Depression Secondary To Service Connected Disability

[bern381]

Last summer I was rejected on a claim for depression secondary to service connected shoulder problems. The examiner stated that my condition could have precipitated depression. The VA said that this language was too speculative and denied my claim as a result of this. I have filed a notice of disagreement and submitted the following evidence and personal opinions to substantiate my claim. What do you think my chance are of winning? Thanks, Bern

· Progress Notes (dated May 16, 2007) which state, “ Client’s depression has continually increased since experiencing pain in left shoulder and limitations related to limited range of motion and not being able to manage all aspects of his assisted daily living.” This note clearly shows that the chronic pain and accompanying limitation of motion that I am experiencing preceded and caused depression.

· Progress Notes (dated November 20, 2007) which state, “ The veteran presents symptoms of depression, which by history is related and caused by chronic pain, which is likely true, will change the diagnosis to reflect this: adjustment disorder with depressed mood, chronic related to pain.” This statement clearly refutes the July 2007 opinion of the VA examiner because it eliminates speculative language and proposes a direct cause. The statement shows that the pain I am experiencing is a result of my service connected disabilities and it preceded/caused the depression I am experiencing.

[Jim MAC]

Bern

I am no expert there are a lot of people on this board are better then me at this but I think you schould win. But then again we are talking about the VA here. The VA motto is delay, delay another 1,000 vets will die today.

Jim

[bern381]

Thanks for the reply, I know how it is to fight denials. I was hoping that this language would refute their claim of speculative language.

[rentalguy1]

You need to straight up ask your VA psych counseler to put the following in your progress notes asap: "the veteran's current depression disorder is at least as likely as not related to his service connected chronic shoulder pain."

It would be even better if they would state "more likely than not related to..." and they might, if you ask. The problem you are going to run into, I am afraid, is that the first note states that you have chronic pain and a limited ROM, and that your depression has increased because of it, but it doesn't say that it was caused by it. Moreover, it doesn't make a clear etiology to your service connected problem. The second statement states that it is "likely" true that the depression is related to chronic pain. The "likely" is a bit ambigious in VA standards, and it doesn't state which chronic pain. I know it's obvious to you and I and the couselor, but you have to look at it from the rater's state of mind, where 2+2 doesn't always equal 4. Try to get the statement that I put above in your records. That would be an almost 100% chance of a win then. Good luck...

[john999]

I agree with Rentalguy. You don't want an opinion or medical notes that leave any room for the VA to wriggle around and come up with alternative NSC causes for your depression. Every doctor worth his salt knows chronic pain and disability can cause depression, but with the VA you have to set it in stone. For instance, for any secondary condition except a very few you must have a medical opinion that states, as Rentalguy says, the secondary condition is at least as likely as not caused or aggravated by the primary SC condition. They deny even the most obvious secondary disabilities for DMII and other systemic conditions without a nexus statement.

[Pete53]

Any chronic medical condition that affects the quality of your life is likely to trigger depression.It should not be to hard to get a Doc to spell it out for you.

Good Luck

[LarryJ]

or, as an alternative, if they will not say that ALL of your depression was/is caused by your shoulder problem/pain such as in their statement “ Client’s depression has continually increased (see, herein lies a problem seeing as how they do NOT say that your service caused your depression, only that it has "continually increased") since experiencing pain in left shoulder and limitations related to limited range of motion and not being able to manage all aspects of his assisted daily living.”

Then what you need to do is file for AGGRAVATION of a pre-existing condition....and, seeing as how they can't quantify the degree of disability that pre-existed, then they will have to rate it as if NO disability existed prior to service. All this is assuming that they DO deny DIRECT service connection, which you won't know whether they did or not until you receive their decision.

Just another avenue that you can explore if and when you find that you need to.