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

[Wings]

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

Rockhound, DSM (mental) diagnoses can flux or remain static over the years. And yes, you can have more than one mental diagnosis (less is better). What matters most, is that the 1). the current DSM diagnosis, together with the 2). VA C&P Exam, fall in line (match) the veterans 3). claimed disability.

If these three don't add up, then the VA Rater has to reconcile (make sense of) the conflicting or complimentary diagnoses. Some of the raters would accomplish this with work experience; and some would follow regulation and either re-exam or send the C-file to VA Central office to reconcile the differences.

It's just overall a better plan of attack, to have the current DSM diagnosis, and the current C&P Exam, and the current claimed disability --all ducks in a row.

Your Psychologist should have No Problem assigning the correct, current DSM IV diagnostic codes. Give her a call. Shedule and appt. OR, go to another psychologist whom would review her report and assign a diagnostic code based on her report or trust the VA to do the right thing? In my humble opinion (IMHO). ~Wings

Edited April 9, 2009 by Wings

[Rockhound]

Wings: I received a call from the Psychologist Phd. and after speeking with her about my diagnosis and how it wasn't reflected in the AXIS, she stated she would write and addendum to her report to reflect opinion and diagnosis in the AXIS. It won't be until next Wednesday before I am able to get into town to see what the addendum covers, nor if she list it as an AXIS I or not. It could well end up with the number of AXIS III problems.

After some consideration, I may leave off the Adjustment Disorder and Anxiety, since I think the VA does not consider this as a chronic condition, even though I have evidence since leaving the service, that I have had problems with it and my Navy Medical Board Evaluation said that I had demostrated moderate impairment for future social and industrial adaptability, but severe impairment for future military service.

Wednesday I will know more.

Rockhound Rider B)

[Pete53]

Good Luck Rock B)

[Wings]

Wings: I received a call from the Psychologist Phd. and after speeking with her about my diagnosis and how it wasn't reflected in the AXIS, she stated she would write and addendum to her report to reflect opinion and diagnosis in the AXIS. It won't be until next Wednesday before I am able to get into town to see what the addendum covers, nor if she list it as an AXIS I or not. It could well end up with the number of AXIS III problems.

After some consideration, I may leave off the Adjustment Disorder and Anxiety, since I think the VA does not consider this as a chronic condition, even though I have evidence since leaving the service, that I have had problems with it and my Navy Medical Board Evaluation said that I had demostrated moderate impairment for future social and industrial adaptability, but severe impairment for future military service.

Wednesday I will know more.

Rockhound Rider

Rockhound, Your case is complex, and you need not worry about "leaving off" anything. It's OK to have multiple diagnoses. Just keep your claim current (as you are). Your good doctor sounds like she's willing to go to bat for you; can't ask for more than that !! Good work !! ~Wings

Multi-axial Assessment

The DSM-IV organizes each psychiatric diagnosis into five levels (axes) relating to different aspects of disorder or disability:

Axis I: clinical disorders, including major mental disorders, as well as developmental and learning disorders

Axis II: underlying pervasive or personality conditions, as well as mental retardation

Axis III: Acute medical conditions and physical disorders.

Axis IV: psychosocial and environmental factors contributing to the disorder

Axis V: Global Assessment of Functioning (GAF)

Common Axis I disorders include depression, anxiety disorders, bipolar disorder, ADHD, phobias, and schizophrenia.

Common Axis II disorders include personality disorders: paranoid personality disorder, schizoid personality disorder, schizotypal personality disorder, borderline personality disorder, antisocial personality disorder, narcissistic personality disorder, histrionic personality disorder, avoidant personality disorder, dependent personality disorder, obsessive-compulsive personality disorder, and mental retardation.

Common Axis III disorders include brain injuries and other medical/physical disorders which may aggravate existing diseases or present symptoms similar to other disorders.

Edited April 10, 2009 by Wings

[Rockhound]

Wings: I was looking through the DSM IV for Disabilities and I believe I found the one that I should direct my claim under.

9327 Organic Mental Disorder, other (including personality change due to a general medical condition)

Now to find all the pertinent 38 CFR's to help support my claim.

Rockhound Rider B)

[Rockhound]

Wings: Update on my Multi Axial Assessment;

04/09/2009 ADDENDUM Status: Completed

Note that diagnosis was missing Axis I. Diagnosis should be as follows:

DIAGNOSTIC IMPRESSION:

Axis I: 1) Personality disorder due to Brain Injury (Organic

Personality Disorder)

2) Major Depressive Disorder, Recurrent;

3) Dysthymic Disorder:

4) Adjustment Disorder with Depression and Anxiety.

Axis II: No diagnosis.

Axis III: Hypothyroidism;

Sleep Apnea, mild;

Hypertension;

Morbid Obesity;

Diabetes type II;

Osteoarthritis, (knees);

Chronic Sinusitis;

Restless Leg Syndrome;

Restrictive Lung Disease;

Minor Cerebral Concussion in 1973; and

Appendectomy – age 16.

Axis IV: Problems with finances.

Axis V: GAF = 50

The Axis I, diagnosises are the major ones that I plan to SC either by residuals of the Acute schizophrenic episode after I show that the change made back in 1974 to a personality disorder was made in error, or as secondary/residuals of the TBI showing the post Traumatic organic personality disorder should have been the correct diagnosis and leaving the Acute Schizophrenic Episode as it should have for a psychiatric disorder.

I have one psychiatrist that shows that the MMPI I had in 1973 and the more current one both showed that their was no personality disorder and she also compaired the current DSM IV and found nothing to indicate any type of personality disorder.

The most resent neuropsychological exam also indicated that their was no personality disorder and if it was in fact a personality disorder, it was a post traumatic organic personality disorder due to my TBI.

The neuropsychological exam also showed mild to moderate cognitive dysfunction in all areas, except significant executive dysfunction.

It appeared to be a good day for supporting evidence for my TBI and Psychiatric CLaims.

Any further comments or sudgestions are greatly appreciated since I am having difficulty deciding how to present this claim since both the TBI and the psychiactric problems are inexerably intwined together, it appears.

Rockhound Rider ;)

p.s. Forgot to add what the neurologist said. Post Traumatic Headaches, Mixed Myogenic - Vascular.

Edited April 16, 2009 by Rockhound