Who To Believe

[Rockhound]

I had a neuropsychology exam/test June of 2008, the person giving the test is a Psychologist with a Phd. She opinioned that, rather than a regular personality disoder I was saddled with by a C&P examiner in 1973, that I had a post organic personality disordered as a result of the head injury while I was in the service, just shortly before my medical discharge.

Now she didn't say it was a diagnosis but when I went to see a neurologist for a TBI screening test, he took her opinion to mean that I was diagnosed by her as having a post traumatic organic personality disorder due to my remote head injury. He also listed the headaches I have been having as post traumatic headaches, mixed myogenic-vascular

My AMVET SO likes what she sees in these reports, but I feel I should try and get the psychologist to clarify her opinion or whether her opinion as a psychologist Phd. is the same as a diagnosis for a medical Dr.????

I want to make sure I cross every T and dot every I before I file this claim for a TBI that caused my so called personality and that the C&P Dr got it wrong to begin with.

I have other evidence that shows my medical and personal history prior to my head injuey, some of it, the most important aspect, I feel would have made a difference back then, were not considered back then and my Dr's agree, I had no signs or symptoms of a personality disorder prior to my head injury, and that the personality disorder only became noticeable afterwards.

Any thoughts and or opinions or sudjestions is greatly appreciated.

Rockhound Rider :D B)

Edited April 7, 2009 by Rockhound

[Pete53]

The personality disorder diagnosis is a custom made VA misinterpretation of your mental health. That phrase will kill your claim.

You should request if the Doc works for the VA a code for the personality disorder and than compare what it says to your life. After you got oit did you get into fights, start fires, go to jail, have problems with authority. If none of this fits you do not have a personality disorder and you need a Doc to say so.

[rentalguy1]

A PhD psychologist carries 95% of the weight of a MD psychiatrist. A opinion from either is fine for rating purposes. What you really need to do is go back and look at the medical records from your visit with this PhD, and see what she wrote in AXIS I. That is the current diagnosis. Whatever she wrote in that space is what you are diagnosed with. I agree with Pete, that a PD is not a good term to have involved in a claim. According to the regs, a PD is not a compensable disease or injury.

§4.127 Mental retardation and personality disorders.

Mental retardation and personality disorders are not diseases or injuries for compensation purposes, and, except as provided in §3.310(a) of this chapter, disability resulting from them may not be service-connected. However, disability resulting from a mental disorder that is superimposed upon mental retardation or a personality disorder may be service-connected. (Authority: 38 U.S.C. 1155)

Section 3.310 deals with secondary conditions. The way I am seeing this, you are going to have to get the TBI sc'd, then get the headaches rated as secondary to the TBI. Since "organic personality disorder" is a term that has not been used for decades, the TBI would actually take the place of the PD. A organic (or post-organic; which simply means "after") personality disorder meant brain damage, among other things. I believe this is what the PhD meant when using that term. I still agree that you should find the ICD 9 code that the PhD used, which should also be in AXIS I. If you can post that code here, we can figure out what the next move should be.

[Wings]

I had a neuropsychology exam/test June of 2008, the person giving the test is a Psychologist with a Phd. She opinioned that, rather than a regular personality disoder I was saddled with by a C&P examiner in 1973, that I had a [b]"post organic personality disorder" as a result of the head injury while I was in the service, just shortly before my medical discharge.

Q. Could you please explain what an Organic Personality Disorder is, and what are its symptoms?

A. Organic Personality Disorder is an old term no longer used in psychiatry. It dates back a number of years, and includes dementia, delirium, psychosis not related to schizophrenia or mood disorders, brain injured patients, patients with diseases that effect behavior, Parkinsonism, etc. Basically, it was what we called folks that acted in a manner consistent with damage to the brain, but not fitting into standard depression, schizophrenia, or anxiety disorders.

Q. I am working with an individual who has an old diagnosis of "Organic Personality Disorder" as a result of brain injury at the age of 14. Can you tell me what is the current DSM code/diagnosis for this?

A. In DSM-III-R, the term "Organic Personality Disorder" was used.

In DSM-IV, the more cumbersome term, "Personality Change Due to a General Medical Condition" is used, which is coded as 310.1. This is defined as "a persistent personality disturbance that is judged to be due to the direct physiological effects of a general medical condition. The personality disturbance represents a change from the individual's previous characteristic personality pattern." (p. 171, DSM-IV).

Examples would include personality alteration due to frontal lobe damage; systemic lupus erythematosis; Huntington's Disease, and many other medical/neurological conditions. The DSM-IV goes on to define several subtypes, such as a "labile, disinhibited, aggressive, apathetic, paranoid", etc.

Now she didn't say it was a diagnosis but when I went to see a neurologist for a TBI screening test, he took [understood] her opinion to mean that I was diagnosed by her as having a "post traumatic organic personality disorder due to my remote head injury".

He also listed the headaches I have been having as post traumatic headaches, mixed myogenic-vascular

My AMVET SO likes what she sees in these reports, but I feel I should try and get the psychologist to clarify her opinion, or whether her opinion as a psychologist Phd. is the same as a diagnosis for a medical Dr.????

If she has a Phd., then she is a Doctor of psychology. If she would apply the correct DSM IV Diagnosis, then you have a very credible, weighty opinion. IMO.

I want to make sure I cross every T and dot every I before I file this claim for a TBI that caused my so called personality, and that the C&P Dr got it wrong to begin with.

I have other evidence that shows my medical and personal history prior to my head injuey, some of it, the most important aspect, I feel would have made a difference back then, were not considered back then and my Dr's agree, I had no signs or symptoms of a personality disorder prior to my head injury, and that the personality disorder only became noticeable afterwards.

Any thoughts and or opinions or sudjestions is greatly appreciated.

Rockhound Rider :D B)

You are doing such good wrok on your claim Rockhound, you are thoorough and follow your best instincts. I sincerely hope you prevail!! ~Wings

Edited April 8, 2009 by Wings

[Rockhound]

You guys seem to have more knowledge of this subject than I do, I really need to do more research on this and see if I can make an appointment to see this psychologist again.

It makes me upset that when they write up these progress notes, they seem always to use medical terminology that is out dated and doesn't conform to the DSM IV. However I do see this as a Personality change due to a medical condition, as a result of my head injury showing some degree of frontal lobe pathology, that of an EEG showing slow wave form of the frontal lobe, which had not been shown to have resolved at the time of the C&P exam where I was given the diagnosis of a personality disorder, inadequate type, associated with inadiquate educational experience.

More research and clarification is what I need but it being the VA psychologist and neurologist, it may be difficult to get.

Rockhound Rider :D B)

[Wings]

You guys seem to have more knowledge of this subject than I do, I really need to do more research on this and see if I can make an appointment to see this psychologist again.

It makes me upset that when they write up these progress notes, they seem always to use medical terminology that is out dated and doesn't conform to the DSM IV. However I do see this as a Personality change due to a medical condition, as a result of my head injury showing some degree of frontal lobe pathology, that of an EEG showing slow wave form of the frontal lobe, which had not been shown to have resolved at the time of the C&P exam where I was given the diagnosis of a personality disorder, inadequate type, associated with inadiquate educational experience.

More research and clarification is what I need but it being the VA psychologist and neurologist, it may be difficult to get.

Rockhound Rider :D B)

Rockhound, the recent psychologist's report is actually very good. I just worry that the VARO Employee (whom are not psychologist's) will understand the language. In fact, the mere mention of "personality disorder" triggers the panic button for our members; so that, we can't look behind that language --to see that the personality can become damaged due to both medical and psychological TRAUMA; then perhaps the VARO Adjudicator is likewise untrained to look behind those trigger words to see the actual medical diagnosis.

It would take a SMART VA Adjudicator to see the medical diagnosis of post (trauma) organic personality disorder is due to the in-service head trauma. HOWEVER, this good doctor did lay out the diagnosis that you were tring to support by law and medical evidence (MRI's, neuropsyche testing, etc).

All you would need to do, to make it obvious to the VA Adjudicator, is to politely ask the Phd. psychologist, if she would be willing to properly codify her diagnosis on Axis I, using the Diagnostic and Statistical Manual, 5th edition, Personality Change Due to a General Medical Condition" is used, which is coded as 310.1. It's just a matter of DSM codification, which is her ethical and professional responsibility to do.

Hang in there, you are doing great!! ~Wings

[Rockhound]

I'll have to write myself a big note to remember to ask the pyschologist to do just that.

My problem now is this. At one time my AXIS I was for an Adjustment Disorder with Anxiety, now it reads Major Depressive Disorder, Recurrent; and Dysthymic Disorder. My Adjustment Disorder with Anxiety just didn't go away and no it wasn't moved to the Axis III, which also seems to be missing a couple of other problem I have, including my Sarcoidosis.

Can you have more than one Axis I problems listed under AXIS I, I have a number of problems listed under Axis III ?

Rockhound Rider B)