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Denied For Depression


12R3G

Question

My GAF is 65, I'm on 2 meds, and my GAF lists several SC condition in Axis III.

Isn't Axis III essenitally the co-morbid conditions affecting the depression? I was claiming depression secondary to existing SC conditions (OSA, DMII, hypertension, tinnitis, etc).

I'm going to file a NoD and ask VA psych/shrink to add note in record that depression is "at least/more likely..." secondary to SC conditions. Any other ideas for direction on this?

Thanks in advance

Chuck

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I will give my 2 cents worth. When bird hunting, novice bird hunters sometimes, when they see a flock of birds over head, shoot into the flock thinking they surely must hit one. That is a mistake. You need to take careful aim at ONE BIRD, not at a flock, as you will almost never hit one shooting into the flock.

Same way with yours. PICK YOUR EASIEST "BIRD" and take careful aim. In other words dont ask for depression secondary to OSA, DMII, hypertension, tinnitus etc. Instead, look up from other cases (BVA CAVC etc) where other Vets were succussfull at, say getting depression secondary to DMII, for example. If Vets have been successful at getting depression SC'd to OSA AND DMII, for example, you could try a "double barreled" shot, but I dont recommend throwing the kitchen sink at em. JMHO.

(Even if you "shoot into the overhead flock" and manage to hit one, then often it will be with only one or two bb's (Shotguns have "bb's" in them), and it wont be enough to "bring the bird down", but often wounds it and it may keep flying but then tragically die from its wounds, sometimes days or weeks later) Good hunters go to great effort not to just wound their animal and leave it to suffer a prolonged suffering, but rather take a "clean shot" and bring home the bacon.

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If you want something secondary to another SC condition you should get a medical statement that explains the relationship between the SC condition and the secondary condition and makes a nexus. You should get something besides a note. You need a medical rational. If you are 100% already why bother getting the depression sc'ed?

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Chuck: I wish you luck to get a VA Dr. to make the statement that anything is as likely as not or more likely than not. Also, unless they give a nexus as to how one is related or caused by the SC condition or conditions, to give their statement weight, A C&P examiner can and would most likely give an opinion to Rebut any general statement without any support.

If you have the money, you would be better off with a IMO to support your claim.

Just remember to keep fighting the fight.

Rockhound Rider :)

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Chuck

Rockbound is right. Getting a nexus statement from a VA doctor is hit or miss. They are not required to write reports regarding service connected conditions. However, some VA psychiatrists will write a note in the electronic record even though there is no requirement that they get involved in adjudication issues. If you do get a report from a VA psychiatrist it can be strong evidence. In cases where I have been able to get a VA clinician to write reports these reports were given weight and used win claims. If you cannot get a VA clinician to write the report then you will need to get a private doctor involved in your claim.

Axis III can involve conditions causing the depression or affecting the treatment of depression. There is no clear-cut way to connect the dots between something listed on axis III to the etiology of a secondary condition. Thus your plan to seek a nexus letter is the best way to deal with this problem. I have seen reports where the Axis I line says something to the effect “depression due to chronic back pain”.

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On the other hand, fishing with a grenade works great. ( see PT109 movie )

I will give my 2 cents worth. When bird hunting, novice bird hunters sometimes, when they see a flock of birds over head, shoot into the flock thinking they surely must hit one. That is a mistake. You need to take careful aim at ONE BIRD, not at a flock, as you will almost never hit one shooting into the flock.

Same way with yours. PICK YOUR EASIEST "BIRD" and take careful aim. In other words dont ask for depression secondary to OSA, DMII, hypertension, tinnitus etc. Instead, look up from other cases (BVA CAVC etc) where other Vets were succussfull at, say getting depression secondary to DMII, for example. If Vets have been successful at getting depression SC'd to OSA AND DMII, for example, you could try a "double barreled" shot, but I dont recommend throwing the kitchen sink at em. JMHO.

(Even if you "shoot into the overhead flock" and manage to hit one, then often it will be with only one or two bb's (Shotguns have "bb's" in them), and it wont be enough to "bring the bird down", but often wounds it and it may keep flying but then tragically die from its wounds, sometimes days or weeks later) Good hunters go to great effort not to just wound their animal and leave it to suffer a prolonged suffering, but rather take a "clean shot" and bring home the bacon.

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Thanks Hoppy! I should have remembered that about getting the Dr. or others to input such as you discribed.

I had taken a psych test and I was able to get a statement by the testing psychologist to input her opinion on what the results of the tests indicated. Knowing that I had a (TBI) Traumatic head injury while in the service and that tests at that time showed abnormal results and seeing that the C&P examiner at that time opinioned that I had a personality disorder, the personality disorder rather than being a developtmental disorder, it was due to my head injury or as she diagnosed it, "personality disorder due to a Brain Injury or rather a Organic personality disorder. Which means a personality disorder due to a mediical condition. Also it was noteworthy enough to list it as an AXIS I problem.

As a result of this, when I got to see a Neurologist, he defered his opinion to that of the Psychologist's opinion. The Neurologist also listed my headaches as Post Traumatic Headaches.

I also got my Psychologist to input her opinion, based on my records and her observation, the in her opinion I did not meet any of the criteria for a personality disorders listed in the DSM IV.

These are some of the types of entries I was able to get entered. Others would of course have to have them referance your depression and their opinion as to it's cause or relation to your SC conditions, espercially if you did not have any notes and/or opinions of depression while you were in the service and/or that the records reflect that the depression developed after and over time as a result of your SC condition or conditions.

It's late and I hope this information and what others have posted help you to better understand what you need to prove your claim.

If you still have doubts and/or questions, don't be shy in asking, their is never a dumb question where the VA is concerned, keep asking until you are comfortable with the answeres you are getting.

On a side note. If you are using the services of a SO/Service Officer, the same goes for them. If you feel they are not giving good advice, they probably are not. check their answers with what you get from here. It's better to be safe in knowing things are being done right and that your SO is doing right by you also.

Rockhound Rider :)

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