The patient is independent, can take care of himself and go out. That excludes Severe Disability. He has resumed working but at a reduced rate and does not attend school anymore. Therefore the rating is MODERATE DISABILITY.C. Upper Moderate:

Work capacity: Reduced

Social activities: Resumed less than half as often as pre-injury

Disruption or Strain: Frequent (once a week or more but tolerable)

D. Lower Moderate:

Work capacity: Unable to work or only able to work in sheltered workshop

Social activities: Unable or rarely to participate

Disruption or Strain: Constant (daily and intolerable)

He sees his friends on a regular basis but far less than before the accident. There are outbursts of anger disrupting his daily activities, but not daily and they are tolerable. This points to Upper Moderate for the

GOS-E.

Discussion

Additional comment

The GOS and GOS-E ratings are driven by the worst element in the list of questions, not by the overall comparison.So if someone still has frequent social interactions, but cannot go out on themselves (i.e., the person is dependent), that would result in SEVERE DISABILITY.The individual's dependence is measured in two areas, one is independence in basic Activities of Daily Living (ADL) and able to deal with emergency situation (inside home independence), the other is able to use transportation (drive, or call taxi/use public transportation if necessary) without assistance (outside home independence).It is uncommon, though, that there is a large discrepancy in answers, and it is always important to go into more depth, maybe with family members, to find out whether seemingly contradictory statements can be supported.