Psych Doc

[babyray]

:D I need a psych doc to give me an IMO for major depression disoder. Could anybody give me some names & numbers? Thx. Chow!!!!

[tssnave]

BR, ~ IMO ~

Regarding your IMO - you stated "My private doc says I had MDD w/ a GAF score of 53; With my meds helping very little."

Is this information in your c-file?

Is your private doc an regular family practice type doctor, a psychologist, or a psychiatrist? How detailed was his statement or did you just send in treatment reports?

Have you found a good IMO shrink yet? Look up social security lawyers and call the ones with the biggest ads in the yellow pages. They can give you referrals to shrinks who write IMO reports.

Also, are you using a VSO? If so, he should be able to give you a referral as well.

If you would make two replies, one to my questions regarding writing your appeal, and one to this post about your IMO search, that would make it easier for me to tract what all we're dealing with here.

Thanks,

TS

Edited August 10, 2009 by tssnave

[babyray]

BR, ~ Appeal ~

Yep, the C&P examiner overwhelmingly supported a 70% rating in Section G. Frank is correct in his assesment. Look over the part of the rating schedule he posted for you and then print out and review Section G of the C&P exam and the mental health rating schedule and read them until you understand how they line up with one another:

Here's the C&P exam link: http://www.vba.va.gov/bln/21/Benefits/exams/disexm37.htm

Here's the mental health rating schedule link: http://www.warms.vba.va.gov/regs/38CFR/BOO...ART4/S4_130.DOC

I would suggest you appeal and request a rating of 70% as well as 100% IU, Permanent and Total. That's what I did, appealed for the whole enchilada so I wouldn't have to make the VA my life's work, and I was successful. I can help you craft your appeal, if you haven't done so already, and others here can chime in and make it even better (wholesale, stick with us here).

You can use your C&P exam comments in Section G as evidence in your appeal. You can cite M21-1MR in your appeal along these lines:

70% Rating

According to M21-1MR, Part III, Subpart iv, Chapter 5, "the RSVR may not rely upon his/her own unsubstantiated medical conclusions to reject expert medical evidence". Given that the VA C&P Exam states that my "mental disorder signs and symptoms result in deficiencies in the following areas (thinking, family relations, work, mood or school) I should be awarded a 70% rating.

100% Individual Unemployability

Furthermore, I have not worked in over X years, due solely to my service connected disabilities and I request evaluation for Individual Unemployablity (and then you include both the IU form and the employer form(s) so you don't have to wait another 6 years for them to get the IU paperwork done).

Permanent and Total

I request Permanent and Total rating due to the chronic nature of my service connected mental illness which the C&P examiner stated that the failure of my mental illness symptoms to remit for over 10 years was due to the chronic health stressors of my other sc disabilities.

Now, Babyray, to effectively fight your rating, I need to know what they wrote in the Reasons and Basis for not assigning a higher rating. This is critical to your appeal. You have to rebut, either with evidence or court cases, whatever it is they used to NOT give you the next higher rating, which, in your case, is 30%.

This information is in your Decision and should be a new paragraph starting with something along the lines of "The reason we did not assign you a 30% rating was .......................... (this is the information I need from you) and then they will cite the rating schedule for 30%.

Thanks,

TS

[babyray]

BR, ~ Appeal ~

Yep, the C&P examiner overwhelmingly supported a 70% rating in Section G. Frank is correct in his assesment. Look over the part of the rating schedule he posted for you and then print out and review Section G of the C&P exam and the mental health rating schedule and read them until you understand how they line up with one another:

Here's the C&P exam link: http://www.vba.va.gov/bln/21/Benefits/exams/disexm37.htm

Here's the mental health rating schedule link: http://www.warms.vba.va.gov/regs/38CFR/BOO...ART4/S4_130.DOC

I would suggest you appeal and request a rating of 70% as well as 100% IU, Permanent and Total. That's what I did, appealed for the whole enchilada so I wouldn't have to make the VA my life's work, and I was successful. I can help you craft your appeal, if you haven't done so already, and others here can chime in and make it even better (wholesale, stick with us here).

You can use your C&P exam comments in Section G as evidence in your appeal. You can cite M21-1MR in your appeal along these lines:

70% Rating

According to M21-1MR, Part III, Subpart iv, Chapter 5, "the RSVR may not rely upon his/her own unsubstantiated medical conclusions to reject expert medical evidence". Given that the VA C&P Exam states that my "mental disorder signs and symptoms result in deficiencies in the following areas (thinking, family relations, work, mood or school) I should be awarded a 70% rating.

100% Individual Unemployability

Furthermore, I have not worked in over X years, due solely to my service connected disabilities and I request evaluation for Individual Unemployablity (and then you include both the IU form and the employer form(s) so you don't have to wait another 6 years for them to get the IU paperwork done).

Permanent and Total

I request Permanent and Total rating due to the chronic nature of my service connected mental illness which the C&P examiner stated that the failure of my mental illness symptoms to remit for over 10 years was due to the chronic health stressors of my other sc disabilities.

Now, Babyray, to effectively fight your rating, I need to know what they wrote in the Reasons and Basis for not assigning a higher rating. This is critical to your appeal. You have to rebut, either with evidence or court cases, whatever it is they used to NOT give you the next higher rating, which, in your case, is 30%.

This information is in your Decision and should be a new paragraph starting with something along the lines of "The reason we did not assign you a 30% rating was .......................... (this is the information I need from you) and then they will cite the rating schedule for 30%.

Thanks,

TS

Thxs TS, this is what they said on my rating decision for not assigning me a 30% rating: A higher evaluation of 30% is not warranted unless there is occasional decrease in work efficiency and intermittent periods of inability to perform occupational task (although generally functioning satisfactorily, with routine behavior, self-care, amd conversation normal), due to such symptoms as: due to such symptions as: depressed mood, anxiety, suspiciousness, panic attacks ( weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events).

I hired a VFW rep last week & he filed a reconsideration claim on 07/30/2009. What shall I do about the recon claim? It says: please reconsider the VARO rating decision dated 02-09-2009, Issue #2, award of 10% for MDD. the evidence of record clearly supports a higher award for this disability. The evidence of record shows suicidal ideation, insomnia, unprovoked anger, depression, isolation and numerous other indicators that my service connected Mayor Depression Disorder is much more severe than the 10% awarded. Please review and reconsider this 10% evaluation.

Should I fired ( can I?) the VFW & filed an appeal on my own w/o a rep? Or try to work w/ him on going for the whole enchilada.

I think I rather tackle this along & w/ your guidance and others I will be sucessful in achieving my goals. Get back w/ me ASAP. Thxs Chow!!

[tssnave]

BR, ~ Apeal ~

Look at your Decision again - there should be at least another sentence after they list the rating criteria for 30% that states "We cannot grant a higher evaluation at this time because this condition does not ................" it is here, in this last sentence of the paragraph telling you what the sx are for the next higher rating that they are supposed to give the reasons and basis for NOT granting you a higher rating. This reason(s) is what you have to attack, either by evidence or court cases.

What is the sentence following ".....such as forgetting names, directions, recent events."?? They should say in there why they are NOT rating you 30%.

Also, back up a bit in the Decision and tell me what they wrote in the two paragraphs above this one. One should start out something along the lines of "We have assigned a 10% rating .... and then they list the rating criteria for 10%". But the paragraph before that one should list the sx that they used to evaulate you at 10%.

To effectively write your appeal you need to know what evidence they are hanging the 10% on (my guess is the meds) and what reason they are denying you 30%.

Let me know and we'll continue to march on your appeal.

TS

[tssnave]

BR, ~ VSO vs No VSO ~

As far as whether or not to use a VSO, that is a hotly debated topic and very many knowledgable vets are on either side of that debate, some for using VSOs and some for not using VSOs.

I take the middle of the road approach. I used a VSO who was in the VARO to funnel my paperwork through. I always asked that the VSO send me a copy of the cover letter they attached to whatever it was I wanted to send the VARO. All my papers got to the VA but there are horror stories of VSOs who don't do what they say they are going to do and if it entails a deadline then it can be critical to your claim.

As far as the VSOs themselves - I have had horrible, great, and so-so service from VSOs (all from the same organization/location). I had one jerk who said "sorry for ya" when the VA denied service connection despite my having both the psychitrist (who works for the state) and the physchologist (who was by that time a full bird on active duty) who treated me on active duty write statements in support of my claim verifying that I was first treated on active duty. Luckily, I got so upset I hung on him and the next time I called, God had his supervisor pick up the call. When the sup found out they didn't even give me a C&P exam with the treating doc letters, he told me they'd do an appeal.

VSO #1 (Jerk) and I have a tenuous relationship during my monthly calls after that until he leaves. I talk to sup a couple more times before they get a new guy in. He's nice enough but a mentally disabled vet like myself, and he can't remember who I am from one monthly phone call to the next so he never really tracks with my claim. He is nice enough and seems to care but I needed someone more together than I am to help me.

I get 50% on appeal and VSO #2 tells me to accept that and file for an increase in a year or so. I tell him no way (we went back and forth on this quite heatedly on the phone - it's a wonder I didn't hang up on him). By this point I have discovered hadit and realize what the rules are and that the VA hasn't followed them. The C&P examiner, in Section G, stated I was 100%, gave a GREAT rationale, stated I was unemployable due to my sc bipolar, and wrote the strongest nexus linking my bp to "chronic since first treatment in military" (which, btw, was 30 years ago).

So I knew I had a clear claim for either 100% P&T schedular or IU P&T. I figured it would be easier to go 70%, IU P&T rather than try for 100% schedular (plus, I don't want a fudicary and 100% schedular, IMHO, opens you up for that nasty bit of business with the VA).

I argue with VSO #2, and he finally relents and agrees to another NOD and gives me some good advice in getting it done (even though he remains on record that I should take the 50% and fight for a higher rating later - I didn't think I could mentally make it through another round with the VA and decided to just gut it out and fight it out up front - and I am very thankful, given the number of new claims and the backlog and older vets going to the back of the line - that I did).

Also, by this point, several years into my claim, I've learned a lot from hadit and decided to ask outright for 70%, 100% IU, P&T in my appeal which is what I did. I sent in a NOD coversheet and then tabbed evidence highlighting the relevant parts for my claim.

VSO #2 has cracked under the pressure by the time I get my NOD together ready for submission and I turn again to the VSO Supervisor. I ask him (beg him practically) to be the person who takes my NOD across the finish line and he does. The VSO can have an informal conference with the DRO and I wanted someone to personally look the DRO in the eye and present the information and ask for a proper rating.

A DRO Conference is out for me - I'm too much of a space cadet sometimes to be able to want to go for a DRO Conference. If I'm depressed I won't get out of bed. If I'm manic I won't sit down. If I'm interepisode I look and talk as normal as the next guy.

So, VSO Sup takes it across the finish line and I get 100% schedular, P&T. I would have rather gotten IU. All you need to do there is show you can't work but with schedular it is based on sx and improvement. But that's a minor point that I had no control over.

Then, after my 100% P&T Decision, a new vet rep comes on board and he's assigned VSO #2's caseload. No biggee, my claim is over. I call him to tell him that my most recent copy of my cfile didn't include my Decision or Codesheet. Since I have my Decision I ask for my codesheet and this %$^#%#@$ tells me I can't have it. He's an even bigger jackass than the very first VSO. I hold myself together and calmly tell him that my codesheet from my first Decision was in the first copy of the cfile I got so I do not understand why I am now "not authorized" (his words, not mine) to have a copy of the Code Sheet from my second Decision.

He grudgingly relents and says he will send me a copy of it (*&^%*&^% can print it off from his computer) which at least he does.

I also ask him to put a copy of my 100% P&T Decision in my cfile. He tells me, and I quote, that he doesn't have time. That the Decisions are all in the system and therefore, there is no need for him to put my 100% Decision physically in my cfile. I let that one got since I have a copy of it so if the VA ever loses it I can send it to them but what an uncoperative #$%%#$@#$@#!!

So, two jerks, one so-so, and one supervisor who was top notch. I think God had a hand in my claim because when I really needed help, I was between VSOs and the supervisor took my calls. He also agreed to my plea to present my case to the DRO.

I still have them as my POA because that's another level of protection, IMO, if the VA sends any paperwork out - they are supposed to send it to your VSO as well as to you so in theory, if the VA doesn't actually send your copy out (it's happened) then your VSO should get a copy and let you know.

Bottom line for me, I used a VSO but it was really hadit and vawatchdog.org that helped me prepare my appeal.

Long winded answer to a simple question but the matter of a VSO really comes down to how good is the actual person who's handling your claim and that can be a real crap shoot.

Hope this helps,

TS

[WHOLESALE]

BR, I found a source in your area that might do an IMO or IME. If he can't he possibly can refer you to someone that does.

Here is his info:

General & Forensic Psychiatry

POGOS H. VOSKANIAN, M.D.

tel. 215 938 7227; fax. 215 938 7474; e-mail: forensics@pol.net

www.forensic-psychiatrist.com

frank