I Am Concerned...should I Be...

[jecsb4]

Need Some Good Old Fashion Hadit Advice

What triggers a new GAF? Here is my background…Just started using the VAMC in 07.

I have several SC conditions, three of which are 30% each. The one I want to discuss is my SC depression. I’ll spare you the reasons why, but initially my C&P for this was evaluated as a GAF of 60. BTY my Appeal C&P for depression was Feb 07. Does that mean I get one every year?

My award letter (after a NOD) said that “we have determined that your pre existing depression was aggravated on active duty and has permanently worsened….. and 30% is awarded, which is a FULL grant of benefits sought on appeal….”

Hard to understand that if this is a FULL grant then why was I rated at only 30% however this not my main issue…

I do currently hold down a job, but it is getting harder to do. I am loosing my ability to focus, get stuff done, I even call my boss by the wrong name sometimes, etc but I don’t meet the VARO criteria for IU and / or P&T. It is upsetting that I have gone to the VA mental health clinic twice in 07 (separate from my shrink Apts) and only got to talk to the RN. She did try to get me to see my shrink but she was out.

I guess the best word to describe myself and my life is that I am overwhelmed. I really should be fired from my job…..

Well here is my real issue (sorry I rambled)….

Well I see the VA Psychiatric Dr. every 2 - 3 months and a few months ago she referred me to a grief counselor, PhD type.

I talked to this Dr. and said I would TRY to go to a weekly meeting. Well one day while I was in the VA for a med apt, I secured a print out of my apt’s, and this Dr booked me for every session for 3 – months. Basically one day a week for 2 hrs a session (group).

I was upset, because I told her I would try to go to a session and check it out so when I found out I had 15+ Apt’s scheduled for the next three months, I got upset, and I called and cancelled them with the VA mental health clerk. I even left the Dr. a voice mail saying I did so because of work (I was not rude). I called in late Sept or early Oct. She didn’t even call me to tell me she scheduled all of these Apts!

There is no way I could get time off for all of those apt’s unless I was working part time or not working.

Here is were I am concerned….on one of my apt’s lists it said I needed a new GAF. When I asked the PCM / Clerk they could not tell me why I needed it or who ordered it. So all I can think about is that this Dr is doing this on purpose! I just had my C&P for depression in Feb 07 and had a GAF of 60 which at the time I believe was accurate, now I am sure it is worse. I don’t know if this GAF is generated by VARO or VAMC – but I think it is the VAMC.

When I got home tonight there was a VAMC voice mail to call her!! All I can think off is this Dr is trying to mess with me. I have a feeling that she doesn’t have enough people in her group sessions and is out to hurt me because I didn’t even go to one session. I know that this sounds like I am so paranoid, I guess I have gotten that messed up, but reading how so many Vets and family of Vets get messed up I am thinking the worse. Now I have to wait to Mon to call so I have the weekend to keep thinking about this….

Thanks.

[Speaking Out]

I wish I could advise you on your concern, but I can't. I'd like to offer some encouragement though to help get you through the weekend. I to am having to wait over the weekend to follow up on an issue with my VA hospital and I have made a plan of things to do to keep myself busy and have decided that when I start thinking about this VA stuff I am going to write it down and then close my notebook and get back to my list. We can easily drive ourselves crazy by our thoughts of what if and thinking about the worst thing that can happen. Try and stay positive and keep busy and know that we are here if you need to vent. I wish I could be more help, but you are not alone and you are in my thoughts! Lisa

[Rockhound]

I too suffer from depression, Major chronic depression and have been on medication for it for over four years now. If your not on medication for your depression now, you better think of getting some, before you are completely over whelmed by your depression. I know, been their done that. Being on medication can also help raise the level of severity your depression has gotten, you'll have to check the schedule for mental disorders to see where you might be at, disability wise.

If your looking for a new GAF, you'll have to either ask for it directly. but If you want a true GAF, you'll have to act how you feel and not the way you want people to see you. having pride in ones self is commendable, but be realistic. If your dirty and missurable at home, that's the way your psychiatrist should see you.

If your looking to stop work, it would be best if your psychiatrist tells you it is time, and have him back it up in writing.

I don't think your Dr is out to get you, they schedule those appointments in hopes you will continue to go to the sessions. Otherwise they would have to give your slot to someonw else.

The groups we have here are very limited and they fill up fast.

I'm not kidding when I say, if your missurable and dirty at homw, that is the way you should look during your appointments. If you don't comb your hair at home, don't do it make yourself look nice. If you don't brush your teeth, If you don't wash. what ever you don't do at home, don't do it when you go to your appointment.

If you can't get into seeing your Dr/psychiatrist, and your VA Hospital has an emergency room, go their and ask for a social worker, tell them your having problems coping. Tell them your over whelmed. You might even think of a 72 hr commitment so you can just let go, you'll at least get your GAF and you may get some additional test to see where your at mentally wise.

If you got vacation time, use that to get away from work and use the time for a 72 hr commitment. Don't let things just snow ball down the hill on you.

Got to go, I'm sort of ranting myself, got a couple more hours before I can take my meds again. whoppee.

Rockhound

[cowgirl]

jecsb4, sounds like you have a few things going on, you are working and you have medical care from the va. MDD is different for each of us, I tried groups for a while, mostly doing individual appointments now. Even taking a side visit to another va doc in same clinic, no harm, actually sort of fun, considering I believe most counselors or doctors in mental health have personal insights. Ok, thats not a proven, just a fun thought I carry round with me.

If your doc offered greif counseling, well, theres probably a reason. If its a goof, anythings possible, just kindly check in by phone (or fax even!) to clarify why. I too would be a bit overwhelmed with that many appointments scheduled, but would definitely inquire for more details (is lunch included? is this a treatment plan that your doctor and you worked out together?) Myelf, I signed my treatment plan and discussion with my doctor; partnership.

Now, if you have enough of a daily schedule shower, meals, errands, old comedy movies and crossword puzzles to keep you going until you can talk to your doctor next week or so, then so be it. You're probably very good people, trying to do best as you can. So, eat regularly, do your chores if ya can and keep good notes for your doc. Oh, and regards those telephone calls, I'd think, be honest, if you dont want phone calls at certain times of day, you can say that, I mean the evenings are yours arent they? Rarely I answer phone while eating dinner, I mean, I'd probably choke and the husband/kids wouldnt like that!

My C-file showed the dates I did show for group, some summary of my interactions, so that was good for the times I was able to attend. Proud me, I participated enough, showed balanced emotions and discussed difficulty attending the meetings during working hours. So, I'm back to occasional visits and discussions that keep my life comfortable. Guess I wouldnt mind a group eventually, if it fit my expansive mdd profile. ptsd mst greif trauma.

Not sure of my current gaf, but will check soon, i'm curious myelsf. Some days for me are better worse than others, personally, just telling the truth is important, I dont havta look good/bad; sometimes I wear earrings tho!

Best to ya, cg

[sixthscents]

I go to individual psychotherapy, and yeah I am rated 30% for depression...

Personally I'd like to address a couple of things mentioned below. I have always presented myself in a neat and orderly manner. When I go somewhere I make a special effort to be presentable, be it the grocery store or the doctor. Doctors can form a clear impression with you doing what you would normally do...

Now I need assistance in dressing, and I dont go to the grocery store anymore... but I still appear well groomed and presentable, and I have NEVER had my GAF raised because of it. I think that probably Rockhound is correct and they are just trying to get you into treatment. I kinda disagee with him on another issue but hes probably right there. Personally if the VA says we want you to do so-and-so, I do. I dont think the individual psychotherapy is doing much good, but neither is it doing harm, and I feel that since I am taking their money, I should accept their treatment (within reason of course). Now thats NOT saying you should - do what you feel is right for you but dont get too panicked about this. Honestly they do new GAFs all the time, quick ones anyway, and sometimes they do full ones (I've had several)... and most likely they will not change your rating.

Even if it does raise your GAF (doubtful) that probably would not affect your rating - since the NEXT GAF is just as liable to go back down. Like I said dont stress it - just talk to the lady and see if the counciling would POSSIBLY be of benefit. If you think so, do it, if not politely decline.

I will say its a hassle going to it every couple weeks, and my main Psych appointment every month - since I no longer drive my baby-sitter has to take me etc. but if it could help I am willing to try it.

I remember once on the board we had someone reccomend screaming at your doctor and going in to see them in pajamas covered in food and stuff....

I'll say now what I said then... present yourself as you would normally going out... (isn't that the real picture anyway). Doctors can see thru stuff like that, and it wont help your rating... IN MY OPINION. Plus take your significant other if possible to your first meeting... They generally know more about how you act than you do.

[Pete53]

I think that almost all the shrinks at the VA give you a new GAF every time they see you. Yes its a medical miracle how much they get done in a 10 minute visit that they usually spend writing prescriptions.

The fact that you are working is not going to help you much as far as getting a higher rating. Raising you current 30% to 50% will probably keep your total VA Math rating at 80%. Best it could do would be to raise you to 90% which is pretty good.

Good Luck to you.