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tck5810

Service Connection For Depression

Question

I need some help/guidance on service connection for depression. While I was active duty a variety of events led me to have a near total breakdown beginning in November 1999. It got so back that my wife was very close to forceably having me admitted to Heidelberg Hospital in Germany. After several sessions with a Chaplain friend of ours, I finally relented and visited a Psychiatrist beginning in about February 2000. He started me on Atavan and Paxi, and I visited him about once a week for nearly 3 months. This is now where it gets complicated...At the end of April 2000, my father had a near fatal heart attach back homein Colorado (on My Daughter's 2nd birthday). I immediately flew back to be with my mom and family, because we weren't sure if he'd survive. As it turns out, he lingered for about 3 weeks, before finally passing away. I extended my emergency leave to help attend to his estate, and for lack of better explanation, I put my on troubles aside to help out my mom. I ran out of my drugs, and quite them cold turkey. Then I got back to Germany, just in time to PCS back to CONUS. I had access to my medical records (the paper ones at least), and I pulled out anything having to do with depression, because I knew I was coming up on my periodic TS reinvestigation, and I absolutely needed that clearance for the job I was going to.

This isn't to say I was better though. I struggled with it for nearly a year longer, finally come out of that bout of depression in about spring 2001. Because I didn't want to lose the clearance, I decided against seeing any Psych or Psychologist, although my wife coudl tell you that I was a basket case at home, after holding together as much as I could at work. I also traveled a lot, so it gave me diversions in thought. Fast forward to my retirement physical in 2003, and I put on there that I had a short bout of depression, but I stated it was because of my father's death and was more grief related than anything else. I did this, because the retirement job I was hired for also need a TS/SCI clearance. So everything hinged around my trying to hide my depression to stayed employed in my field.

In May 2005, I noticed that I was starting to experience a lot of anger issues, especially at home. I started seeing a counselor in the summer of 2005, but then it was easy to couch the sessions around dealing with our Autistic son. So I used many convenient excuses to hide the fact that I experienced several extended bouts of depression. And in 2005, I had no filed yet for any VA benefits. Then in January 2007, I had a C4-6 anterior fusion, which worked for a few months until I began having an unrelenting bout of severe pain. That led me to 7 monhs of cervical steroid epidurals. As they no lone worked, I agreed to a double laminectomy in June 2008, where the surgeon emplaced rods and screws. I woke up from that surgery with severe pain and hyperthesia to my left arm and hand. It didn't help that I could not get referred for physical or occupational therapy.

Along with several other problems, I finally filed a comprehensive claim with the VA through my VFW VSO. I received an inital 70% evaluation, which was later knocked down to 60% because a QTC examiner (without ever doing an exam of my neck) said that I had full range of motion. That caused me to be dropped fom 20% post-surgery for my neck to 10% permanent. In the same claim, I was basically turned down for everything else. I submitted a NOD, and even went to an independent medical examiner who I thought said all the right things, and in most cases he did. He even commented on a Thyroid problem that at least started in 2000 when I was on active duty, except that nobody ever contacted me from the MTF to tell me that my thyroid was very low....more on that later. I have recently received my DRO review letter. It seems that I've been S/C'ed for nearly everything I had initially requested, although I don't yet know what level I'm at with any of those ratings yet. The letter, with very little discussion of the reduction on my neck, just stated that I was going to be placed back at 20%, and that I would also receive at 10% incease to 20% for DDD for the lumbar region. So I think for the moment I'm generally happy with where my claim is going. However, I was denied yet again for depression, even though I've been seeing a Psychologist pretty steady for 4 years, and I recently started seeing a MTF Psychiatrist (I'm no longer worried about clearances).

In my NOD, I wrote a very lengthy explanation of my depression, and how I'd been seen at the Heidelberg Army Hospital, and that I had used my father's passing as a way not to call attention to the depression at the time. I also had my wife write a letter to state from her point of view how I have been. Now though, not only was I dealing with that initial depression, but because of the damage done to my spinal cord in my June 2008 surgery, the pain that was initially in my left arm and hand has spread to nearly all of my body. It has intensified in my Left arm and had to the point that I cannot stand even my kids touching me. I turn on it at night, and I wake up, or I never fall asleep because it hurts too much. I'm on many differnent drugs to help me sleep and several anti-depressents and anti-anxiety drugs. But apparently the VA didn't S/C my depression, because they have no records showing that I was ever treated for it; this after I told them what treatment facility I was seen at. Betweent he pain and the depression, my work is now effected signifcantly. i have a very high pressure position which demands much of me, especially in making decisions, but I out too much, and even when I'm there I feel like all I'm concentrating on is pain, since it never lets up now. Even if I didn't have depression during my A/D career, I sure have it now, after living with unrelenting pain for nearly 2 1/2 years! Still the DRO refused to S/C it! I need some advice on how to get them to understand what I'm going through.

I mentioned that I had a problem with my thryroid (low) way back in 2000, that I was never told about. Well, when my initial claim came back denied for nearly eveything, for the first time I went through every single page of my SMR. By then though, I already had found out I had hypothyroidism, thanks to the insight of my new family doc. AFter my June 2008 surgery I had to completely quite physical activity, and my weight ballooned up 75 pounds. When I went in to see him about he, ran some blood tests and immediatley put me on thyroid replacement medicine. Fast forward to about this time last year when my big brown envelope showed up. When I saw that I had not been given a fair deal, I started lookikng though every page of my record. Low and behold, I found out that I had been administered a thyroid blood test in August 2000, and had never been notified of the results, which were nearly identical to the test I had been given in August 2009. So I filed a new claim for hypothyroidism. My weight has come down some, but it's still way above where it should be,and this with a very strict diet. I take synthoid everyday now,and will for the rest of my life. I can only wonder why nobody at the military hospital notified me back when I was still active, so that I could have started the medication 8 years earlier, but that's where it is now. I was also denied S/C for insomnia, rather because of the depression, chronic pain, or hypothryroidism (which hasn't been adjudicatedyet), since it is not a disease but a symptom.

So I'm stuck in not knowing how else to make the VA understand the depression is longstanding,and it has gotten worse because of the chronic pain Ilive with daily, eventhough I tried to explain that to them. I'm sure my next step will be to appreal to the VBA. But I want to make sure my ducks are in a row, and my explanations can be substantiated. I'm sorry for such a long message, but Ihope there are some seasoned folks out there who can advise me on what to do next.

Thanks,

TCK5810

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5 answers to this question

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Are you saying there are no records of your psychiatric treatment in the military? If that is so then you must get a medical opinion that your chronic pain is the cause of your depression. Was your ETS physical used in your depression claim.

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Are you saying there are no records of your psychiatric treatment in the military? If that is so then you must get a medical opinion that your chronic pain is the cause of your depression. Was your ETS physical used in your depression claim.

Yest to using my ETS physical for my depression claim. My ETS physical states that I did experience depression, but the VA has locked in on my statement on the front page of the physical form that the depression dealt with my father's death...which in part it did. BUT, I was already in a major bout of depression by the time that had happened. I had been taking Atavan and Paxil, prescribed by an Army MTF Psychiatrist in early 2000, months before my father passed. And his passing was sudden so it wasn't something I was already having to deal with. I don't know why the Heidelberg hospital doesn't have a record of my having been treated in their Psych clinnic, or of the prescriptions given to me. Can I use a reliable witness, such as my former chaplain and my wife's statemdng (she's a nurse) to explain that depression had already hit by the time my father died...and it went on for a much longer time afterwards also? Again, I downplayed this at the time because I didn't want to lose my clearance.

My VSO agrees with you that I should get it as secondary to my chronic pain. The thing is though that multiple doctors have diagnosed me with Major Depression for at least 18 months, and that's in the records they should have reviewed in making their decision. Plus I'm on two anti-depressants, and anti-anxiety medication, and lunesta to help me get to sleep, because of prolonged insomnia. It's 1215 AM as I write this, I have a nerve block procedure at 0800, and i'm lyingin bed wide awake, and this after I didn't fall asleep until 4 am this morning, getting up at 8:30 for work.

thanks!

TCK5810

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2 ways to go.

1. Find the records from Germany and they may state the true reason for the depression.

2. Talk with your doc, see if they feel that your depression is due to your service connected issues. If they say yes, ask them to write a letter or at least note it in the treatments records. If they say no, then yur just spinning your wheels.

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Yest to using my ETS physical for my depression claim. My ETS physical states that I did experience depression, but the VA has locked in on my statement on the front page of the physical form that the depression dealt with my father's death...which in part it did. BUT, I was already in a major bout of depression by the time that had happened. I had been taking Atavan and Paxil, prescribed by an Army MTF Psychiatrist in early 2000, months before my father passed. And his passing was sudden so it wasn't something I was already having to deal with. I don't know why the Heidelberg hospital doesn't have a record of my having been treated in their Psych clinnic, or of the prescriptions given to me. Can I use a reliable witness, such as my former chaplain and my wife's statemdng (she's a nurse) to explain that depression had already hit by the time my father died...and it went on for a much longer time afterwards also? Again, I downplayed this at the time because I didn't want to lose my clearance.

My VSO agrees with you that I should get it as secondary to my chronic pain. The thing is though that multiple doctors have diagnosed me with Major Depression for at least 18 months, and that's in the records they should have reviewed in making their decision. Plus I'm on two anti-depressants, and anti-anxiety medication, and lunesta to help me get to sleep, because of prolonged insomnia. It's 1215 AM as I write this, I have a nerve block procedure at 0800, and i'm lyingin bed wide awake, and this after I didn't fall asleep until 4 am this morning, getting up at 8:30 for work.

thanks!

TCK5810

I see that you are saying you think you can not get secondary depression to chronic pain because it is pre-exisiting because of your fathers death ( or at least this is what the VA and evidence is showing)

Remember a service connected disability is anything the was caused or AGGRAVATED by service. Remember the word Aggravated.

Create your claim something like this:

* While in service I developed depression due to my fathers death, I was treated with medication X and therapist X. (provide records)

* I then recieved X & X injuries which continue to cause chronic Pain for which I am currently Serivce Connected.

* When I recieved the X & X injuries there was a marked decline in my handling of my depression.

* My current and previous psychs believe that the Chronic Pain I experience from my service connected condition aggrevates my depression. ( provide IMO's from Psych that confirm this view)

* I am requesting service connection for my depression secondary to my service connected X & X (list SC'ed conditions) by way of aggravation.

* X medications that I take also contributes to the aggravation of my depression. Read your pain meds for side effects etc. and if tere is anything helpful submit the med slip that comes with each bottle as evidence too.

I think because of the lack of material evidence from your initial bout and treatment of depression it is going to be hard to prove cause. But Chronic Pain is one type of aggrevation that works more often than not when it comes to depression.

Good Luck

*

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In my NOD, I wrote a very lengthy explanation of my depression, and how I'd been seen at the Heidelberg Army Hospital, and that I had used my father's passing as a way not to call attention to the depression at the time. I also had my wife write a letter to state from her point of view how I have been. Now though, not only was I dealing with that initial depression, but because of the damage done to my spinal cord in my June 2008 surgery, the pain that was initially in my left arm and hand has spread to nearly all of my body. It has intensified in my Left arm and had to the point that I cannot stand even my kids touching me. I turn on it at night, and I wake up, or I never fall asleep because it hurts too much. I'm on many differnent drugs to help me sleep and several anti-depressents and anti-anxiety drugs. But apparently the VA didn't S/C my depression, because they have no records showing that I was ever treated for it; this after I told them what treatment facility I was seen at. Betweent he pain and the depression, my work is now effected signifcantly. i have a very high pressure position which demands much of me, especially in making decisions, but I out too much, and even when I'm there I feel like all I'm concentrating on is pain, since it never lets up now. Even if I didn't have depression during my A/D career, I sure have it now, after living with unrelenting pain for nearly 2 1/2 years! Still the DRO refused to S/C it! I need some advice on how to get them to understand what I'm going through.

tck,

My very first suggestion to you is keep it simple.

I actually did read your entire post and please believe me, if you go into all

of that in regards to a VBA claim - it will not be read.

All that counts is STR/SMR's, and medical evidence.

If something isn't documented and if a doctor doesn't write things it's like

it does not exist.

If you give them all this other stuff it will just muddy up your claim and provide

them with plenty of information to use, to deny your claim.

You posted,

" However, I was denied yet again for depression, even though I've been seeing a Psychologist pretty steady for 4 years,

and I recently started seeing a MTF Psychiatrist (I'm no longer worried about clearances)."

What exactly is stated in the Reasons and Bases Section to support the denial ?

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