Chronic Pain Syndrome And Depression

[foleyj]

Since this is my first post I will give a brief background. As you can see from the profile I have been rated at 60% for my SCD's, here is the breakdown;

20%-SCD for lower back injury, annular tear and herniation L4-L5

20%-SCD for weakness, pain and numbness or right leg

20%-SCD right shoulder, torn capsule

20%-SCD left shoulder, torn capsule

I also have right and left hip bursitis secondary to the back injury that I submitted a claim for but was denied because of lack of evidence. I am also being treated for depression that started after I began receiving my disability benefits. I recently obtained documentation from my Ortho stating that the hip pain is related to my back injury. So that is something that I am going to resubmit to the VA as new evidence since it was denied previously. I also went to my psychiatrist and he filled out the nexus letter stating that the depression was possibly related to the chronic pain syndrome related to my injuries. My question is how do I proceed with the my claim as far as the depression? Should I claim depression and chronic pain syndrome, or should I claim as a separate disability? This is the first time that I have obtained documentation that diagnosis chronic pain syndrome. Also, can the psychiatrist diagnose chronic pain syndrome? Any guidance would be appreciated.

Jason

[luvHIM]

Welcome to Hadit! I have just a couple of questions: 1) you have indicated that treatment for depression began "after" you began receiving your benefits...what date or time frame would that be? 2) Your doctor indicated that your pain issues may possibly have something to do with your depression "may possibly" will kill the claim from the start. Why? Well, the doctor is not making a definitive statement. Plus, you are going to want more than his/her opinion supporting your claim. 3) Were you treated for depression or any type of mental disorder in service? Lastly, your psych doc can diagnose chronic pain syndrome from your medical records; but the liklihood of his/her dx carrying any weight might falter because he/she is making a diagnosis outside of his/her specialty, unless he/she has been a clinical physician in times past.

My psych docs do not delve into my physical issues. However, they may note something in my records as to the affect of my pain on my mental condition. But I have never had one to make an outright diagnosis of any kind.

An, for the record, it does appear that your current depression would be secondary to your chronic pain disorder...I would not refer to it as a syndrome because a syndrome is not a disease. It is more like a manifestation of many things and can easily be flipped to suggest that your depression causes your pain. Wording is key with the VARO. Anyway, hopefully others will chime in on this one. Best regards.

[foleyj]

Thanks for the response. I began receiving disability benefits in 2000 and I began the treatment for depression in 2004 as my injuries began to worsen. I have been on 2 types of medications the entire time, welbutrin and paxil. I had the psych fill out the nexus letter that I found on this site and he checked the second option under is related to. I was not treated for any time of depression or mental disorder in the service, this did not begin until after the service and all of my injuries began to worsen. Hope that answers you questions and makes things a little clearer.

[LarryJ]

Regarding the Chronic Pain Syndrome.

Somatoform Disorders

9421 Somatization disorder

9422 Pain disorder

9423 Undifferentiated somatoform disorder

9424 Conversion disorder

9425 Hypochondriasis

VerDate Aug<

There is such a thing as Pain Disorder and it should be claimed as such with the diagnostic code of 9422.

It is often, even in VA, BVA, etc., proceedings and in veteran's claims, referred to as Chronic Pain Syndrome.....matter of fact, that is what my VA psychiatrist called it, but, if you don't want to confuse the issue then it should be referred to (and claimed as) Pain Disorder.

It would in this case, as in mine, be considered to have arisen as a result of pain associated with SC'd conditions. Do not claim it as being aggravated by SC'd disabilitys......they'll shoot that down. They sent me a denial before I realized what I had done.

[mags1023]

Thanks for the response. I began receiving disability benefits in 2000 and I began the treatment for depression in 2004 as my injuries began to worsen. I have been on 2 types of medications the entire time, welbutrin and paxil. I had the psych fill out the nexus letter that I found on this site and he checked the second option under is related to. I was not treated for any time of depression or mental disorder in the service, this did not begin until after the service and all of my injuries began to worsen. Hope that answers you questions and makes things a little clearer.

Hey Foleyj:

Welcome! I am currently rated for major depressive disorder that is secondary to my service connected chronic pain. The C&P psych that I saw annotated that my depression was more likely than not caused by my chronic pain and do to that I cannot enjoy the things in life that i used to such as playing golf, racquetball, woodworking......ect. Are you being treated by the VA for depression? You may not need a C&P if that is the case. You should be ready to file for compensation for your depressive disorder. Are you a gulf war vet? If so, get a GW exam. Chronic pain in joints is a symptom of gulf war illness. With the conditions you are currently rated for, you should be able to get connected for these 2 conditions.

[foleyj]

Thanks Larry. When I send the information back to the VA would I submit as new evidence for my existing SCD's of, or as a new claim secondary to my SCD's? Also would I need to submit copies of my medical records from the psychiatrists that have diagnosed me and prescribed medications?

[foleyj]

Thanks mags1023,

I am not being treated by the VA for depression. The depression started a few years after I started receiving benefits for my SCD's. I am not a Gulf War Veteran I enlisted just a few must after the war started to wind down. If you see from my response to LarryJ would I submit

as new evidence for my existing SCD's of, or as a new claim secondary to my SCD's? Also would I need to submit copies of my medical records from the psychiatrists that have diagnosed me and prescribed medications? I have the nexus letter that the Dr filled out and he checked off that the depression is possibly related to the chronic pain. He also noted that I suffer from chronic pain due to my injuries. I have searched the site for sample letters but I have not found any, could you point me in the right direction if you know of any samples that I can refer to? Basically what I am looking for is what exactly should I put in the claim as far as symptoms, meds, lack of interest in things that I used to enjoy, etc... Any information that you can provide would be great. Thanks.