Need Input

[bern381]

I been seeing a psych doc outside of the VA system in order to gain evidence to bolster my claim. The doc has said that she will write me an IMO after she gets to know me. In the mean time, she has written a short letter to support my claim of depression secondary to chronic pain from service connected disabilities. However, before I submit it as evidence I would like to ask you all to review it to see if it passes muster. Here it goes:

To Whom It May Concern,

I met with xxx xxx for an initial psychiatric on February 17, 2009 regarding his depressive symptoms and anger issues. At that time, I diagnosed him with Depressive Disorder NOS, rule out pain disorder associated with psychological factors and general mediical condition. Based on his self-reported lack of any psychological history prior to the onset of his shoulder pain, it does appear that his mood symptoms were at least partially precipitated by the onset of pain and have been perpetuated by the chronic nature of the pain and his preoccupation and frustration with his unsuccessful attempts to alleviate it. Most likely, there are also yet other underlying factors that perhaps the focus of pain is covering up. His depressive symptoms and preoccupation with his pain have led to impairments in work productivity as well as issues with interpersonal relationships.

xxx xxx, D.O.

[ruby]

I been seeing a psych doc outside of the VA system in order to gain evidence to bolster my claim. The doc has said that she will write me an IMO after she gets to know me. In the mean time, she has written a short letter to support my claim of depression secondary to chronic pain from service connected disabilities. However, before I submit it as evidence I would like to ask you all to review it to see if it passes muster. Here it goes:

To Whom It May Concern,

I met with xxx xxx for an initial psychiatric on February 17, 2009 regarding his depressive symptoms and anger issues. At that time, I diagnosed him with Depressive Disorder NOS, rule out pain disorder associated with psychological factors and general mediical condition. Based on his self-reported lack of any psychological history prior to the onset of his shoulder pain, it does appear that his mood symptoms were at least partially precipitated by the onset of pain and have been perpetuated by the chronic nature of the pain and his preoccupation and frustration with his unsuccessful attempts to alleviate it. Most likely, there are also yet other underlying factors that perhaps the focus of pain is covering up. His depressive symptoms and preoccupation with his pain have led to impairments in work productivity as well as issues with interpersonal relationships.

xxx xxx, D.O.

If you haven't filed a claim, wait and get the proper documentation. Look at Berta's section on IMO's.

If you have I don't think I would send this in, I don't think it will help. What does the underlined section refer to, it doesn't appear to help your claim. It says to me that there are other causes to your depression then pain.

[Hoppy]

Most likely, there are also yet other underlying factors that perhaps the focus of pain is covering up.

This statement is rather vague. I do not see how it would hurt in the long run unless the underlying factors are identified and given separate GAF's.

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At that time, I diagnosed him with Depressive Disorder NOS, rule out pain disorder associated with psychological factors and general mediical condition

This sounds like a "provisional diagnosis". She is saying that she needs more time treating you to make an accurate diagnosis.

I am not sure the VA will use a provisional diagnosis.

[cowgirl]

Hoppy and Bern, interesting discussion and good question. My first claim psych c&p after discharge(years ago) was weird.

Bern, do you have a copy of the VA compensation exam for depression? Hope this helps http://www.vba.va.gov/bln/21/Benefits/exams/disexm37.htm

Best to ya,

Cowgirl'up2009!

Edited October 30, 2009 by cowgirl

[bern381]

Thanks for the input, it is greatly appreciated. I'm sorry I didn't give more background. I filed this claim more than two years ago. For the last 14 months it has been pending a DRO review. If I had to do it over, I would opt for a DRO hearing. Anyhow, I was hoping to use this letter to bolster my claim when it is reviewed. My psych doc at the VA clinic changed my diagnosis to depression, caused by chronic pain. Do you think that this letter will support her assertions? I realize that some portions of the letter are vague and I am worried that it could be used against me. However, some of the statements in the letter are very supportive. Will the positives outweigh the negatives? As far as the last statement in the letter (may be other underlying factors) I think she made the statement because I am a new patient and she is still getting to know me. If I could get her to delete the last statement, would the letter be supportive? Thanks, Bern381

[broncovet]

My 2 cents worth: The VA likes to hear the words, "The Veterans condition is at least as likely as not related to military service" Since your doc did NOT say that, but, I will admit it is close..maybe even

"close enough for the government" if your pain condition is SC'd..however it does leave the door open that other conditions could be also causing your pain. I think it depends on the sympathy of the rater, and the RO, and how they interpret the "favor the Veteran" rule. My experience has been the "favor the Veteran" rule is interpreted by the RO as "forget the Veteran", but others have had a much better experience than I have. IMHO if your RO is Cleveland, New York, Detroit, or St. Pete..make plans for a LONG LONG fight and a denial. However, if your RO is Maine or New Mexico, start looking at new cars for your Retro payment, as the last two states RO's are very liberal at approving Veterans claims while the first four are Veterans "Christmas Busters"..the Terrible 4 RO's.

[carlie]

Personally, I would NOT submit this letter as I feel VA would

relate it as a negative on a claim for depression secondary to pain.

jmho,

carlie