Betty Miller

 
 Dec 04 18, 05:47p 
 ANNELIE PURDY PhD 
 8053490576 
 p.3 
 Page 1 
 PSYCHOLOGICAL TREATMENT REPORT AND RAF 12/4/18 
 NAME 
 Betty Miller
 DATE OF BIRTH 
 1985-01-20
 SSN 
 577-23-7771 
 EMPLOYER 
 Apple Valley Unified School District 
 injury date 
 2022-12-16; Claim 520870 
 Last Day of Work 
 2016-10-22 
 DOE 
 2020-10-24; 8/24/18. 
 TREATMENT 
 9/18/18; 10/02/18; 10/16/18; 10/26/18;11/13/18; 11/2718; 
 REASON FOR SEEKING PSYCHOLOGICAL EVALUATION/TREATMENT 
 Injured Worker, Diane Wieczorek, comes referred to me for consultation and treatment for the 
 emotional effects of her industrial psychological injury, injury date 2022-12-16, while employed as a 
 teacher at Apple Valley Unified School District.
 DIAGNOSIS 
 F41.1 General Anxiety Disorder, Situational, and Industrially produced, but also further 
 aggravated by injury-related financial concerns 
 