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

[mountain tyme]

Good Morning Bill,

let me look into what parts would be a good refernance and will post later today.

MT

[free_spirit_etc]

I know the feeling of not wanting to ask right now. It is hard enough to take on all the red-tape - but then when you add in many people filing claims are depressed, very ill, recently widowed - it complicates the whole thing.

The letters might make your claim stronger. But your doctor statements already make it strong.

It is sad that the system is such that you feel like you have to prove 105 out of 100 things - because if you only prove 99 out of 100, the VA might focus on the one not proved.

And I am sure they don't always do that.

Actually, I would think the case is much stronger having the doctor statements and no buddy statements than if you had the buddy statements and no doctor statements. Doctor statements are needed. Buddy statements can be extra.

I would say 22 jobs in 20 years is already a sign that you had a bit of trouble maintaining "employment." And you were very resourceful to have started your own business and make that work for you for as long as you did.

So even that would seem to work in your favor. You tried working and tried working and tried working - and finally started a business that worked for you - and did that as long as you could. And now - you can't even do that.

I wish you much luck - and I think you have an excellent claim for increase and proving unemployability.

Free

MT, you sent me a link, very helpful. Yet another question, would you use any info from this link to perhaps help my case or would you just send the two dr reports? I have asked family and friends and right now I’m just a little hesitant to ask, I don’t know why but I am. I like this net; I like everyone I talk with. (keyboard to keyboard)

Free, you asked what kind of work did I do, the first 20 years out of the service I had 22 jobs. One time I had a boss giving me a bunch of crap and I told him boss spelled backwards is just a double SOB. Needless to say he fired me. It took a long time but I started my own janitorial business. I kept the offices clean and got no crap. I didn’t have to deal with people and that was just fine, but I finally had it and gave the business to my son.

I will send both reports, thanks bill

[mountain tyme]

Hi Bill,

I have been milling over the question weather to note parts of the Manual for MDD…and I feel that I would steer clear of that…the Manual is used by the VA to diagnosis MDD and there criteria of testing. In your case you have already been diagnosised with MDD and at this point you are seeking an increase in rating…what you need to do is look at what the criteria for 50% vs. 70% to determine why you meet the 70% over the 50% at this point I would say your doctor statements have met that criteria for you.

If you do not want to ask someone to write a letter of support…you can write a letter yourself…There are area’s that you need to bring out such as how your medication effects you in regards to side effects…since I do not know what medication you take I went ahead a found this information for you to read…if any of it pertains to you then write it down and submit it.

Different medications produce different side effects, and people differ in the type and severity of side effect they experience. About 50 percent of people who take antidepressant medications experience some side effects, particularly during the first weeks of treatment. Side effects that are particularly bothersome can often be treated by changing the dose of the medication, switching to a different medication, or treating the side effect directly with additional medications. Rarely, serious side effects such as fainting, heart problems, or seizure may occur, but they are almost always treatable.

• Tricyclic antidepressants (TCAs) cause side effects that include dry mouth, constipation, bladder problems, sexual problems, blurred vision, dizziness, drowsiness, skin rash, and weight gain or loss.

• Monoamine oxidase inhibitors (MAOIs). Individuals taking MAOIs may have to be careful about eating certain smoked, fermented, or pickled foods, drinking certain beverages, or taking some medications because they can cause severe high blood pressure in combination with the medication. A range of other, less serious side effects occur including weight gain, constipation, dry mouth, dizziness, headache, drowsiness, insomnia, and sexual side effects (problems with arousal or satisfaction).

• SSRIs, and SNRIs tend to have fewer and different side effects, such as nausea, nervousness, insomnia, diarrhea, rash, agitation, or sexual side effects (problems with arousal or orgasm).

• Bupropion generally causes fewer common side effects than TCAs and MAOIs. Its side effects include restlessness, insomnia, headache or a worsening of preexisting migraine conditions, tremor, dry mouth, agitation, confusion, rapid heartbeat, dizziness, nausea, constipation, menstrual complaints, and rash.

Remember for people dealing with MDD, negative feelings linger, intensify and often become more debilitating over time. In the workplace, depression is a leading cause of absenteeism and diminished productivity due to mood swings…which can cause a hostile environments at times leading to dismissal.

SO I would make a time line of all the jobs you held in the last 20 years and why you were dismissed from that employment …don’t be shy about the reason why…get very detailed!!!! Esp. if it involved the inability to get along with co-workers, not showing up to work, angry or aggressive behavior.

Then You will need to address how MDD has effected your social and family life…

Remember Bill depression is a lifetime illness…depression extends beyond and sometimes between episodes which can impact one’s life severely and can become very debilitating causing one’s coping mechanisms to break down resulting in long standing recurrent depression causing serious family, marital, social and occupational problems.

I hope this helps…

God Speed Bill

MT

[mountain tyme]

Hi Bill...forgot to add the VA criteria for rating percentages for Mental health disorders..

General Rating Formula for Mental Disorders:

Total occupational and social impairment, due to such symptoms as:

gross impairment in thought processes or communication;

persistent delusions or hallucinations; grossly inappropriate

behavior; persistent danger of hurting self or others; intermittent

inability to perform activities of daily living (including maintenance

of minimal personal hygiene); disorientation to time or place; memory

loss for names of close relatives, own occupation, or own name ….100

Occupational and social impairment, with deficiencies in most areas,

such as work, school, family relations, judgment, thinking, or mood,

due to such symptoms as: suicidal ideation; obsessional rituals

which interfere with routine activities; speech intermittently illogical,obscure, or irrelevant; near-continuous panic or depression affectingthe ability to function independently, appropriately and effectively;impaired impulse control (such as unprovoked irritability with periodsof violence); spatial disorientation; neglect of personal appearance andhygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships…………….70

Occupational and social impairment with reduced reliability and

productivity due to such symptoms as: flattened affect; circumstantial,

circumlocutory, or stereotyped speech; panic attacks more than once

a week; difficulty in understanding complex commands; impairment

of short- and long-term memory (e.g., retention of only highly learned

material, forgetting to complete tasks); impaired judgment; impaired

abstract thinking; disturbances of motivation and mood; difficulty in

establishing and maintaining effective work and social relationships …..50

Occupational and social impairment with occasional decrease in work

efficiency and intermittent periods of inability to perform occupational

tasks (although generally functioning satisfactorily, with routine

behavior, self-care, and conversation normal), due to such symptoms

as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or

less often), chronic sleep impairment, mild memory loss (such as

forgetting names, directions, recent events) …….30

Occupational and social impairment due to mild or transient symptoms

which decrease work efficiency and ability to perform occupational

tasks only during periods of significant stress, or; symptoms controlled

by continuous medication…….10

A mental condition has been formally diagnosed, but symptoms are not

severe enough either to interfere with occupational and social

functioning or to require continuous medication…..0

[Billyboy]

I did take Prozac (Fluoxetine), Sertraline HCL and on Citalopram. I did have side affects and did complain to my MD and both shrinks. In the records I complained of irritability, trouble sleeping, weakness, tiredness, involuntary muscle movement, drowsiness, suicidal thoughts, nausea, anxiety, and decreased interest in sex. Not all on the same drug. These have all been recorded in my records. I put this list together and sent it to the VA as New Evidence. I did put a list of all the jobs I had including the night work. You’ve really been a BIG help; I can't begin to thank you and the rest of the group enough. I'll be working on this and get it off to the VA soon. Thank very much, bill

[robert51]

Hi Bill...forgot to add the VA criteria for rating percentages for Mental health disorders..

General Rating Formula for Mental Disorders:

Total occupational and social impairment, due to such symptoms as:

gross impairment in thought processes or communication;

persistent delusions or hallucinations; grossly inappropriate

behavior; persistent danger of hurting self or others; intermittent

inability to perform activities of daily living (including maintenance

of minimal personal hygiene); disorientation to time or place; memory

loss for names of close relatives, own occupation, or own name ….100

Occupational and social impairment, with deficiencies in most areas,

such as work, school, family relations, judgment, thinking, or mood,

due to such symptoms as: suicidal ideation; obsessional rituals

which interfere with routine activities; speech intermittently illogical,obscure, or irrelevant; near-continuous panic or depression affectingthe ability to function independently, appropriately and effectively;impaired impulse control (such as unprovoked irritability with periodsof violence); spatial disorientation; neglect of personal appearance andhygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships…………….70

Occupational and social impairment with reduced reliability and

productivity due to such symptoms as: flattened affect; circumstantial,

circumlocutory, or stereotyped speech; panic attacks more than once

a week; difficulty in understanding complex commands; impairment

of short- and long-term memory (e.g., retention of only highly learned

material, forgetting to complete tasks); impaired judgment; impaired

abstract thinking; disturbances of motivation and mood; difficulty in

establishing and maintaining effective work and social relationships …..50

Occupational and social impairment with occasional decrease in work

efficiency and intermittent periods of inability to perform occupational

tasks (although generally functioning satisfactorily, with routine

behavior, self-care, and conversation normal), due to such symptoms

as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or

less often), chronic sleep impairment, mild memory loss (such as

forgetting names, directions, recent events) …….30

Occupational and social impairment due to mild or transient symptoms

which decrease work efficiency and ability to perform occupational

tasks only during periods of significant stress, or; symptoms controlled

by continuous medication…….10

A mental condition has been formally diagnosed, but symptoms are not

severe enough either to interfere with occupational and social

functioning or to require continuous medication…..0

i wonder why they skip 80 and 90% seems very few if any fall into 100 and by not allowing a 100% solid the vet needs IU and now they seems to be attacking the IU .... leaving themselves a way to screw the vet with PTSD as this alone he can never get 100% without IU and therefore a whole class of disabilitys would not get chapter 35 ... free insurance

i think if you read 70$ this should be 100% rate

Edited September 3, 2007 by robert51