Anexity Or Depression

[81150 CAFB]

I am currently recovering post op from a lumbar fusion of my L4-L5 vertsbrae (~4 weeks). This surgery followed a diskectomy at the same level that didn't take. I am still in the process of gathering information to get service connected. My question is related to filing for either anexity/panic attacks or depression. About a year a half prior to my surguries I was diagnosed with panic attacks/anexity and prescribed lexapro, propananyl and clonazepam along with Xanax. The lexapro really started working and I haven't had any attacks for at least a year. Since my second surgery, which is still very painful, I have had around a dozen panic attacks with the trigger being my pain and lack of progress and thinking about the reality of my situation (might not get better). Even though I was diagnosed prior to my back surgeries can I claim panic/anexity as secondary to my back claim since it has definately gotten worse?

I am also suffering from some depression due to the pain and missing over 3 months of work so far among other issues. I am a little hesitant to file for depression for work reasons. I think that either issue would be rated at the 10% level as hopefully being managed with medication. I have an appointment tomorrow with my physchiatrist and I have already talked to her about my attacks and depression and she said she would up my meds to higher doses. I also understand that you can only claim one mental health issue.

I would, right now, rather file for panic/anexity. But would the previous diagnosis prior to my surguries negate any claim even though it has gotten worse.

Any help or comment would be appreciated.

[LarryJ]

81150,

I read through this and the part where you said (vindication!!!) really got me. I know exactly how you feel, but I have not yet had surgery on L4 through S1. I think I would rather give birth to a dozen babies than ever feel ruptured disc pain ever again, and I'm a guy! Re-learning how to walk was painful and tough, but I did it. Regardless, I'm fighting the good fight to get SC for this. I really hope you get SC too!

I know some people who had the laminectomy, but only a couple told me that they actually feel better. Regardless, they all say the sciatica hurts bad.

Have they talked about doing a fusion?

Somewhat related, when my 3rd molars were extracted, I was in so much pain for so long, that I knew something was wrong. Nothing really showed up on the x-rays and, of course, my initial claim was denied. During my appeal, an arthragram was done, which proved that they screwed up. That was my (vindication!!!). I'm SC for this, but filed for an increase recently.

Don't forget about chronic pain, in addition to the anxiety/panic attacks, from the MH viewpoint! I'm also requesting SC for this. I understand the VA will grant SC for only one MH condition, but the most severe one counts as the %. In my case, I hurt all the time and eat blended food because I can't chew much. If I move my back the wrong way or lift incorrectly, there goes my back too! If I take pain meds or relaxers, the pain is less, but I can't function. So it's a no win situation, but I am not giving up!

Because you are not SC, you cannot have the VA pay you at 100% rate for being out of commission for 21+ straight days, because of the condition. However, after you get SC, I wonder if it might be possible to get this retroactively until you get back to work. Someone else here might know more about this than I do. It's just a thought, but might be possible.

Regarding the anxiety/panic attacks, have they given you any meds to help you overcome the attacks? Beware if your general doctor or a nurse practitioner tries to prescribe something. You'll probably need to visit with a psychiatrist for the best results. They know more about those meds than anyone and could possibly give you some genuine relief in that department.

Make sure your nexus/IMO is worded right and has the etiology too!

I am also curious if the secondary issues can be rated as secondary as the same time you ask for SC.

Hope you get to feeling better!

You can get as many psychiatric conditions as you have, service connected (as a matter-of-fact, you SHOULD make sure and get as many SC'd as possible, for reasons that will become, possibly, clearer on down the road). But, as you noted, they will only pay for the SC'd psych condition that has the highest rating possibility.

Major Depression (Major Depressive Disorder) is the one psychiatric condition that the VA appears to have the best understanding of, and it is usually the easiest to get service connected with the highest percentage of most all the other psych conditions.

just sayin'

[81150 CAFB]

Did you file your claim for compensation within one year of discharge? That would make it easier. You have to get the back SC'ed first. Once you get that SC'ed then your secondary conditions will be considered. That is just how the VA works. Did you have any psychiatric problems in service? What kind of discharge did you get?

I got out of the Air Force in 1991 and had the first surgery in 1989. 20 years later I had the same surgery as in 1989 just on the other side. Three months later I had the fusion done at the same level. The last appointment I had with my private nuero I causually brought up the fact that my initial injury was probably to blame...he then said it was definately caused by my discectomy in 1989. Pretty much said what we back guys know...you will always have problems now (only 40 years old) and It's just a matter of when the disk above and below and will fail. I would hope to get a good nexus from him plus show my 40+ pages of SMR's related to my back and surgery. I would think that it would be obvious that my recent back surguries would be service connected (4 ruptures on the same disk), but you can never tell from all the poor rating decisions by the VA posted about on the board.

No physchiatric problems in Air Force with Honorable discharge. His and my contention are that the increase in panic/anexity attacks in the last month is related to my current situation. Can't you file in your initial claim to include any secodary conditions?

Thanks for your help.

81150

[81150 CAFB]

You can get as many psychiatric conditions as you have, service connected (as a matter-of-fact, you SHOULD make sure and get as many SC'd as possible, for reasons that will become, possibly, clearer on down the road). But, as you noted, they will only pay for the SC'd psych condition that has the highest rating possibility.

Major Depression (Major Depressive Disorder) is the one psychiatric condition that the VA appears to have the best understanding of, and it is usually the easiest to get service connected with the highest percentage of most all the other psych conditions.

just sayin'

Honestly I am just concerned about having the "major depression" tag following me around. I do suffer from deprssion and it will probably get worse if this fusion doesn't take and I need more work done or worse...they tell me this is the way it will be. Any one not 100% rated with major depression have any problems with jobs (current or potential)? During my visit with my physchiatrist 3 months ago we did discuss depression related to my chronic pain. I could easily get diagnosed as depressed. I am just concerned i guess. uckily my meds cover anexity and depression.

Thanks for the advice.

81150

[81150 CAFB]

Vsync,

I really did feel vindicated once they found the double rupture. It felt like know one belived that I was or could be in that much pain for that long after a simple "minimally evasive" surgery. I even went back to work after taking 5 weeks of short term disabilty and suffered greatly. I had to arrive early and work through lunch so I could leave early due to the pain and trying to miss getting stuck in traffic...and all I had to do was use up all of my vacation time for the time I was missing. Great thing about my job is there is occasionally some travel involved (which is great for your back on long car trips :( My boss actually asked if I could drive three hours away and do some work in the field the week of my scheduled fusion surgery. I had a hard enough time driving to work. Oh well-they belive my now.

I am currently 5 weeks post op from my fusion surgery. It is not going well. The sciatic pain is still prevalent along with really bad back pain. I have an appointment next week with my neuro...we will see what he says.

"Because you are not SC, you cannot have the VA pay you at 100% rate for being out of commission for 21+ straight days, because of the condition. However, after you get SC, I wonder if it might be possible to get this retroactively until you get back to work. Someone else here might know more about this than I do. It's just a thought, but might be possible." This would be nice since I have been out of work on short term disabilty for about 3 months already.

I have been seeing a physchiatrist since July 2008. They have prescribed lexapro and clonazepam. They have worked great until about a month ago. He just upped my dosage of clonazepam to try and control the anexity/panic.

"Make sure your nexus/IMO is worded right and has the etiology too!". I think it is a pretty good nexus, but I am not sure about the etiology. Any suggestions? I have an appointment in a month and he was very veteran friendly...so if need to "suggest any changes" he would probably reword the letter.

"Hope you get to feeling better!". Thanks...this site has been very helpful and welcoming.

81150

[Berta]

81150

"had surgery (discectomy) on my L4-L5 disk on the right side while in the Air Force"

That should certainly establish the inservice nexus for the claim.

"Make sure your nexus/IMO is worded right and has the etiology too!". I think it is a pretty good nexus, but I am not sure about the etiology. Any suggestions? I have an appointment in a month and he was very veteran friendly...so if need to "suggest any changes" he would probably reword the letter."

The doc should follow the IMO criteria here under the IMO forum.

He should have your SMRs as well as all other med recs so that he can directly refer to this inservice nexus as causing your present condition.

There is info here under the search for Temporary Convalescent 100% comp.

It would not hurt to find that and see if you met the regulation criteria and you could apply for it as a retro payment that might be possibly awarded when they hopefully award you SC for this.

[Berta]

PS he should also state that your depression or anxiety (whichever one is the formal diagnosis) is direct due,in his opinion, to the chronic pain from your disability.

It sounds like your SMRs have plenty of evidence here for service connection.