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

[mags1023]

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.

I would submit as a new claim and as secondary to your SC disabilities. Sounds like your Nexus letter should cover what the VA needs to get started, but they will probably send you for a C&P exam anyway. You may want to get your psychiatrist to give you a GAF score if he hasn't already done so.While the GAF is not the only thing the VA uses, it does weigh heavily in the decision making process. Your letter just needs to say what you have already put down in these posts. "You are depressed because you aren't physically able to do the things you used to enjoy due to the service connected conditions that you suffer from." You may want to expound on the activities you used to enjoy doing and how your conditions preclude you from doing them now. I would include any pertinent evidence you have now, copies of course and include them as enclosures to your letter. I always submit the form and in remarks type "See attached statement". Mail it certified with return receipt. Good luck!

[john999]

Chronic pain disorder is considered an emotional disorder and will not be rated separately from depression. The kinds of things you might want to use to describe your pain disorder is sleep disturbance, inability to enjoy life, preoccupation with pain, panic disorder. inability to maintain a social life etc. It should be more than not being able to play tennis or do sports.

If you have chronic pain you probably have depression as well. They go hand in hand.

[Berta]

I wish that doc had said probably and not possibly- better yet he should have said at least as likely as not-

or more than likely.

Did he make any statement as to how this might affect your employability when you are a civilian?

[vmo]

I wish that doc had said probably and not possibly- better yet he should have said at least as likely as not-

or more than likely.

Did he make any statement as to how this might affect your employability when you are a civilian?

I see an internal medicine physician for primary care. A few years back, I obtained a IMO concerning my SC knees and spine. I explained the importance of his statement "more likely than not" or "at least as likely as not", etc,. After some discussion, he rewrote his IMO to include "more likely than not". The good "Doc" asked me if his statement/IMO would help?? I told him, Yes!! And, it was "more likely than not" that I would pay my bill.

[foleyj]

Thanks for all the help. I got the form from this site and it was described as a nexus form. On the form it has 3 possible choices for the doctor to check the first choice states Related to, the second Possibly related and the third is more likely as not to be related. The Dr. checked the second one which I am assuming is better than the last one.

[john999]

"Possibly related" is speculation. That won't get service connection for you. That is not the kind of language you want to beat the VA. More likely than not or at least as likely as not is better by far.