hypertension Question

[Billyboy]

I am seeing a Psychiatrist and a Psychologist. I have an open claim for 50% working on TD. The Psychiatrist wrote "Mr. ******** has been under my care for long history of mood disorder and has been complaint with his treatment. He has been suffering from depression and anxiety in addition to his physical condition related to chronic back pain, neck pain, fibromyalgia, arthritis and hypertension. He seems to be unable to hold any gainful employment.

Signed, Staff Psychiatrist. I did not use this because you all said the VA would deny because she add back, neck pain which I am not connected for. The Psychologist told me I should be 70 or maybe 100% disabled. I asked for a letter stating this and he told since i had an open claim for TD he could not write such a letter? "It would be inproper"? What say ye all. bill

[Josephine]

He has been suffering from depression and anxiety in addition to his physical condition related to chronic back pain, neck pain, fibromyalgia, arthritis and hypertension. He seems to be unable to hold any gainful employment.

Billyboy,

I read that your psychiatrist states in addition to. I don't read that he is stating that your other illness, which are not service connected are causing the depression and anxiety.

This is my take on this.

Let's see how the others read this, but I would think that this report should be turned in.

Josephine

[sixthscents]

I would file the claim, and state provide clinical refrences to depression linked to chronic pain. There are numerous studies which show that most people who suffer from chronic pain, also suffer from depression/mood disorders due to the pain. These same studies show that in the absence of pain, these symptoms of depression normally abate.

I'd file it based upon the link between chronic pain, which you do have an injury which causes it that seems to be service connected already or is pending. I wouldn't try to get the Psych to say anything else, they normally refuse. However you can ask him if he believes that there is a causation or link between you service connected injuries and you chronic pain from these already service connected injuries. Simply put ask him what he believes is CAUSING your mood disoreder, and ask him to annotate it into his notes.

Either way I'd file the claim.

[Ricky]

Don't they normally indicate this in the axis? Most that I have seen indicate in axis one - mood disorder/anxiety NOS due to general medical condition

Then in axis four (I think it is four) they list your general medical conditions ie back problem, chronic pain, hypertension, etc......

I do not really know for sure but like I said the mental evals that I have seen look something like the above. Now to me that would indicate that mental condition is due to the conditions listed in axis four. However, if some of them are NSC I guess the rater might question what amount each contributes to the mental diagnosis.

This is really a question in answer to the original question I guess. Sorry maybe Bob or one of the others can clarify my confusing post hahshahaha......

[Billyboy]

I am 50% MDD, 10% Tinnitus and 0% loss of hearing = 60%

"The Psychologist told me I should be 70 or maybe 100% disabled. I asked for a letter stating this and he told since i had an open claim for TD he could not write such a letter"? "It would be inproper"?

Can you tell my why the shrink does NOT want to write a letter for me? Is it something that is not done while you have an open case? bill

[cloudcroft]

It may be due to what lots of vets encounter in the VA system: One VA doctor does not care to go against/contradict what some other VA doctor says...you know, stepping on a fellow doctor's toes as it were.

IMO, it has nothing to do with a case being "open" because if it did, then how could a vet send in any more/new evidence during an open claims case if it weren't allowed? You need to send whatever helpful evidence comes up during the claims process whenever you get it...and you can...there's no regulation preventing that. And a case that is "closed" means a decision has been made...so how is your new evidence -- in this case a statement from the Ph.D. -- going to help you THEN when you had it to submit BEFORE the decision was made but couldn't because the case was "open"? It doesn't make any sense.

I think it's simply because the VA Psychologist does not want to make waves with the VA Psychiatrist. It would be "improper" only in the sense that "in-house rules" are not to cause discord within the "team" so they tend to cover each other.

AFAIK, there is no legal reason why one VA doctor can't contradict another VA doctor...it's probably the peer pressure thing going on. It would take some guts for a doctor to buck the system, too, and I think few VA docs probably have that. So they just don't want to rock the boat.

JMO,

-- John D.

Edited August 28, 2007 by cloudcroft

[free_spirit_etc]

I am with Josephine on this one. If you have SC for the OTHER conditions - or SOME of them - they shouldn't be able to deny secondary just because the psychologist also mentioned back and neck (which are not SC).

I think it would be close to impossible to separate out how much of your depression and anxiety is related to your SC conditions and how much is related to you NON Sc conditions - therefore they would have to attribute the whole amount to the SC conditions.

IF you had very minor SC conditions and a HORRID back condition - that would be different.

I think it is horrid that the VA has a system in which a vet is afraid to submit supporting evidence because of one line that the VA might take out of context. However, that IS the way it is - so you were wise to check it out before sending it.

The veteran benefits manual suggests vets get copies of their own records and only send in the ones that support the claim. You are NOT REQUIRED to send evidence which does NOT support your claim.

But again - it is a poor system when a vet has to fear sending a very favorable statement because the VA can have a tendency to pull a tiny part out of the statement and quote it out of context.

Free

He has been suffering from depression and anxiety in addition to his physical condition related to chronic back pain, neck pain, fibromyalgia, arthritis and hypertension. He seems to be unable to hold any gainful employment.

Billyboy,

I read that your psychiatrist states in addition to. I don't read that he is stating that your other illness, which are not service connected are causing the depression and anxiety.

This is my take on this.

Let's see how the others read this, but I would think that this report should be turned in.

Josephine