Request Advice On Mental Health Disorder Claim

[georgiapapa]

I am thinking about filing a mental health disorder claim but I want to make sure my claim has a chance of success and also make sure I am not filing it prematurely.

Since October 2011 I have had a claim pending for AO Multiple Myeloma and peripheral neuropathy secondary to multiple myeloma. As a result of anxiety from my cancer diagnosis, I have also been going to a VA psychologist and a psychiatric NP since the summer of last year. I am currently on medication for anxiety.

After viewing some of the comments on hadit about anxiety and depression secondary to service connected disabilities, I decided to request copies of my VA mental health records to see if a claim may be justified.

Some of the comments in my records include the following:

"axis I - adjustment disorder with mixed anxiety and depressed mood (ICD-9-CM 309.28) primary."

"adjustment disorder with anxiety secondary to medical condition - multiple myeloma."

"sleep disorder."

"nightmares"

"status: fair, continues to struggle emotionally."

"anxious mood"

"withdrawn"

"anticipatory anxiety"

"hopeless and helplessness"

"labile"

"anxious, depressed"

"memory deficiencies"

My Axis V - GAF scores range from 45 to 58 with most in the mid 50s.

Last August I had back to back appointments on the same day with my psychologist and psychiatric NP. During these appointments, my psychologist gave me a GAF of 45 and the NP gave me a GAF of 58. This was my lowest and highest on the same date. I can't figure this out.

I believe the information I received justifies a mental health disorder claim but I would like input from others familiar with claims for mental health disorders.

QUESTION: Since I am in the middle of a claim for multiple myeloma, should I wait and make sure it is approved before filing a claim for the mental health disorder or should I make it part of my pending claim for multiple myeloma?

I really hate to do anything to delay the processing of my current claim but I would also prefer not to delay the effective date of my mental health disorder claim if it is approved.

Your input would be appreciated.

Thanks...Georgiapapa

[john999]

I think you have a good psychiatric claim secondary to the AO disorder. If you have a presumptive AO disorder and you set foot in Vietnam there is no quesion you will be SC'ed. What would be your rating when you get rated for the cancer from AO? If you are going to be 100% there is no rush about filing the mental health claim. What I would want is a no nonsense letter from a psychiatrist saying that your anxiety and depression are secondary to your AO disease before I filed my claim.

John

[georgiapapa]

John

I was boots on the ground in vietnam in 1967 & 1968. Multiple myeloma is on the AO presumptive list. At this time I really don't expect a 100% rating for my multiple myeloma because I am in early stage. My oncologist seems concerned that my neuropathy is getting worse and is considering stem cell transplant. If I have the stem cell transplant I may qualify for a temporary rating of 100%.

I am very satisfied with my VA psychologist and NP and I think they would give me a letter if they are permitted to do so by the VA. The NP is the one who entered the comment about my anxiety disorder being secondary to multiple myeloma. If necessary, I will try to get a strong IMO from an outside psychologist or psychiatrist. I will try to get my ducks in a row before I do anything. I appreciate your advice.

georgiapapa

[john999]

Did you see combat in Vietnam and/or do you have any combat badges or medals. If so then you can file a claim for PTSD on its own. If you file a secondary claim the original claim has to be accepted and you have to have a rating decision aleady in place. For instance, on the neuropathy if you had accepted diabetes claim from AO the PN claim would be a natural secondary claim for your DmII. Have you had a very complete physical exam. I discovered by accident that I had a condition secondary to my DMII when I went into the VA to have them look at a bump on my leg. They did a CT scan and found out I had artery disease. That is a well known secondary condition of DMII but the VA never looked for it on its own but only by accident did they discover it.

John

[georgiapapa]

John,

I did see combat in an artillery unit. Our unit participated in several combat operations which are well documented in my service records. I also have the Vietnam combat ribbon and Vietnam service ribbon.

Our unit was subjected to mortar attacks on a regular basis. I had fellow marines in my unit who were KIA or WIA while I was with them in Vietnam. However, I don't think I have PTSD from what I experienced in Vietnam. I have never been evaluated for PTSD.

I have had thorough physical exams and have other health problems including obstructive sleep apnea, mitral valve prolapse, GERD, neuropathy of all extremities, hypertension, hand tremors, frequent headaches, gastritis, bilateral hearing loss, tinnitus, arthritis and multiple myeloma. I am service connected for hearing loss (10%), tinnitus (10%) and shoulder injury from Vietnam (10%). Other than my multiple myeloma, neuropathy and anxiety disorder, I don't think I have anything else that I could service connect unless it is conditions related to the contaminated water at Camp Lejeune when I was there in 68, 69 and 70.

Thanks for your input. If you have any other suggestions, let me know.

Georgiapapa...

[donna68]

Georgiapapa,

Applying for a MH condition now or waiting can have different outcomes. If you apply now, it could hold up your claim but the good thing is you will also get you a higher rating. As far as the PTSD, it is an axis I disorder, so when they gave you an axis I diagnosis, if you had PTSD at that time it would have been included in the axis I diagnosis. Based on your symptoms, you would rate at about a 50% for adjustment disorder secondary to your multiple myeloma.

One thing to investigate is (and Im not totally sure about this) but I recall hearing that since VA must review VAMC records when making their decision on all claimed conditions, and since the VA doctor said your adjustment disorder is secondary to your multpile myeloma, then VA may have to honor the date of your multiple myeloma claim and consider the mental condition secondary based on the multpile myeloma or MH diagnosis, which ever came second, because technically the evidence is already in their posession and the opinion that it is secondary was already provided.

Another thing you can consider is send in a VA Form 21-4138 just inquiring about the status of your claim and then add a note like "I am following up on my claim for ___, the aniticipation or long wait for my rating decision is making my anxiety worse". Once you do that, then you have just created an ambiguous claim for anxiety and hopefully they will miss tand not do the development for it (which is what holds up yur claim), then when you get your multiple myeloma rating you put in the claim for anxiety and adjustment disorder secondary to multiple myeloma and then they have to give you the effective date of the 21-4138 you sent in asking about the status of your claim. Sounds twisted, but you are not being dishonest.

Hope this helps and isnt confusing.

Donna

[sharon]

You can do an informal claim by stating, " I intend to file a claim for Depression/PTSD/Adjustment Disorder. You have one year from the date you file your intent to file a formal claim and maintain your date of claim.