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Berta & Others...i Got The Drs Note From The Va Clinic


Cherie33

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Ok Berta,

Here is what my dr. wrote in my record.

quote "****I strongly feel that, more likely than not, this pt is unemployable (totally + permanently) due to her psychiatric condition which has only worsen in time, + I suspect her chronic psychotic condition will be re-diagnosed from major depression with psychotic features to schizoaffective disorder****" unquote.

So, what do you think? I will submit this along with the letter that I received from the Vocah Rehab...Will I still need a C & P exam?

Thanks,

Cherie33

Edited by Cherie33
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as long as the psychiatric condition the doctor means is what you get SC for now- that should be fine-

Did the doctor make a nexus statement to your service?

I am a little surprised at the new diagnosis suggested-

I hope that part does not hinder the claim- did the doctor give a full complete medical rationale for his opinion?

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As long as the psychiatric condition the doctor means is what you get SC for now- that should be fine

I am a little surprised at the new diagnosis raised in the opinion and hope this doesn't hurt the TDIU claim but it really shouldn't.I just hope VA understands that part.

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  • HadIt.com Elder

Should work but I would follow up to get a perm diagnosis.

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as long as the psychiatric condition the doctor means is what you get SC for now- that should be fine-

Did the doctor make a nexus statement to your service?

I am a little surprised at the new diagnosis suggested-

I hope that part does not hinder the claim- did the doctor give a full complete medical rationale for his opinion?

Yes, that is what I am SC for now. Now back when I was trying to get an increase for major depression, he wrote another letter, and mentioned the schizoaffective disorder. Allow me to quote: "I feel that she is deserving of an increased SC rating for >50% as I suspect she has developed a chronic psychotic process independent of her depression, more consistent with schizoaffective disorder, and will probably never be able to work again. unquote. He wrote this letter on Oct 06.

Now, he only said what I wrote. He didn't elaborate on it. What do you mean ny nexus statement?

Cherie33

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It's all lumped under the same category, so as long as you are already rated for major depression you should be fine (nexus isn't an issue there).

However, that is a fairly lackluster evaluation from a medical standpoint and you may need a more detailed write-up in order to further develop the claim for an increase. A GAF + full eval + symptomology + prognosis would help...in other words, make him/her elaborate on the eval in better detail and you'll be fine. Also, make sure he clarifies the schizo stuff.....just saying "I think it may lead to a schizo diagnosis" will not fly imo; he is the doctor and he should definitively diagnose you one way or another.

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I agree with Jay: It doesn't matter what the diagnosis is for rating purposes when it comes to mental disabilities. IIRC, they all have the same etiology: The mind, and so they -- if you have multiple mental issues -- can't be rated separately...that would be pyramiding.

Unlike physical disabilities, all the mental disabilities are "lumped together" and only the most disabling mental diagnosis is stated along with the % given for it.

For TREATMENT, however, of course it matters because you need to be treated for exactly what you have, not for something you do not have. But for RATING purposes, vets should not be too concerned about what they are rated FOR re: their mental disability (disabilities).

Although I think the VA should be more precise in this -- assign the proper mental diagnosis right up front -- they aren't so that's just how it's done presently. And to be honest, with two (or more) shrinks often giving two different diagnoses of the same veteran, maybe it's just not possible to be 100% accurate anyway. Far from it.

In fact, we all know pinpoint accuracy really isn't possible when it comes to psychiatry.

-- John D.

Edited by cloudcroft
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I agree with Jay: It doesn't matter what the diagnosis is for rating purposes when it comes to mental disabilities. IIRC, they all have the same etiology: The mind, and so they -- if you have multiple mental issues -- can't be rated separately...that would be pyramiding.

Unlike physical disabilities, all the mental disabilities are "lumped together" and only the most disabling mental diagnosis is stated along with the % given for it.

For TREATMENT, however, of course it matters because you need to be treated for exactly what you have, not for something you do not have. But for RATING purposes, vets should not be too concerned about what they are rated FOR re: their mental disability (disabilities).

Although I think the VA should be more precise in this -- assign the proper mental diagnosis right up front -- they aren't so that's just how it's done presently. And to be honest, with two (or more) shrinks often giving two different diagnoses of the same veteran, maybe it's just not possible to be 100% accurate anyway. Far from it.

Alrighty then...I am 50% Major Depressive Order and 30% Irritable Bowel Syndrome = 70% total. So, basically I have been diagnosed with 2 separate problems, which relates to 2 separate body systems. So, I should be good to go with filing for TDIU. Right?

Thanks Everyone for all of your help. Its wonderful to be able to talk with others that have "Been There" "Done That".

Cherie33

In fact, we all know pinpoint accuracy really isn't possible when it comes to psychiatry.

-- John D.

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Alrighty then...I am 50% Major Depressive Order and 30% Irritable Bowel Syndrome = 70% total. So, basically I have been diagnosed with 2 separate problems, which relates to 2 separate body systems. So, I should be good to go with filing for TDIU. Right?

Thanks Everyone for all of your help. Its wonderful to be able to talk with others that have "Been There" "Done That".

Cherie33

It really doesn't matter which, or how many, disorders you have when filing for TDIU as long as you can prove that any, or all, of them prohibit you from seeking gainful employment. BTW, if your psych thinks your mental disorders are sufficient enough to make you unable to work I would seek a schedular increase for the major depression while you're at it......in my opinion, you should be at least 70% based on what you've written.

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I'd be concerned with the insertion of the word "independent" in his sentence:

"... as I suspect she has developed a chronic psychotic process independent of her depression..."

By definition, independent could well be interpreted to mean that it does not have anything to do w/ your sc md. I'm w/ the other poster who said the doc should be able to make a diagnosis not gander a guess based on suspicion (which the VA could use against you).

I'd ask the VA doc to clarify, get a copy of it, and get an IMO either way. If the VA doc says it's all sc, then hunky dory, an IMO won't hurt, but if the VA doc isn't clear then an IMO can give you a claim for reasonable doubt.

Good luck and keep us posted,

TS

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  • HadIt.com Elder

TS good thoughts on interpeting a Psych Dr statement. Have seen odd diagnosis type statements with words like "suspect" and "probable" or "possible". My thoughts, trained professionals "may" use these words as cautious insurance. My recent SC claim had this type of Dr. statement, odd type diagnosis supported with sentences of current DSM IV content. It worked.

Although I see "mental disabilities" comingled, I too feel treatment and recognition for a specific correct issue is important. In my thoughts, I prefer to see a "specific issue" I applied for recognized, treated and compensated for. In reality, I have to recognize time and effort towards gains achieved sideline my "specificity" desire. Could be I am thankful to get some care, better than none, along with hard earned compensation. Have a g'day mates! cg

Edited by cowgirl
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