C&p Psych Exam Vs. Psych Doctor (progress Notes)

[bern381]

I have been pursuing service connection depression secondary to chronic pain (service connected shoulders). I was reviewing my denial letter and the basis for the denial was the word "could" as in the pain could cause depression. The VA determined that this was speculative language and basically denied my claim as a result of this. Since the denial, the psych doc at the clinic has changed my diagnosis from dysthmic disorder to depression caused chronic pain. Consequently, depression caused by chronic pain is found througout my progress notes. Will the diagnosis/opinion of my psych doc be enough to tip the scales and put the benefit of the doubt in my favor?

[bern381]

I had an appointment with the primary care doc today. So, I decided to take a copy of the nexus letter and give it to the psych doc while I was there. When I retrieved the paper she checked the probably box. This is strange. Even though she clearly states in my progress notes that the "veteran presents symptoms of depression caused by chronic pain." This is further supported by the dx: adjustment disorder with depressed mood, chronic related to pain. Luckily, I got to the paper before it was associated with my file. I have an apppointment with her in early February, should I broach then subject or should I let it lay where it is? Thanks for the help

[john999]

That is why you get a private opinion, so that if the doctor does not want to give you the opinion you want you can shitcan it. "Probably" is poison. Your shrink seems to be showing the gutless disease. Many VA doctors simply won't stick their necks out for their patients. You can't win a VA claim with a "probably". You need "as least as likely as not" minimum.

[bern381]

She has told me that she is not sure what originally caused my depression. However, she is sure that the root of it is now pain from my shoulders. When I consult a psych doc outside of the VA, what should I bring with me and how should they state things in their write up? I want to make sure I get it right the first time. Thanks.

[rentalguy1]

I would get it changed to "at least as likely as not"

[bern381]

Rental Guy, I appreciate your time and patience. I get so frustrated sometimes. They skirt around the issue and agree with the problem. However, getting them to put it into words can be excruciating.

[rentalguy1]

I take the blame on this one. I am using a nexus form that was given to me by a DAV VSO. It is poorly worded, and I need to re-write it for future use.