The patient can care for herself independently and go out alone, so she is not considered to be in a state of severe disability. She has resumed her volunteer work but at a reduced level, indicating an upper moderate disability rating. Her social activities have decreased and she experiences frequent but tolerable disruption or strain on a weekly basis, consistent with an upper moderate disability classification.

1. Case Study 9: Upper Moderate Disability
The patient is independent, can take care of
herself and go out alone. She therefore is not
in the SEVERE DISABILITY category. She
has resumed her volunteer work but at a
reduced level, which means a GOS rating of
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)

2. Case Study 9: Upper Moderate Disability
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)
Her family visits her a lot, but it appears her social
activities have decreased and there is frequent but not
constant strain. Upper Moderate on the GOS-E.

3. Case Study 9: Upper Moderate Disability
Additional Considerations:
 For a retired person the occupational status
can be evaluated by comparing the amount
of volunteer work, if any, or household
responsibilities pre and post-injury
 It is important to differentiate the inability to resume
activities from other situations that are not related to
the TBI