Provider Documentation for AD(H)D, Psychiatric, and ...
3. Please list DSM-5 or ICD-10 diagnostic codes, date(s) diagnosed, and indicate which constitutes the disabling condition. IV. Statement of Disability. 1. Disability confirmation. In your opinion, does any condition listed above substantially limit a major life activity and thereby rise to the level of disability? * Yes: No: Not Sure: a. ................
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