tdiu Ssdi For Bipolar, Applying For Va....comments / Helpful Answers?

[ZenLife]

Hi everyone. I'm Jay, long time viewer, first time poster. I've been wading through these forums for a while, as well as dozens of other sites, and I have a couple of questions / concerns. Maybe someone can give me an idea if I have a claim or not, and if so, what to expect. Sorry if this post is a little long, it's hard to sum up 6 years in a paragraph!

Here's my Sit. Rep.:

Served USMC '99 - '04

• Didn't know it at the time, but I'm Bipolar, then and now, it's life long.
  
  • Had several disciplinary actions throughout 5 yr. service, nearly got discharged 2 months before my EAS because of repeated infractions. Got lucky, and squeaked out with a "General Under Honorable". Discipline / poor impulse control is common for Bipolar people in general, especially having the first episode after a major lifestyle change or around age 20 (i.e. entering the military at 18). I'm not certain if this would help or hurt my claim.
    
    • Diagnosed and treated one time by MACG28 BAS for Depression / sleep disturbance in 2003. Bipolar disorder is often initially misdiagnosed as Depression. Medications were ineffective and worsened my situation - I didn't want to be discharged, so I did what a lot of us do - dealt with it as best I could until my EAS to preserve the benefits I'd worked my butt off for.
      
      • I'm not certain if either of the above could help provide service connection or not - input would be most appreciated.
        

      Currently I recieve SSDI for Bipolar , the only condition I intend to apply for w/ VA

      [*]
      I bean receiving treatment early 2005.
      [*]
      Applied for SSDI in Dec. 2005.
      [*]
      Awarded Benefits May 2008.
      [*]
      Award states that I've been disabled since June 22, 2004, the day after my last day of active duty.
      [*]
      Three evaluations with average GAF's of 55 from three Dr.'s were partial basis for this award.
      [*]
      Award included documentation from my military medical record concerning the diagnosis of Depression.
      [*]
      No other medical claims or job history.

      I currently receive care for my condition, and have been receiving care since Jan. 2007

      My questions are:

  [*]Do I have service connection based on the in-service diagnosis, since depression is the precursor to or misdiagnosis of, bipolar?

  [*]My Dr. is willing to write a letter for me to serve as a nexus. He is concerned over his legal liability - is there any in this case?

  [*]If his letter is disregarded by the VA, would my SSA award serve as a nexus, since it includes the early in service diagnosis?

  [*]Since the SSA considers me disabled, will the VA look at it similarly and give weight to my award?

  [*]Do I apply for TDIU with my initial application?

  [*]Would my effective date be that of my award letter in 2008, my last date of employment in 2004, or the date I file, in a couple of days?

  Any and all input would be greatly appreciated. Thanks for taking the time to read this. And a special thank you to all the men and women who take the time to help others navigate the VA/SSA jungle!!!

  Semper Fi!

[Berta]

I remember your first post and replied-

It was acknowledged somewhere here but it is gone.??

What is the exact disability you have claimed?

In my past post I think I mentioned a Bi polar vet friend of mine.

I had sent him a SF 180 for his personnel records as well as his SMRs.He kept forgetting to send it to NARA.

Meantime his claim was in appeals ( for over 10 years)

I knew something he had mentioned to me over a decade ago -and felt his SMRs would not help him.But if something was in his 201 file-THAT would help his claim.His forgetfulness was part of his bipolar problems (probably from the meds) but Finally he sent the form in (couldnt handle the online request)

and Bingo we got his VA shrink who I knew quite well to write an IMO for him associating this inservice evidence in the 201 file with his current disabilty.

He also had been on SSA for Bi Polar for many years.

He called me up one day in great excitement -he had been proposed incompetent by VA but his wife would become his fiduciary and he was OK with that because they owed him almost 1/4 a million in retro. 100% P & T for Manic Bi polar

He then suggested to take me to lunch because I helped him -but to lunch in Ireland!

Of course he didn't owe me anything and is still a wonderful friend of mine.

My long point here is for Bi polar claims if that is what you are claiming could show evidence of symptomatic ewtiology within a personnel file as well as the inservice SMR military file.

"is there any chance that the award itself could be considered a nexus, as it clearly states that my disability began at my EAS using both in-service records and current treatment records for the same condition?"

Possibly if the SSA award is for exactly what you claim now. A Psychosis is a "chronic presumptive" under those regulations which should be here at hadit.

."My SSDI award was based on Bipolar" but is the VA claim for Bi polar?

You might not even need an IMO- have they sent you a VCAA letter yet?

They will need any private treatment records too.The VCAA letter will tell you exactly what they still need.

Your SSA records are crucial here.It sounds like you have some more detailed info from SSA then they usually send out.

Make sure you send them COpies only and get proof of mailing for whatever you send to them.

Edited January 21, 2011 by Berta

[carlie]

Thank you for the helpful links. For now though, I think I might be better off staying with my current provider. I know I'm fully covered medically and I'm much more familiar with the staff. I've never been comfortable with new Dr's.I do have one question, perhaps someone will have an idea about this;Currently, my concern is the nexus part of proving a service connection,

Zen,

If you meet the eligibility criteria for the vet centers there is

1) No charge for services

2) It's allowed and good to have more than one mental health provider

3) Additional medical documentation of your issues and what they are related to.

The Vet Center's have some provider's with the right pedigree to write

an opinion that might provide a nexus.

Of course there's no way to know if they can be of help unless you give them

a try - you don't need to drop anyone you are currently receiving services from.

I'm not trying to shove the Vet Center's on you just giving you more information on ways they can help.

Many here have found them to be wonderful, a big help with their claims for evidence

and nothing at all like going to a VAMC appointment.

I hope you at least consider chewing on it for awhile and not just totally dismiss the opportunity.

[ZenLife]

I'm going to find out a little more about my local Vet Center, it isn't very far from where I currently go. I'm not closed to the idea entirely. My paranoia just gets the better of me sometimes. I have poor social skills and I'm a very quiet and private person. As a consequence, I tend to get the short end of the stick sometimes, I don't go out much.

The first post is still here. I did notice that I had to click the link at the bottom to see everything though, the one that says "Review the complete topic".

For the claim, I listed three things in the following order (I followed the chronological course of records):

1. Major Depressive Disorder

2. Bipolar Disorder

3. Tension Headaches / Migraines

MDD is what I was originally seen for in service. (A copy of that service record was part of the SSA decision.)

1 1/2 yrs later I resumed treatment for that, and the Dr. added Bipolar Disorder. (That exam was also part of the SSA award.)

The headaches are something that I've always had, but the only mention of them I could find was on my separation exam.

I was just taking Excedrin for the HA's until last year when my doctor told me he could give me something stronger to help prevent them. Call me naive, but I didn't even think of that as an option. I included them in the claim since there is a mention of them on the sep exam and I have current treatment for them. I thought there might be some issue of a secondary claim there.

I haven't gotten a reply (VCAA) yet.

The exact disability I receive SSDI for is Bipolar alone. It took 3 yrs and a hearing before an ALJ to reach a favorable decision.

I included 3 release of info forms in the application, one for my local SSA office, and two for where I'm being treated now. They changed management, so there are two different offices that maintain records.

I requested treatment records myself, but all I got were summary notes and listed prescription history. I know they have more info than that, but they won't release it to me (to avoid harming the patient / interfering w/ treatment). I thought the VA may be able to get more complete records from them.

The only info I have from SSA is the actual award itself. It listed the reasoning of the ALJ and the evidence considered.

As for service records in support of Bipolar...This is something that I didn't touch on in the claim. I seriously considered it and even gathered the copies of every disciplinary action taken while I was in service. I just didn't go through with it because I thought that might lead an examiner to immediately think "shitbird' and can my claim. After all, if I list a history of disciplinary actions and claim them as related to Bipolar, couldn't they simply say "you're not a doctor, there's nothing to support that"?

Overall, I had trouble remembering dates & times, being late & feeling tired constantly. Sorry this following part is a little long, but I want to answer your question accurately.

My first psychological "break" was in late recruit training, typical of Bipolar - early 20's + major life change. There isn't any record I know of though.

I had attentiveness problems in MOS school (had to take Basic Electronics twice).

2 years into service and 3 counts of Article 86 (UA) later, I found myself as a guest of the Corrective Custody Unit and reduced to E-2 after NJP (#1).

*note - when I say UA, I'm not talking about going AWOL ar anything like that. I was late by a few minutes, or simply forgot that I had a certain duty on a given day that was outside of my normal schedule.

One year later, I had my rank back and was doing my best to keep on the straight & narrow.

Then I had an episode, 3 more UA charges with 45 days. That was NJP (#2), reduced again & restricted to barracks. The reduction was suspended for 3 months. Later I got another UA and the reduction was vacated, I was an E-2 again. (I have a history of self-defeating behavior, that much I've learned).

At this point I was pretty well convinced that I as a terminal screw-up and that it simply wasn't going to end well for me.

In June of 03 I was seen for a sleep disturbance and given Ambien. The doctor DX it as insomnia, even though I had told him that I was having trouble sleeping too much as well. I forgot a duty driver assignment and got another UA the end of that same month.

My SSGT decided something more was wrong with me at that point, had me see the doctor (His wife is Bipolar, he recognized a lot of the symptoms).

July of 03 I was DX w/MDD and given Zoloft. The Zoloft certainly "helped" the insomnia part - I overslept, another UA.

I gave the Zoloft a fair try, determined to make it to EAS without any further problems. I quit taking it in November when I got another UA, it was making hard to stay alert and remember things. That was NJP (#3) & reduction to private. After that, I didn't touch anti-depressants again while in service. I spent each day dreading being locked in a little cell in Fort Leavenworth.

They began an administrative separation board to separate me from service <2 months early. If they had succeeded, I would have found myself with an OTH discharge based on a pattern of minor misconduct.

I formally requested in writing that I be allowed to discharge with a general under honorable conditions, citing the service I had given to my unit and the awards I had earned in those 5 years. Despite my troubles, I did my MOS job very well and had saved them a truckload of money improving the maintenance system. The board agreed and I got an honorable discharge.

I know this is long, but I hope I answered your questions.

[ZenLife]

I just want to add something....I know that last post doesn't cast a very flattering light, but believe me, I worked my butt off those 5 years.

I keep a 1st class PFT, knew my job inside and out, and received several awards (for saving a costly training mission from being scrapped, improving the training facilities at our unit, and catching an error that was costing my unit an additional $25,000/yr.)

I even volunteered for and completed an additional MOS school for the sole purpose of training my coworkers in techniques that cut our maintenance budget in half.

99.9% of the time, I was the first in and the last to leave. Deployed or in garrison, no job went unfinished.

Make no mistake - I loved being a Marine.

[Berta]

I didn't take it that way at all-

Would your current doctor who treats the bipolar/MDD issues, be willing to prepare an IMO for you if it is needed?

They would need all SMRs and VA/non VA medical records and they need to follow the IMO criteria here at hadit.

Neither any VA C & P doctors or any raters will take the time to fully establish any nexus.

It has to be clear to them and a good IMO doctor,with credentials that match or out weigh any C & P doc credentials could help considerably here.

When they send the VCAA letter however, then you will know better what evidence they will need.

At this popint early in the game yo might want to think about the IMO and ask the doc you have now if they could prepare one for an inservice nexus to your claimed conditions based on all available medical info yo can give them.

They could charge a fee so this is something to plan ahead for too.

VA might have enough information and you could possibly get a favorable C & P result to award the claim but I wouldn't depend on that. When the C & P comes up mention to the C& P doc the SSA award.

[ZenLife]

I've had several doctors over the years. I've been with my current doctor since the end of 08.

I asked him about an IMO, he noted it on my treatment chart as "wants independent medical opinion".

That was several months ago when I wasn't entirely certain what an IMO was. I had the basic idea though.

His reply was that he could give his opinion of my condition but couldn't legally comment on anything he didn't personally treat me for (i.e., my in-service treatment). He said that there was a matter of being legally liable for any statement he issues. He works for a state hospital so he probably has to worry about that sort of thing regularly.

In short - I can get his opinion, but I don't know how helpful it'd be in establishing a medical nexus.

When I first began going to that facility, I showed my first doctor the diagnosis from the military. Foolishly, I didn't have a copy. And I know that the SSA used it in their decision, but I don't know if my doctor copied it and sent it to them or if he sent the one I gave him.

I know it's in my MRB with the VA, but it might be some time before I can get a copy of it to show my current doctor.

I'll talk to him though and see what I can do.

Is the history of infractions something I should consider for the IMO, or would I be better off simply trying to establish a nexus for the MDD? I'm asking because I don't know if he'd be willing to state that they were probably early manifestations of Bipolar or not. I'm thinking maybe I should try to have keep the statement as simple and clear as possible.