tdiu Decoding C&p Language

[navydoc2]

I received copies of my c&p physicals today for both my claims of increased depression and bilateral hearing loss with tinnitis. Here are the findings of the increased depression: I also have a TDIU claim

Axis I Major Depression

Axis II defer

Axis III See Med list

Axis IV Unemployment

Axis V GAF score is 50

The veteran cannot work due to anxiety, agoraphobia and worsened depression

The prognosis is guarded. He is mentally capable of managing benefit payments in his own best interest. Mentally, he occasionally has some interference performing activities of daily living because of his left Knee and depressive problems. He has difficulty establishing and maintaining effective work/school and social relationships because of his isolation. The best description of the claimant's current psychiatric impairmentis: psychiatric symptoms cause occupational and social imparment with occasional decrease in work efficiency and intermittent inability to perform occupational tasks although generally the person is functioning satisfactorily with routine behavior, self care and normal conversation. The above statement is supported by the following symptoms: depressed mood, anxiety, suspiciousness, chronic sleep impairment and mild memory loss such as forgetting names directions or recent events . He has no difficulty understanding commands. Based upon the examination, the claimant needs to seek follow up treatment. The claimant requires therapy and medication management. This information was conveyed to the claimant during the examination. The claimant does not appear to pose any threat of danger or injury to self or others.

Audiology: puretone

right

500hz 1000hz 2000hz 3000hz 4000hz b+C+

30 40 35 50 40 41.25

left

500hz 1000hz 2000hz 3000hz 4000hz b+C+

35 40 40 65 60 56.25

Diagnosis:

For the claimant's claimed condition of BILATERAL HEARING LOSS, the diagnosis is bilateral hearing loss. The subjective factors are the claimant report of hearing loss. The objective fators are audiometric findings.

For the claimant's claimed condition of TINNITUS, the diagnosis is bilateral persistent tinnitis. The subjective factors are claimant report of tinnitus. The objective factors are the claimant's subjective report.

For the right ear, the claimant has moderate, mixed (sensorinural and conductive) hearing loss. For the left ear, the claimant has a moderately severe mixed (sensorineural and conductive) hearing loss. If treated the problem will cause a change in the hearing threshold level because resolving any middle ear pathology can improve air conduction thresholds.

Answers to the questions from VA

In reference to the question "IT IS LESS LIKELY AS THAN NOT THAT THE VETERAN'S HEARING LOSS IS RELATED TO ACOUSTIC TRAUMA FROM COMBAT NOISE", due to the presence of an air-bone gap bilaterally with flat tympanograms normal ear canal volumes and absent ipsilateral acoustic reflexes.

It is as least as likely as not that the veteran's tinnitis is related to acoustic trauma from combat noise due to the reported time of onset and the noises inherentin those duties that are known to cause tinnitis.

If anyone can shed some light on these findings and what to expect from my RSO please help me. thanks in advance.

navydoc

[navydoc2]

name='john999' date='Jul 4 2009, 08:46 PM' post='152931']

Navydoc

Being an in-patient might really help your cause. Also, steady record of psychiatric treatment is very important for IU claims. You want documentation of your inability to work and your low level of functioning. You are getting good advice here. The VA knows that once you get IU you will never work again, so they make it hard to get it. I had been seeing a VA shrink for years and had a recent in-patient stay, and I still had to fight like cats and dogs to get IU even after I got SSDI, so it is not easy. You have to turn over every rock and jump through every hoop to get it. People here have been on SSDI for years and the VA still denied them IU or 100%, and they had to fight on to get it. Don't be discouraged because they make it hard and act stupid when you know you can't work due to your SC.

Believe me I do appreciate the advice I've received here, I've learned more about my claims and how to go about the whole process here than any advice a VSO has ever given me. I'm taking notes and sucking it in like a sponge. thanks to you guys I'm an informed veteran. If the need arises I will not hesitate to go inpatient and I do plan on continuing my treatment.

Edited July 5, 2009 by navydoc2

[Hoppy]

navydoc2

John pretty much answered your question. The VA does not focus on any one statement made by a doctor or GAF score. The law allows them to base a rating on a more general perception of your ability to function. That is where being an in-patient and treatment works in your favor.

My perspective was from the point of getting 100%. I took this from the statement that you could not work. I did not think that the C&P doc would have made that statement unless you told him that you could not work. C&P docs do not make such an assessments unless the veteran has stateted an inability to work.

The question in your claim that I see from the way the C^P was written is that I did not get the impression the C&P doc thought that your current state of functioning would not improve. I have seen docs specifically say that improvement was not expected. Instead the doc in your case talked alot about treatment. I am not sure that they would make a big jump in the rating based on that C&P.

The one year and a half without work time frame is approaching the point where I have seeh raters start conmsidering that there is a significant problem. Hospitalization is not necessary. However, an extended period of unemployment combined with treatment would show that your condition is definately in need of a higher rating.

The fact that the timeframe you have not worked was not discussed in the C&P shows the superficiality of the exam. I would expect that the time frame without employment should have been brought up by you and re ststed by the C&P examiner. This is an important factor. If you get back into treatment definately let them know the lenght of time you have been out of work. I often tell veterans to get the free SSD income statement and take it with them to the treatment appointment and to submit a copy to the RO with a statement insupport of the claim.

If you really are at a point in your life where you think that continued employment is not an option then you need to load for bear and take the best evidence with you to the treatment appointment or any future C&P and for sure get it to the RO.