Emotional Instability Reaction Term

[Josephine]

Emotional Instability Reaction _ code 460 - may not always be a " Personality Disorder"?

[

Citation Nr: 0302710

Decision Date: 02/12/03 Archive Date: 02/19/03

DOCKET NO. 99-19 695 ) DATE

)

)

On appeal from the

Department of Veterans Affairs Regional Office in No. Little

Rock, Arkansas

THE ISSUE

Entitlement to service connection for an anxiety disorder.

REPRESENTATION

Appellant represented by: The American Legion

WITNESSES AT HEARING ON APPEAL

Appellant and spouse

ATTORNEY FOR THE BOARD

J. D. Deane, Associate Counsel

INTRODUCTION

The veteran served on active duty from August 1958 to March

1959.

This case comes before the Board of Veterans' Appeals (Board) from a July 1999 rating decision of the North Little Rock, Arkansas, Regional Office (RO) of the Department of Veterans

Affairs (VA).

The Board remanded the veteran's claim in July 2001 for action consistent with the Veterans Claims Assistance Act of 2000 (VCAA), Pub. L. No. 106-475, 114 Stat. 2096 (2000) (codified as amended at 38 U.S.C.A. § 5100 et seq. (West Supp. 2001)). In August 2002, the Board further developed

the claim, ordering a VA examination to evaluate the veteran's disability.

The veteran had a personal hearing before the undersigned

Member of the Board in May 2001.

FINDINGS OF FACT

1. All evidence requisite for equitable disposition of the veteran's claim for service connection has been obtained and examined, and all due process concerns as to the development

of the claim have been addressed.

2. The veteran has a current anxiety disorder, which was diagnosed as an emotional instability reaction during his military service.

CONCLUSION OF LAW

An anxiety disorder was incurred in active service. 38 U.S.C.A. §§ 1101, 1110 (West 1991 & Supp. 2002); 38 C.F.R. §§ 3.303 (2002).

REASONS AND BASES FOR FINDINGS AND CONCLUSION

Service connection is granted for a disability resulting from an injury suffered or disease contracted while in active duty or for aggravation of a preexisting injury suffered or disease contracted in the line of duty. See 38 U.S.C.A. §§ 1110, 1131 (West 1991 & Supp. 2002); 38 C.F.R. § 3.303

(2002). In general, establishing service connection for a disability requires the existence of a current disability and a relationship or connection between that disability and a disease or injury incurred in service. See 38 U.S.C.A. § 1110 (West 1991 & Supp. 2002); 38 C.F.R. §§ 3.303, 3.304

(2002); Cuevas v. Principi, 3 Vet. App. 542, 548 (1992); Rabideau v. Derwinski, 2 Vet. App. 141, 143 (1992).

I. Entitlement to Service Connection for Anxiety Disorder

The veteran contends that he currently suffers from an anxiety disorder as a result of his active service, and that service connection for his psychiatric disability is appropriate. After a review of the evidence, the Board finds that the record supports his contention, and that service connection for an anxiety disorder is warranted.

Most of the veteran's service medical records are unavailable. The National Personnel Records Center reported that they did not have such records for the veteran, and that they had probably been accidentally destroyed in a 1973 fire at that facility. However, a January 1959 treatment record

states that the veteran complained of chronic anxiety reaction. Another report from January 1959 noted that the veteran was admitted to the hospital in a lethargic state after ingesting an overdose of pills. The February 1959 Medical Evaluation Board report lists a diagnosis of emotional instability reaction including symptoms of lability of emotions, suicidal gesture, lowered tolerance to frustration, difficulty in accepting authority, and somatizations when under stress.

The veteran has also submitted VA outpatient treatment records, statements from his wife, and his own statements to support his claim. VA outpatient records from 1997 to 1999 show treatment for a major depressive order, insomnia, and a history of substance abuse. In the May 2001 hearing

transcript, the veteran as well as his spouse described his symptoms during and after separation from service.

A December 2002 VA examination report lists a diagnosis of anxiety disorder. The examiner noted in his report that the veteran complained of chronic sleep impairment and anxiety during the examination. The examiner also stated that the veteran was casually groomed and cooperative with an anxious mood as well as exhibited limited insight and adequate judgment. No gross memory impairment, hallucinations or delusions were noted in the December 2002 examination report.

The examiner stated that the veteran had received a diagnosis of emotional instability reaction during service, a term that was no longer part of the diagnostic nomenclature. It was noted that the symptoms reported in service appeared to be the same as symptoms described by the veteran in the

examination report. The examiner opined that there appeared to be a nexus between the emotional instability diagnosed in service and the veteran's present symptomatology.

In brief, the record shows that the veteran's current anxiety disorder is related to his period of active service. The opinion contained in the December 2002 VA examination report establishes a link between the veteran's current anxiety disorder and the symptoms diagnosed as an emotional

instability reaction during his active military service. Service medical records reflect that the veteran suffered from an emotional instability reaction while in service. In the December 2002 VA examination report, the examiner specifically stated that the veteran's current disability is

attributable to his period of active military service. The Board finds that the veteran's claim for service connection of an anxiety order must be granted.

II. VCAA

A change in the law, on November 9, 2000, redefined the obligations of VA with respect to the duty to assist and included an enhanced duty to notify the claimant of the information and evidence necessary to substantiate a claim for VA benefits. See Veterans Claims Assistance Act of 2000

(VCAA), 38 U.S.C.A. §§ 5100 et. seq. (West Supp. 2002). Implementing regulations for VCAA have been published. See 38 C.F.R. §§ 3.102, 3.156(a), 3.159 and 3.326(a) (2002).

Except for amendments not applicable, the provisions of the regulations merely implement the VCAA and do not provide any rights other than those provided by the VCAA.

As noted above, the Board remanded this appeal to the RO in July 2001 for action consistent with the VCAA. As this decision of the Board is a complete grant of the benefit sought on appeal - i.e., service connection for an anxiety disorder - the Board concludes that sufficient evidence to

decide the claim has been obtained and that any defect in the notice and development requirements of the VCAA that may exist in this instance would not be prejudicial to the

veteran.

ORDER

Service connection for an anxiety disorder is granted.

MARY GALLAGHER

Member, Board of Veterans' Appeals

IMPORTANT NOTICE: We have attached a VA Form 4597 that tells

you what steps you can take if you disagree with our

decision. We are in the process of updating the form to

reflect changes in the law effective on December 27, 2001.

See the Veterans Education and Benefits Expansion Act of

2001, Pub. L. No. 107-103, 115 Stat. 976 (2001). In the

meanwhile, please note these important

Josephine

[Pete53]

When you file your Appeal with Form 9 you need to answer all the reasons the VARO used to deny point by point. I believe that if you are specific use rational arguments and provide evidence to back you up you will win. The VA is in the box and not you. Once they deny and spell it out they have to justify what they have put on paper and you go on offense and they have to defend their pathetic stupidity.

If the VA was smart and I don't for a second think that they are they would want to preserve their little Kingdom by treating Veterans better. There are not that many Veterans left and we are leaving at the rate of 1800 a day. That means that there will be 6.5 million fewer Vets in 10 years.

[free_spirit_etc]

Pete made some good points on the point by point argument. Build an argument that doesn't leave them wiggle room.

Also and idea for generating more evidence - is to just get someone to diagnose you.

I don't even think they would have to be willing to write any opinion, or provide any nexxus statements.

It seems like you have the nexxus evidence firmly in place.

You have evidence of your pre-service state of functioning.

You have evidence of treatment for anxiety in service.

You have evidence of the drastic change people saw in you after the service.

You have recieved ongoing treatment showing the condition has been chronic.

You have a C&P exam where the doctor clearly states there is no question that you suffer from anxiety - the question was whether it started in service.

(The fact that he made the statement that you diagnosis had not been under question - and the only question to be addressed is whether it was incurred in service - and points out that your treatment records show MUCH earlier treatment than the VA had indicated - . His statement would lead me to believe that they informed him of your diagnosis - did not question it - but asked him to provide an opinion as to it's onset, while also indicating that your treatment didn't start until much later than it did.)

And you have the C&P that says your problems stems from a personality disorder - but also links it to problems back in the service.

So - the battle is not as to whether the problems started in service.

The battle is fighting the personality disorder diagnosis.

So you might want to get diagnosed.

If your local college has a graduate program in psychology - they are ALWAYS looking for people who are willing to let graduate students do psychological testing on them.

You might want to volunteer - and take all the tests - and see what the tests show.

I don't know for sure if you could use any of those as evidence - but they could give you some indication of what a psychological profile might look like with some intensive testing.

Then you might want to schedule yourself for some psychological testing.

Maybe your treating doctor can help with that. Maybe she can refer you to someone who will do some of the tests on you and send her the reports.

Again, I don't think they would have to be willing to write any VA opinions for you (which is what scares so many docs off). You already have the opinions and evidence.

But they can send your doctor REPORTS of TESTS which SHOW what your diagnosis is - using the standard diagnostic tools.

I think this could add strength to your case if you have to appeal.

You have supportive statements and diagnosis.

You have one C&P that lables it as something else.

You have actual psychological testing that shows that the lable is not appropriate ADDED to all your supporting evidence.

If the ONLY thing the VA has to deny you is the diagnosis in the C&P they sent you to AFTER the first C&P was in support of the claim, (and some crap discharge code) and ALL of the other evidence is in support of the claim INCLUDING diagnosis based on psychological testing, (especially if the second C&P did NO testing before giving you a diagnosis that was completely different than the treating doctor or the first C&P) it will be awfully hard for them to wiggle out of that one.

Free

[Josephine]

I have my Statement of the Case here at the computer with me and this is what it says.

October 7, 2004

STATEMENT OF THE CASE

WE have enclosed a Statement of the Case, a summary of the law and evidence concerning your claim. This summary will help you to make the best argument to the BVA on why you think that our decision should be changed.

WHAT YOU NEED TO DO:

To complete your appeal, you must file a formal appeal. We have enclosed a VA From 9, Appeal to the Board of Veterans Appeals, which you may use to complete your appeal. We will gladly explain the form if you have questions.

The benefit you want

The facts in the statement of the Case with which you disagree, and

The errors that you believe we made in applying the law

The Division Review Officer ) DRO) has completed a preliminary review of your file and has determined that, based on the evidence currently of record your claim cannot be granted. THIS IS NOT THE DRO'S FINAL DECISION.

We are sending you this Statement of the Case so that you can better understand your appeal. An examination is being scheduled at the VA Medical Center. The Va Medical Center will notify you about the date and time to report for the examination.

DECISION:

Service connection for chronic anxiety with depression is denied

REASONS AND BASES

The additional service medical records submitted from The National Personnel Records Center and the report form Dr. P dated april 2004, are considered to be both new and material and your claim for service connection for an acquired psychiatric disorder is reopened.

You were seen for a psychiatric consultation in March 1964. You complained about being unhappy with the Navy since boot camp. Assessment was emotional immaturity, dependency, and instability which precluded futher military service. Your post treatment records show that you were diagnosed with anxiety in 1979 ( WHAT A JOKE, THEY WERE SITTING THERE WITH MY MEDICAL RECORDS FROM 1965 TO DATE) Dr. P reported that he reviewed your March 1964 psychiatric consulatations and expressed an opinion that your current anxiety and depresssion began in service.

How do you fill out a Form - 9 on this Statement of the Case?

1. I turned in the " Psychiatric Records from the Archives in March 2004. This was 7 months before this decision was made. You would think that by reading this, that I turned them after this Statement of the Case.

I called the counslors about the Statment of the Case. They said get that form - 9 filled out and back in within 60 days.

I did.

Josephine

Edited August 15, 2007 by Josephine

[free_spirit_etc]

Yep. I think one of the boxes they put themselves in (by trying to box YOU in) was giving you the label Histrionic. It just doesn't match your other evidence whatsoever. So it will be easier to disprove.

If they wanted to attribute your problems to a personality disorder - they should have used the "avoidant" or "anxious" personality disorder. Then it would be much harder for you to argue that the anxiety you feel is "generalized anxiety disorder" which began in the service after some traumatic events, rather than a "anxious personality disorder" - that was always present ready to come out as it was built in to your personality to be so.

Had they given you THAT label - you would have a heck of a time trying to prove that your anxiety is an aquired consition (was caused by something) rather than a "constitutional defect."

But they did NOT give you that label. They gave you the HISTRIONIC label -which doesn't fit the picture created by all your other evidence.

And it is too late for them to change that. They had their chance to give you a personality disorder label that matched your symptoms - to make it really hard for you to fight the aquired vs inborn battle. And they can't go back and decide - "Oh no. She is NOT Histrionic. She is Avoidant / Anxiety Personality Disorder."

It will be MUCH easier for you to prove that you are NOT Histronic, than that your anxiety is not caused by an anxiety related personality disorder.

Histrionic personality disorder would have been back at that church, declaring they were a war hero, insisting on being the ONLY one who could play the organ, throwing a fit that someone else played the organ while they were gone serving their country, set out to turn everyone against the other organ player, dressed to the hilt, trying to seduce half the deacons, etc. etc.

It sounds like what they might have done during the exam was to set you up and take advantage of your anxiety to create an emotional reaction - and then used that emotional reaction (when you felt very unsafe and fearful) as a basis to say you "over-react emotionally."

Based on what you said the nurse shared, they may do that all the time. They might not even know they are doing specifically that. They might think they are saving the world. Doctors can easily do that in psychiatric cases - intentionally or unintentionally set the patient up to display exactly what the doctor is looking for. Thye can push your buttons until you explode in anger, or react emotionally, or wither up inside -- and then see what they expected to see - and THINK they are helping you.

So it is hard to say whether the doctors were working with the VA to deny you - or if the VA just knew which doctor to send you to to get the information they needed to deny the claim.

But again, I think the doctors gave them the wrong label to work with.

Here is some more info - with some diagnostic criteria from the World Health Organization

http://oaks.nvg.org/disorders.html

GENERAL diagnostic criteria for personality disorders that are not attributable to gross brain damage or disease or to another psychiatric disorder, must meet the following criteria in addition to the specific criteria for any personality disorders:

a. Markedly dysharmonious attitudes and behaviour, involving usually several areas of functioning, e.g. affectivity, arousal, impulse control, ways of perceiving and thinking, and style of relating to others;

b. The abnormal behaviour pattern is enduring, of long standing, and not limited to episodes of mental illness;

c. The abnormal behaviour pattern is pervasive and clearly maladaptive to a broad range of personal and social situations;

d. The above manifestations always appear during childhood or adolescence and continue into adulthood;

e. The disorder leads to considerable personal distress but this may only become apparent late in its course;

f. The disorder is usually, but not invariably, associated with significant problems in occupational and social performance.

A deep problem pattern can be manifested in two or more of these areas:

· Cognition: perception and interpretation of self, others and events.

· Affect: the range, intensity, labilit, and appropriateness of emotional response.

· Interpersonal functioning.

· Impulse control.

For different cultures and subcultures it may be necessary to develop specific sets of criteria with regard to social norms, rules and obligations. For diagnosing most of the subtypes listed below, clear evidence is usually required for at least three of the specific items in a clinical description list.

To recap: to qualify as a sign of a personality disorder a long-lasting pattern must be rigid and detected across a broad range of personal and social situations. It must lead to obvious and marked distress or impairment in social, occupational, or other important areas of functioning.

Its start can be traced back at least to adolescence or early adulthood. It is not better accounted for as a manifestation or consequence of another mind-disorder, and is not due to the direct physiological effects of a substance e.g. drug or a general medical condition such as head injury.

A blend of legal issues and psychiatric ones also result in this: People under 18 years old who fit the criteria of a personality disorder are usually not diagnosed with such a disorder, although they may be diagnosed with a related disorder. Antisocial personality disorder cannot be diagnosed in persons under eighteen.

Mainly Personality Disorders

THERE are differences between personality disorders and other mental disorders. For example, the obsessive-compulsive personality disorder (OCPD) is defined differently than the obsessive-compulsive disorder (OCD). In the following you can find personality disorders defined by the concepts that professionals use, with nothing omitted from the central definitions.

Anxious (Avoidant) Personality Disorder

Anxious (Avoidant) Personality Disorder ? WHO F60.6

PERSONALITY disorder chalked out by at least three of the following:

a. Persistent and pervasive feelings of tension and apprehension;

b. Belief that one is socially inept, personally unappealing, or inferior to others;

c. Excessive preoccupation with being criticized or rejected in social situations;

d. Unwillingness to become involved with people unless certain of being liked;

e. Restrictions in lifestyle because of need to have physical security;

f. Avoidance of social or occupational activities that involve significant interpersonal contact because of fear of criticism, disapproval, or rejection.

Associated features may include hypersensitivity to rejection and criticism.

Diagnostic criteria for 301.82 Avoidant (Anxious) Personality Disorder - DSM-IV

Individuals with this Cluster C Personality Disorder are socially inhibited, usually feel inadequate and are overly sensitive to criticism.

A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:

1. Avoids occupational activities that involve significant interpersonal contact, because of fears of criticism, disapproval, or rejection.

2. Is unwilling to get involved with people unless certain of being liked.

3. Shows restraint within intimate relationships because of the fear of being shamed or ridiculed.

4. Is preoccupied with being criticized or rejected in social situations.

5. Is inhibited in new interpersonal situations because of feelings of inadequacy

6. Views self as socially inept, personally unappealing, or inferior to others.

7. Is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing.

Borderline Personality Disorder

Emotionally Unstable (Borderline) Personality Disorder - WHO F60.3

There is a marked tendency to act impulsively without considering the consequences, together with affective instability. The ability to plan ahead may be minimal, and outbursts of intense anger may often lead to violence or "behavioural explosions"; these are easily precipitated when impulsive acts are criticized or thwarted by others.

Two variants of this personality disorder are specified, and both share this general theme of impulsiveness and lack of self-control.

Impulsive type:

The predominant traits are emotional instability and lack of impulse control. Outbursts of violence or threatening behaviour are common, particularly in response to criticism by others.

INCLUDING: explosive and aggressive personality (disorder).

EXCLUDING: dissocial personality disorder.

Borderline type:

Several of the marks of emotional instability are present; in addition, the patient's own self-image, aims, and internal preferences (including sexual) are often unclear or disturbed. There are usually chronic feelings of emptiness. A liability to become involved in intense and unstable relationships may cause repeated emotional crises and may be associated with excessive efforts to avoid abandonment and a series of suicidal threats or acts of self-harm (although these may occur without obvious precipitants).

INCLUDING: - borderline personality (disorder)

Diagnostic criteria for 301.83 Borderline Personality Disorder - DSM-IV

Individuals with this Cluster B Personality Disorder behave impulsively and their relationships, self-image, and emotions are unstable.

A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

1. Frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating conduct covered in Criterion 5.

2. A pattern of unstable and intense interpersonal relationships chalked out by alternating between extremes of idealization and devaluation.

3. Identity disturbance: markedly and persistently unstable self-image or sense of self.

4. Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, Substance Abuse, reckless driving, binge eating). Note: Do not include suicidal or self-mutilating conduct covered in Criterion 5.

5. Recurrent suicidal conduct, gestures, or threats, or self-mutilating conduct.

6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).

7. Chronic feelings of emptiness.

8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).

9. Transient, stress-related paranoid ideation or severe dissociative symptoms.

Histrionic Personality Disorder

Histrionic Personality Disorder - WHO F60.4

Personality disorder chalked out by at least three of the following:

a. Self-dramatization, theatricality, exaggerated expression of emotions;

b. Suggestibility, easily influenced by others or by circumstances;

c. Shallow and labile affectivity;

d. Continual seeking for excitement, appreciation by others, and activities in which the patient is the centre of attention;

e. Inappropriate seductiveness in appearance or behaviour;

f. Over-concern with physical attractiveness.

Associated features may include egocentricity, self-indulgence, continuous longing for appreciation, feelings that are easily hurt, and persistent manipulative behaviour to achieve own needs.

INCLUDING: - hysterical and psychoinfantile personality (disorder)

Diagnostic criteria for 301.50 Histrionic Personality Disorder - DSM-IV

Individuals with this Cluster B Personality Disorder exaggerate their emotions and go to excessive lengths to seek attention.

A pervasive pattern of excessive emotionality and attention seeking, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

1. Is uncomfortable in situations in which he or she is not the center of attention.

2. Interaction with others is often chalked out by inappropriate sexually seductive or provocative conduct.

3. Displays rapidly shifting and shallow expression of emotions.

4. Consistently uses physical appearance to draw attention to self.

5. Has a style of speech that is excessively impressionistic and lacking in detail.

6. Shows self-dramatization, theatricality, and exaggerated expression of emotion.

7. Is suggestible, i.e., easily influenced by others or circumstances.

8. Considers relationships to be more intimate than they actually are.

Posttraumatic Stress Disorder (PTSD)

When an individual who has been exposed to a traumatic event develops anxiety symptoms, reexperiencing of the event, and avoidance of stimuli related to the event lasting more than four weeks, they may be suffering from this Anxiety Disorder.

Diagnostic criteria for 309.81 Posttraumatic Stress Disorder - DSM-IV & DSM-IV-TR

A. The person has been exposed to a traumatic event in which both of the following were present:

1. The person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others.

2. The person's response involved intense fear, helplessness, or horror. Note: In children, this may be expressed instead by disorganized or agitated conduct.

B. The traumatic event is persistently reexperienced in one (or more) of the following ways:

1. Recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Note: In young children, repetitive play may occur in which themes or aspects of the trauma are expressed.

2. Recurrent distressing dreams of the event. Note: In children, there may be frightening dreams without recognizable content.

3. Acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur on awakening or when intoxicated). Note: In young children, trauma-specific reenactment may occur.

4. Intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.

5. Physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.

C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following:

1. Efforts to avoid thoughts, feelings, or conversations associated with the trauma.

2. Efforts to avoid activities, places, or people that arouse recollections of the trauma.

3. Inability to recall an important aspect of the trauma.

4. Markedly diminished interest or participation in significant activities.

5. Feeling of detachment or estrangement from others.

6. Restricted range of affect (e.g., unable to have loving feelings).

7. Sense of a foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span).

D. Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following:

1. Difficulty falling or staying asleep.

2. Irritability or outbursts of anger.

3. Difficulty concentrating.

4. Hypervigilance.

5. Exaggerated startle response.

E. Duration of the disturbance (symptoms in Criteria B, C, and D) is more than one month.

F. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Specify if:

Acute: if duration of symptoms is less than three months

Chronic: if duration of symptoms is three months or more.

Specify if:

With Delayed Onset: if onset of symptoms is at least six months after the stressor.

Also: Acute Stress Disorder, battle fatigue, gross stress reaction, shell shock.

The VA is in the box and not you. Once they deny and spell it out they have to justify what they have put on paper and you go on offense and they have to defend their pathetic stupidity.

.

[Josephine]

Free,

I have to laugh at that darn HISTRIONIC PERSONALITY. I had an asthma attack late Sunday night and had to go to the emergency room with a follow up visit yesterday with Dr. P.

As I waited for him to come back. I sat there thinking about that dumb thing. My blood pressure was 150/ 72.

My heart was beating faster than a freight train and I was thinking " Oh, God, He knows what those two psychiatrist said about me.

To me it is so embarrassing to have that type of label attached to your back.

DR. P is my husband's and my youngest daughters doctor.

I wanted to sit down in the floor and cry.

Thanks so much for the information. I own the DSM IV book and there is nothing in there about emotional instability reaction.

Always,

Josephine

Edited August 15, 2007 by Josephine

[Pete53]

Josephine:

Free has shown you the way. She has really invested a lot of time in providing a road map for Victory.

I want to thank you both for posting cause I know that when you win we will all celebrate.

Thanks to all who posted on this thread cause it shows how the VARO tries to make up Disorders and Diagnosis that is not even in The DSM.

I think that the VARO should be required to DSM Code that they use to deny benefits.

Pete