that cl~rlt 1s not capable of holding dortvn a job in current condition. There is no diagnosis of
FTSD from acceptable source. Hotever, there are diagnoses of MDD, severe., and Delusional Disorcier. Basd on
the available evidence, clmt's persecutory clelusional system appears to have persisted from kLQD to present.
Cofldition equals 12.03, 2,3. Not capable. Recomnd 18 fnonth dlary.
416 - CASE ANALYSES
Indicate whether this 416-Case .4nalgsis is for:
Other Period(sj: 11 / 15/2010 - Fresent
Details:
The claimant has no medically determinable irrlpairment.
These findings complete the medical portion of the disability determination.
MC /PC or SDM Sipnature
Donald Sv,artz, M.D. 12/05/2011
MEDICALLY DETERMINABLE IMPAIRMENTS AND SEVERITY
MEDICALLY DETFRMIN.4BLE IMPAIRMENTS (A4l3I)
- . . . .. .. q.
,, , . . .. . - -

uoes me Inmviaua have one or more memca~~y aeterrmnable lmparments r
< .-rn
?I=;,
IMPAIRME?Tf DIAGNOSIS
2950 - Schizophrenic, Paranoid and Other Functiona.l
Psychotic Disorders
2902 - Affective Disorders Secondary
SECTERITY
Severe
PSYCHIATRIC REVIEIV TECHNIOLTE (PRT]
PRTl
Indicate whether this Psychiatric Review Technique (PRT) assessment is for:
Other Periud(z): 11) 15i2010 - Present
'A' CRITERIA OF THE LISTINGS
12.03-Schizophrenic,Paranoic~,anc~ Other Psychotic Disorders
A medically determinable impairment is present that does not precisely satisfy the diagnostic criteria above
12.04-Affective Disorders
A nledicallg determinable impairxlent is present tha.t does not precisely satisfy the diagnostic criteria above
'B' CRITERIA OF THE LISTINGS
12.03-Scllizophr~ic,Pa1'a1loid,and Other Psychotic Disorders
12.04-Affective Disordefs
Restriction of Activities of Daily Living: Moderate
Difficulties in Maintaining Social Functioning: Mar-Ired
Difficulties in Maintaining Concentration, Persistence or Pace: B~1ark.ed
Repeated Episodes of Deconlpensation, Each of Extended Duration: None
PRT - ADDITIONAL JXPLANATION
Delusional Dlsorder and MDD, severe
Not capable
Recommend 18 rnor~th dia.ry
equal 12.03
MC IPC or SDM Sinnature
Ellen Atkns, Ph.D 12107/2011
LISTINGS CONSIDEREI)
Listing Descriation Subsection PRT Assessment

Schizophrenia and Other Psychotic
Disorders
Affective Disorders
PRT 1
PRT 1
MEDIC.4L DISPOSITION
Medically Equals Listing - The severity of one or more of the MDI(s) medically equals current listing criteria.
12.03 Schizophrenia and Gther Ps~/chotir, Disorders
SYMPTOMS AND CREDIBILITk'
ASSESSMENT OF POLICY ISSCTES
This section has been considered but does not apply to this claim.
MTEIGHING OF OPINION EVIDENCE
There is no indication that there is medical or other opinion evidence.
RESIDUAL FUNCTIONAL CAPACITY
hIc, P-FC IIvIR-FC assessments are associated with this claim.
RECONCILING OF SOUFKE OPINION
ASSESSMENT OF POLICY ISSUES - CONTINUED
There 1s no 111dicatlon that there IS oplnlon eolcfence from any source.
DETERMINATION
Based on the documented findings, select the determination:
Disabled
~ndicate which of the f ollowillg Acquiescence Rulings are applicable
None of the kRs considered apply to this cla.im
Is there medical evidence of DAN
No medical evidence of DAA
REGULATION BASIS CODE
Regulation Basis Code;
E 1 -2OCFK404.1520~1)-DIE CLP,II\?
Alleged onset date:
11,f15(2010
Enter the established onset date:
llj1512010
Is this a closed period?
No
Diary type and reason code:
Medical 11-nprovernent Expected (MIE) k,

Diary date:
05j0112r313
Assess the individual's capability:
Capability un~'esolvecl.
Review of the followir~g r~~edical evider-~ce suggest@):
Individual is
Incapable
MC /PC or SDM Signature
Ellen Atpins, Ph.D 12(07(2011
Disability Adjudicator/Examiner Signature:
Bryan Civalier 12/138/2011
?CAT version: 7.1.06

~ ~ -
SCICIAL SECURIlY ADMINISTRATION
1 3EE'IbI.RTlOi.l
2 CDS T3CE
DDs uD0 DRS DUB ll.17~P;X
s51
HUr-JrJ
DANIELLE S GARCIA
PO BOX 1485
BURUNGTON VT 05402
u
5. :lih:EiHC AOC:ESS OF CLAlb:Al.:T ,irc!uda Z li Code,
DISABILITY DETERMINATION AND TRANSMlllAL
5 -1LlPlG ATE
08/29/2011
J SS:,!
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BURLINGTON DISTRICT OFFIC~.SSA
56 PEARL STREET
BURUNGTON, VT 05401
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CODE
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Clmt Phone: 602-683-1138
DDS Rece~ved 09/22/2011
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Disability
DETERMINATION PURSUANT TO THE SOCIAL SECURITY ACT, AS AMENDED
'5 CLOllAAH 7 jlS23LEC
1:; P?lYiP- 3I.;G~4CSl.~ E73','SYS.
CODE t:C
:EE SICO'l:CF 1 :I;C;VCSIS
12
2950
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a 3rg35 / ll/l5/2010 SCHIzOpHRENLA, pAMNoIA 8
AFFECTNEiMOOD DISORDERS
OTHER PSYCHO~IC DISORDERS
B. [7 Ceased
17 C>l4,9'i 7 iP; ' 8 REASON
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12/08/2011 ELLEN ATKINS, PH.D. 38
I I I
j2Z S?EC CODE
38
CRAIG ANTHONY JARVIS
453 STONE CUTER5 WAY
MONTPELIER VT 05602
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3s E;CI?Y;I:IT:I MULTIPLE
t(3NC6'itCi
35 Bi91S CODE 136 YE+ D l i 137 $5.4 PEF=ECE;4T,hil'>.'E
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( SSA 132 DLTi
CODES
CODE
b:Q'iE5i'EBt
Form SSA-831-C3 (5189)
Oper B3C Date 12/08/2011 Case # 0150819 Dec AL [7 DECISION CASE TOhlTROL

JOB SCREENING QUESTJON AIRE
111 11 (~1-1rn%uhum
mloyerr S m A MONICA LIBRARY
mloyee namex DANIELLg S GARCIA CASE NUMBER: 0150819
JOB TITLE:
LIARA~~,' FAGE
1. Name of individual cornplctbg form: JANGT-
2. Work relationship to employee:
3. How long did you work with or observe
4. Why did the employee leave the job?
5. Please rate the individual on the items below:
DATES OF EMPLOYMENT CfN THIS JOB
Generally Could Had Some Had Great Not Applicable
Do Without Difficulty with Difficulty with
Problems jhis Function this Function
a. Could learn job duties in expected
amount of time. Comments or
Examples if a problem:
0
b. Accepts instructions and reasonable
criticism. Comments or Example if a
problem:
0
c. Asks questions and requests help.
Comments or Examples if a problem:
17 17 0
. -
d. Has acceptable grooming and dress for
the job. Comments or examples if a
problem:
f7
e. Cooperates with coworkers as required.
'Comments or Examples if a pmblem:
%
0 0
f. Avoids disrupting others. Comments or
examples if a problem:
17 0 0

g. Adapts to work changes such as hours,
equipment, location. Comments or
Examples if a problem:
Generally Coulq 1 IHad *$! 0 (;I 6 FJajXdGreat Not Applicable
Do Without Difficulty with Difficulty with
Probtems this Function this Function
h. Performs repetitious tasks.
Comments or Examples if a problem:
0 0
i. Understands and carries out simple
directions in reasonable amount of time.
Comments or Examples if a problem:
j. Start. work on time. Comments or
Examples if a problem:
k. Has acceptable attendance. Comments
or Examples if a problem:
0 0
1. Understands and follows safety
guidelines. Comments or Examples if a
problem:
rn. Needs ordinary amount of
supervision and attention.
Comments or Examples if a problem:
CI
a
6. Please provide any other information which you feel would help us evaluate the individual's work activities:
Date *
/g