tinnitus Mental Evaluation

[tom91]

Another question regarding my recent claims and results -

My claims were for r/l knee, back, tinnitus/hearing loss. The listing of my various doctor's I provided to the VA also included the multiple psychiatrists that have treated me for bipolar. Today, I received an appt. notice for compensation/pension exam at the VA PACS (Psychiatry Ambulatory Care Svs) facility. At this point I had not included a claim to mental illness...?

My exams done in preparation for discharge did not include a mental evaluation. Anyone know if it was required? Could they perhaps have noted their failure to do so and recognize the error?

[Rockhound]

You give us very little history of your military service except you were in the Gulf War. Now here is where I open a can of worms. Gulf war, war, bombs, explotions, killing, dying, fear of dying. etc. etc. etc. Does any of this relate to your time spent in the Gulf war? Even if you do not have a traumatic event that the VA requires you to have to qualify for PTSD, you can still be suffering from its effects, just depends on the circumstances of your service while in the Gulf War. The explosions/bombs can also be the cause of a mood disorder due to post concussion syndrom. It could even be the result of a vehicular accident.

You don't say what caused your knee, back injury and hearing loss. Flying off the handle for no apparent reason are symptoms of any number of problems that may have physical, neurological, and mental reasons for them and should be fully explored. It's important that the C&P examiner have a complete record of your military service while in the Gulf War that may reflect anything I mentioned above and as complete a medical record as you can provide. If you have any action reports, buddy statements, field injury reports, and also whether you are a recipiant of a purple heart from the Gulf war or other combat related awards.

If you don't mind having your wife with you at the C&P ask if she will go with you, to help you, not only with what she can tell the C&P examiner, but to help you from flying off as it were.

Even with the limited information you have offered, I agree with others when I say you do not have a Bi-Polar disorder, it is more likely that you have a mood disorder with PTSD like symptoms. You deffinently need a better evaluation as to the proper diagnosis of your mental condition. If need be and you have the money, look into getting an IMO from a privet Psychiatrist, one who will look over all your records, speak with your wife, read your buddy statements and so on. Once he has done this he can then determine the correct diagnosis and whether or not their is a in-service Nexus.

Good luck.

Rockhound Rider B)

[john999]

I had a bi-polar diagnosis. There is bi-polar 1 and bi-polar 11. What kinds of meds do you take? Some with bi-polar are depressed most of the time and some are manic most of the time, and some go from one extream to the other. It is really a new term for manic-depressive. If there is nothing in your SMR's about being bi-polar then it is harder to get that diagnosis, and if you have the diagnosis the VA is more likely to try and say it was pre-existing. If you have PTSD or depression due to injuries and disabilities then that is easier to connect to service. Depression due to disabilities would be the easiest I think. PTSD you need verifiable stressors.

[tom91]

In response to the last couple of replies....

1)I currently take depakote (for anger mgmt, panic attacks, & bi-polar),clonazepam (for panic attacks, manic episodes, anxiety), zolof (depression), risperidone (psychotic disorders/bipolar, treatment resistent depression), and ambien (insomnia).

2) Been to civillian psychiatrists a number of times but it has been a couple of years. Currently seen at VA. They were to have gotten copies of my records.

3) I double checked my SMR's and there is nothing referenced in it regarding psychiatric treatment. The discharge exam report lists a number of conditions, to include psychiatric and it was checked off 'normal' by the medical doctor examining me. I do recall seeing a psychiatrist once during service to discuss depression and anger (with reactions to hurt others in my defense). It's not in my records that I obtained from the VA; therefore, not sure of where it went to. The psych just said you 'need to divorce your wife' after the discussion progressed.

4) There would multiple incidents that should be recorded in my personnel files that relate to me 'going off...losing my temper'. Such incidents include throwing my coffee mug across the room just because someone put something in my coffee as a joke. Another incident that would be during Gulf War, is putting a knife to a guy's throat because he was standing over me in my sleep and when I awoke, that was my reaction. I continue to be 'jumpy', in the fact that I will swing at people if that come up on me.

5) As for my tenure in the Gulf War, I experienced scud missile attacks, our unit had to go to the frontlines (forward support battallion) and was only furnished empty weapons and a bannette (?....knife). I often feared for my life and had also been told to watch my back for other soldiers.

Additional thoughts?

[john999]

I think you are going to have to go for the PTSD if you can verify your stressors. If there is nothing in your records about psychiatric and it is has been over 10 years since you were discharged I don't think the bi-polar will fly. If you can link depression to physical injuries that would fly. Depokote is for bi-polar disorder. You can have panic, bi-polar and PTSD at the same time.

[tom91]

Do you think the fact that VA has treated me since 1994, only three years following discharge, play a factor? Maybe promising? What led to me going at that time was thoughts of suicide. Further, I've been treated consistently since then.

[rentalguy1]

It wasn't treated in service or the presumptive period, therefore you have to have a nexus. You have no records of treatment during service, therefore the nexus will have to tie it to something that is already sc'd. If you'll take the angle I spoke of, you'll win. If you stray from it, you will most likely lose. Sorry to be blunt. B)