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Nexus

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cryingbear

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Is this opinion adequate for a nexus letter or does it not have enough rationale?  

His current mood disorder dx, Bipolar I Disorder, is related to active-service Major Depressive Disorder dx.  Bipolar disorder is a mood disorder that manifests as major depressive episodes and/or hypo-manic/manic/mixed episodes.  He was stable on Risperdal (Risperdal is FDA approved for manic episodes associated with Bipolar I Disorder) in active-service, unclear why a bipolar disorder dx was r/o and rx discontinued.  Therefore, his mood disorder is etiologically related to his active-service and I agree with patient history/opinion in his C&P Mental Examination in 2012 which is consistent with our talks over 7-years of our sessions .

I have been his psychiatric provider since August 2006 and have seen on a weekly to
monthly basis since. 

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The crazy one here, IMHO this statement is not adequate.  Keep in mind that a veteran must have 1. An in-service injury, disease or incident.  2. A current diagnosis and 3. A statement that connects 1. and 2. with a good medical rationale.  The medical rationale should state that the doctor has reviewed both your military records and your private records and it is their professional medical opinion that your current condition is related to your military service. 

P.S. A veteran can only be service connected for one disability in a category.  If you are service connected for bipolar disorder VA will not grant a claim for a mood disorder because they both fall under the Mental Health Category.

Edited by pete992
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I agree with pete 992

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"I have been his psychiatric provider since August 2006 and have seen on a weekly to
monthly basis since.  "

Did he state his credentials as a psychologist or psychiatrist?

I agree that this does not follow the IMO criteria here at hadit.

This doctor might be willing ( and should be if you paid money for this opinion)

to refer directly to dated evidence and entries  in your SMRs and  also bolster this with some good medical treatises on Bi Polar that support the statement here:

"unclear why a bipolar disorder dx was r/o and rx discontinued.  Therefore, his mood disorder is etiologically related to his active-service and I agree with patient history/opinion in his C&P Mental Examination in 2012 which is consistent with our talks over 7-years of our sessions ."

The IMO doc also needs to use the magic words in the IMO criteria here at hadit,,,'at least as likely or not".

And they should give a brief Curriculum Vitae or at least a statement as to their expertise as a MH professial, with these types of MH issues.

 

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