Mental Evaluation

[Ricky]

Since I have never received a mental evaluation before can anyone please explain what this thing means? I did not request it they just did it during my last visit to Birmingham. This is what it states:

Vet suffers from nightime panic attacks that onset in 2005/ At that time vet learned that his grandaughter was being molested by stepfather (his daughter divorced that man an moved back in with vet and his wife.) seh is still living there with her three children. vet suffered a stroke at that time (service connected) and was anxious acout his own health. Denied Agoraphobia. Attacks occur about 4x/month and are moderate in intensity.

MEMORY; Vet periodically loses things or forgets appointments, but memory is generally intact.

AXIS I: Mood disorder related to a general medical condition; Anxiety disorder. NOS IF ANY ADDITIONAL MENTAL DISORDERS HAVE BEEN DIAGNOSED, EXPLANATION OF HOW THE SYMPTOMS ARE RELATED TO OR ARE PART OF EACH MENTAL DISORDER: Mood disorder: periodic depressed mood; feelings of hopelessness and worthlessness; Anxiety disorder: nightime panic attacks; anxiety possibly contributes to vet's IBS sxs; The two disorders are inter-related and likely affect each other.

AXIS II: NONE

AXIS III: HTN, DMII, NEUROPATHIC PAIN, CVA, SLEEP APNEA, GERD, HYPERCHOLESTEROLEMIA, DEJERINE-ROUSSY SYNDROME LEFT SIDE;

AXIS IV: CHRONIC PAIN

AXIS V: GLOBAL ASSESSMENT OF FUNCTIONING: SCORE 62 - CURRENT FUNCTIONING

Is there is occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks due to mental disorder signs and symptoms, but with generally satisfactory functioning (routine behavior, self-care, and conversation normal)--YES

EXAMPLES AND PERTINENT SYMPTOMS - INSOMIA AND NIGHTTIME PANIC ATTACKS LEAT TO CONSTANT DAYTIME FATIGUE.

WAS A MEDICAL OPINION REQUESTED--NO

Any help with this would be appreciated. I assume it was conducted to determine my claim for sleep apnea but as you can see sleep apnea was only mentioned one time and then the last statement of WAS A MEDICAL OPINION REQUESTED - NO. If this is true why in the heck did they do the exam. Based upon the outcome of the exam should I file a claim for a mental disorder. I work so I do not know if this would be possible.

[Berta]

I dont see IBS as listed under an Axis- at all- is the IBS service connected? if so you can claim anxiety as secondary to the IBS due to this exam-

it looks like the doc used the night-time panic attacks and overlooked the apnea-and attributed this anxiety (panic) to NSC reason-

but then did associate anxiety to the IBS-

What here is part of the 50% SC rating you get?

[Ricky]

Berta - I had a new claim in for IBS due to service in GW1. Along with this I had a new claim in for sleep apnea. The sleep apnea claim was due to sleep problems, daytime sleepniness, snoring, gasping for breath that began durin my service ( 1997-my retirement in 2000). After retirement they continued to treat my "sleep problems" and in 2005 conducted a sleep test which provided that I suffered from moderate to severe sleep apnea and currently treat with CPAP.

So to answer you question IBS is a new claim and is pending. Sleep Apnea is a new claim and pending. On 27 June I hade two C&P exams. One with a general C/P Doc and one with this Physc doc. The general Doc commented on PN and IBS. When I asked him about the Sleep Apnea he said the Physc Doc should have covered that. I told him that she said she "thinks" they want her to comment on IBS. He said nope, IBS was to be covered by him and the sleep problems were to be covered by the Physc doc. Then they sent me home.

What NSC reason do you see that she attached the panic attacks to? The way I read it was that they were connected to a general medical condition which is my CVA and Dejerine-Roussy syndrome, both which are currently service connected. Did I read this wrong?

Thanks a million for your time and advice.

PS: I really wish she had not added to the confusion of the RO. I would have helped if she had issued some type of opinion which explained her diagnosis of what truly caused the anixety then provided that the IBS could be a result of the anixety. The IBS began in 2002........the anixety began in 2005 after my service connected stroke.

Edited July 30, 2007 by Ricky

[john999]

I think I would file a claim for the panic and anxiety as secondary to a general medical condition and same for the chronic pain disorder. I am service connected for chronic pain disorder as part of general medical condition. They will roll it into the panic and anxiety disorder to come up with a overall rating. It looks to me like a 30% type rating for a mental disorder. I would get another doctor to say without doubt that the panic is secondary to some service connected condition. You can't leave any openings for the them to ascribe another cause because they will.

[Ricky]

Thanks John. So you do not think the C/P docs statement of "Mood disorder related to a general medical condition; Anxiety disorder" would do the job? My claim is all spread out. I have in a claim for post stroke depression which is under appeal (form 9). The appeal is based upon they failed to provide ratings for my face, arm/hand and leg/foot and post stroke depression damage due to the cva.

So should I start a new claim for the anixety or try to use this to support my post stroke depression? This is where all of the anxiety is coming from (this and dealing with the VA).

[Ricky]

My other question is WHY WOULD THEY REQUEST A C/P AND NOT ASK FOR AN OPINION FROM THE DOC ON SERVICE CONNECTION? Seems to be a big waste of time to me.

[john999]

I think if you general medical disorder is service connected then any emotional reaction would be service connected also. If you become depressed over your medical condition then you should be service connected for depression.