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.

[bern381]

The DRO review has recently denied my claim of depression secondary to service connected shoulder pain. The basis for this denial appears as follows:

The above cited report of the VA psychiatric examination from the VAMC in Cleveland was reviewed and considered. The VA examiner again reviewed your claim folder and medical chart and conducted another clinical interview and examination. The examiner noted that throughout the examiniation that you focused on chronic pain as the source of your depressive symptoms although you did not appear to be in distress during the interview. The examiner also noted that you have been enrolled in the VA pain clinic and per assessment notes, you displayed a passive approach to treatment and were focused on being found permanently and totally disabled rather than on pain management. In conclusion, the VA examiner that it is not clear what the basis of your depression is and that, while there is some relation to chronic pain, your depressive symptoms are more consistent with a dysthmic disorder that is more characterlogical in nature. The examiner noted that your pain clinic notes that your shoulder pain should not limit your ability to work and that you have been focused on being disabled rather than recovering. The examiner concludes that while some of your depression appears to be secondary to chronic pain, some of it is charaterlogical and has its roots in your personality make-up. It is impossible to assign percentages to each of these sources of depressive symptoms, but it would be helpful to see how well you respond to treatment recommendations from the pain clinic. In short, the examiner indicates that a diagnosis of depressive disorder not otherwise specified and does not attribute this disorder to your service connected shoulder pain. As the medical evidence fails to establish a secondary relationship of your depressive symptoms to service connected disability, service connection must remain denied.

How does one rebutt an out and out lie - I never mentioned nor do I want to be declared permanently and totally disabled. Also, I have never reported that I did not think I could work.

The person who prepared this report and the person who examined me have both stated that my pain at least to some extent causes my depression. Now, however, their focus is on depression as part of my personality make-up. Should I or could I claim that the pain at the very least aggravates or increases the depression. If I changed the basis of my claim in this way would my calendar start over again as far as the date of the claim?

Last but not least, the C & P examiner described my DSM 4 as follows:

axis 1 depression

axis 2 passive dependant traits

axis 3 referred to appropriate specialist

axis 4 problems coping with pain

axis

[bern381]

axis 5 gaf 55

I was researching the dsm4 and it appears that axis 4 refers to things that that contribute to the disorder. Should I use this in my appeal? Any and all comments are appreciated. Thanks for your input.

[Pete53]

You need a Independent Medical Examination aimed at refuting the C&P. In my opinion it is the only way that you can win this one.

[john999]

Yes, the only way to win over this kind of slander is to get your own medical opinions to rebut it. These jerks can say anything and if you don't have a medical opinion of your own to overrule them they will go with the lying evidence and deny you. The VA said one time that since I had a degree in psychology that was evidence of fraud in my mental claim. It is such an outlandish lie that all you can do is get an opinion to shoot it down. It is the fastest way to deal with it, otherwise you may win another C&P exam on appeal and they will shaft you again just to teach you a lesson.

[Maurice]

Hi Dale, The highest for the lbp is 40%

[broncovet]

I agree with Pete. Veterans who were not depressed before they went to the Va will be depressed when they find out how long it takes to get their claim processed. It is also very depressing to know that the VA spends billions fighting against Veterans trying to deny him benefits. If I recall, the Office of General Counsel has something like 300 lawyers whose job is to "attack" Veterans who are appealing a denial of benefits, to help make the denial stick.

If the VA can afford 300 lawyers to deny Veterans claims, it looks to me like 150 of these lawyers should be paid to defend the Veteran, if not all 300 of them. After all, the VA is supposed to serve its Veterans, not attack them.

Edited June 5, 2009 by broncovet