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Axis 3


sbrewer

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According to the DSM-IV - Axis III is General Medical Problems, and Axis IV is Psychosocial and Environmental problems.

As you said this would be where a NSC condition is listed.

If a NSC condition is proven as secondary to the service connected condition- the Axis III would state the condition but I do not believe any comment as to secondary would be in that part of the report.

It would be in the medical narrative as to whether this doctor found Axis III disabilities in any way secondary to or caused by those they are claiming as service connected.

In this BVA case:

http://www.va.gov/vetapp00/files3/0029759.txt

The BVA stated:

"

The evidence that supports the veteran's claim consists of

the VA hospitalization summary reports, which show a

diagnosis of sinusitis under Axis III. Axis III is for

reporting current general medical conditions that are

potentially relevant to the understanding or management of

the individual's mental disorder. DIAGNOSTIC AND STATISTICAL

MANUAL OF MENTAL DISORDERS 39 (4th ed. 1994). Therefore, the

diagnosis of sinusitis under Axis III could be perceived as a

positive nexus between the psychiatric diagnosis under Axis I

and the veteran's service-connected sinusitis, to include

headaches."

The BVA found the Axis III diagnosis relevant to the veteran's claim.

(unfortunately-the BVA adds:

"The Board finds, however, that the preponderance of the

evidence is otherwise against a relationship between the

veteran's psychiatric disorder, which has been variously

diagnosed, and his service-connected disabilities, to include

sinusitis." They denied the claim.

The VA should look at the entire disabling picture in the Axis reports.

However , each part of the Axis information should be supported by evidence of direct service connection or evidence that the Axis diagnoses are secondary to at least one (usually Axis I) that there is medical evidence of service connection.

This claim shows what I mean a little better-a good read

http://www.va.gov/vetapp01/files03/0120962.txt

The veteran's report was :

"Axis I -

PTSD, chronic, 30 percent SC; Major depression, recurrent,

secondary to PTSD. Axis II - No diagnosis. Axis III -

Allergic to testosterone patch; S/P pituitary adenomectomy,

May 1998' "Post polio syndrome," DJD; GERD/HH;

hyperlipidemia. Axis IV - 2-mild-church crowd exposure.

Axis V - 60 in the last 12 months; 60 now."

Axis V is the GAF. Regardless of the GAF at 60 the BVA held:

"ORDER

Subject to the rules and regulations governing awards of

monetary benefits, a 100 percent rating for post-traumatic

stress disorder is hereby granted."

This case shows that the VA must consider all medical evidence in determining a proper award.

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VA did consider the entire diagnosis. Axis III is a factor in determining a GAF score. In this case the BVA accepted the mention of the sinus condition on Axis III as medical nexis for the sinus condition but held it still didn't reach equipose to SC the sinusitis as secondary to the psych condition.

Does Axis 3(physical conditions) espeially if it is non sc conditions, play a role into the rating process?

Thanks

sbrewer

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