cwk05

Anyone have any input on the Psoriasis Exam.

GAF: 60 See Doctor once a month.

I just received copies of my C&P Exam results in the mail and would like some feedback. I currently have two pending claims. One for entitlement to service connection for anxiety disorder secondary to the psoriasis and the second for an increased rating for psoriasis currently evaluated at 30%. 1st Exam: Mental Disorder Exam Results Diagnosis #1: Anxiety Disorder, with Generalized Anxiety, due to residuals of psoriasis. Diagnosis #2: Mood disorder, with depressive features, due to residuals of psoriasis. Medical History: Patient has been in psychiatric treatment with a civilian psychiatrist since May 20, 2007. He has been treating him for OCD and GAD. In a letter dated 1/24/2011, his psychiatrist indicates that the patient's symptoms of anxiety and depression have increased due to his psoriasis which covers a large part of his body. "The itchiness causes sleep deprivation, which amplifies the frequency and severity of his anxiety and depression." He also reports that it affects his ability to teach because he loses concentration. He is irritable and unapproachable to his students. He is embarrassed about how he looks and does not participate in many activities. His psychiatrist also indicates the patient is having panic attacks at home and work. He is treating the patient with Zoloft 100 mg qd and Ativan 1mg prn. In today's exam the patient reported that his doctor recently increased his Zoloft to 125 mg qd and increased his prn dos of Ativan to 2 mg. The patients psoriasis is affecting every aspect of his life from work, to family, to friends and leisure activities. Symptoms: Level I: Depressed Mood, Anxiety, Chronic sleep impairment. (Not sure why he did not check off Panic Attacks that occur weekly or less often?) Level II: Disturbances of motivation and mood. Level III: None Level IV: None Other Symptoms: The patient has symptoms of feeling self conscious about his psoriasis. He is embarrassed when his skin starts bleeding. Once he has a flare up he gets very anxious, irritable, and depressed. Occupational and social impairment Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with normal routine behavior, self-care and conversation. Current global assessment of functioning (GAF) score: 60 QUESTION #1: Any idea what percentage I might qualify for, if any, based on this examination? I've been seeing a private psychiatrist for 3 years regarding the anxiety created by the psoriasis. All records were sent in to RO. I see him once a month. 2nd Exam: Increase in service connection for psoriasis Physical Exam: multiple scattered erethymatous scaling plaques and lesions on scalp, front and back of ears, right bridge of nose, all 4 extremities, both axilla, groin, buttocks, some nail involvement is noted as well in feet.Exacerbation of skin symptoms has caused increased anxiety as his is a teacher and cannot conceal facial, ear lesions.10% of exposed head and neck and hands affected 50-60% of body affected. My VA Derm. stated an increase to more than 50% over the last year. QUESTION #2: Would I qualify for an increase from 30% to 60%? Thanks for any feedback