Help! Bipolar Claim Denied Solely On Genetics

[bluevet]

My C&P doctor gave me a gaf of 53, but he denied service connection and his only reasoning was that bipolar disorder is a genetic condition. This makes no sense since many vets are receiving benefits for this illness. I was chaptered out of the Army with a personality disorder, but I have since been diagnosed with bipolar by 3 different doctors, including the C&P doctor who acknowledges in the report that the Army doctor had diagnosed "personality disorder", He then concurred with the bipolar diagnosis and stated that no other mental illness exists. How can they deny me based solely on this doctor's opinion that bipolar disorder is genetic? I need to find a vet friendly psychiatrist or psychologist to review my records and right a letter. Does anyone know of someone they can recommend? Please private message me if you can recommend someone. Thanks!

[bluevet]

You said you were “chaptered out' due to the PD.

I helped a vet (after many years of denials and no SC at all) get bi polar service connected (100% P & T) due to a few entries in his 201 Personnel files and proof of a Captain's mass he got in the Navy..No one at VA or DAV ,for years, had picked up on these entries.They were not in his SMRs, they were a few discipline problems noted in his 201 file.

The Navy in those days did not understand at all that he had exhibited symptoms of bi polar with his sudden erratic and unusual behavior. His VA shrink wrote a letter for him to support his claim, with full medical rationale as to the inservice events in the 201 file as being as likely as not symptomatic of bi polar.

PD and bipolar have major differences.

Can you possibly scan and attach the denial here and the evidence list the VA used?

(Cover your personal info name, address, C file # before you scan it)

Thanks Berta. You will notice that my 201 file is not included in the evidence list. While in service I completed basic, AIT, Airbourne, and Air Assault training with no disciplinary action. I think that most psychiatric professionals would find it hard to believe that I could accomplish all of that with PD then have a sudden, uncharacteristic meltdown. In Feb, 1990 I was hospitalized for 30 days after a suicide attempt. The symptoms and observed behaviors noted in my medical records were identical to my current bipolar symptoms. Again, I believe what I need is to find a phsyc professional who agrees and and is willing to opine that the Army doctor's diagnosis was likely incorrect and draw a nexus between my in service hospitalization and my current diagnosis. In other words, to say that my in service hospitalization was most likely a result of bipolar disorder rather than PD. This should not be difficult since I have received 3 different diagnosis for bipolar disorder and 0 doctors have found PD. I was first diagnosed with BPD in 1999 at Park Place, but those records have been lost. My 2003 records from Park Place do mention my 1999 diagnosis, so that should be adequate. It's is my understanding that PD is not transitory and that it is very unlikely that a PD that existed in 1990 simply vanished on it's own and that I developed BDP as a completely unrelated occurrence. Thanks again!

Edited January 24, 2014 by bluevet

[carlie]

It would help to have the Reasons and Bases Section of the denial too.

[bluevet]

blue,

I am well aware that a TBI is not required for SC of bipolar disorder.

I asked if you experienced or were treated for a TBI on active duty because -

if you were, then a personality disorder can be SC'd due to TBI.

This, by the way - is the only way a PD can garner SC.

I'm not sating whether you have or do not have,a PD - but after all,

you did post that you were chaptered out of the Army with a personality disorder.

IMO, this will continue to be a hurdle, maybe even more so if years have elapsed

any severance pay was made, and how soon after being inducted, you were chaptered out.

For the record a PD disorder can be co-morbid with bipolar disorder, it's not always that way,

but it can be that way.

Yes, you are correct, many veterans do receive SC compensation for bipolar disorder.

Some are even members here and they also had to get past the PD diagnosis for SC.

There are specific rules that have to be followed for a change in diagnosis, 38 CFR 4.125,

that I will post below.

It is most likely the va decision maker that denied SC, not the examiner.

You posted that since discharge you have been diagnosed with bipolar by 3 different doctors,

including the C&P doctor.

Did they state they reviewed your SMR/STR's and relate the diagnosis of bipolar to active duty and

support the opinion with full medical rationale ?

Overcoming the denial, if it was due solely to a C&P reasoning that bipolar is a genetic disease,

should not be very difficult.

Just food for thought if you want the claim to succeed, take it or leave it - that's up to you.

jmho

4.125 Diagnosis of mental disorders.

(a) If the diagnosis of a mental disorder does not conform to DSM-IV or is not supported by the findings on the examination report, the rating agency shall return the report to the examiner to substantiate the diagnosis.

(b) If the diagnosis of a mental disorder is changed, the rating agency shall determine whether the new diagnosis represents progression of the prior diagnosis, correction of an error in the prior diagnosis, or development of a new and separate condition. If it is not clear from the available records what the change of diagnosis represents, the rating agency shall return the report to the examiner for a determination.

(Authority: 38 U.S.C. 1155)

[61 FR 52700, Oct. 8, 1996]

Thanks Carlie, I have the QTC doctor's DBQ in my posession. The doctor acknowledges review of my SMRs and that I they reflected a diagnosis of PD. He then diagnosed BPD with no other conditions. He did not offer any direct opinion on the relatability of my in service hospitalization and my current diagnosis. He gave my service connection probability less than 50% and here is a direct , complete quote of his rationale.

"The claimant has been hospitalized for a long time for hypomanic disorder, suicidal ideation and erratic behavior. He has been treated with multiple mood stabilizers and has responded well. The bipolar condition is a mental condition totally independant of the service- bipolar disorder is due to advanced imbalances in the brain caused more likely due to genetic condition.

I was taken by surprise by this doctors final DBQ because it didn't reflect my experience during my C&P exam. Please read this post that I left right after my appointment and you will see that something changed dramatically between my exam date and the doctor issuing his report.

Please note that when the doctor made this recording in my presence, I clearly heard him state that my connection probability was above 50%. The doctor's report was not sent to the VA until QTC's deadline had passed and I called to inquire. I don't know why this doctor changed his mind between the time he recorded his report and the time he issued it, but I suspect that QTC "QA" had something to do with it, because when I called to inquire I was told that the QA department had sent it back to the doctor and it was awaiting his signature.

Edited January 13, 2014 by bluevet

[john999]

That QTC doctor is full of it. He believes he is doing the bidding of the VA by discounting environmental issues in bipolar. Stress of military life can cause healthy people to have breakdowns. Military causes healthy people to have PTSD, depression and psychotic breaks. I was in a military mental hospital and there were officers on the ward who had lost their minds in Vietnam and plenty of enlisted as well. One Marine who seemed perfectly normal to me had had a blackout that lasted a week and amnesia. He went AWOL. He was lucky to get the help he needed instead of bad conduct discharge, and/or DX of personality disorder. One other guy and been AWOL for about a year doing crimes. He got lucky and doctors said he was schizophrenic instead of sociopath.

John

[bluevet]

It would help to have the Reasons and Bases Section of the denial too.

Thanks Carlie,

The rationale is on the denial letter that I posted and I also posted the complete direct quote of the rationale from the DBQ.

[63SIERRA]

Have you asked them about genetic testing? It seems to be quite common nowdays.