Bipolar Worsened, Applying For Rating Increase

[thurston511]

Hi, I appreciate all the good information shared here. I have a couple of questions that I hope are simple. I'm confused.

SC Bipolar Disorder 1999, rated 50%, after a re diagnosis from depression, 10% (VA's idea, I didn't ask) have been enrolled in VA health care system regularly since 2002, so there must be a huge medical file. (I've never seen it nor requested it.)

Been on different medications, but mainly lithium and wellbutrin for last 5 years. Ambien for sleeping.

Anyway, my condition has worsened since 2005, and even one of the psychiatrists I saw for quarterly med checks told me he used to be a C&P ratings examiner, and said he thought I was a 70% rating, but he never went further than that, or to suggest I go that route, or how to. (That was in 2011)

Perhaps it is a conflict with his position as a VA employed doctor, I don't know. That's all he said about it, and became evasive when I showed an interest in his comment.

Then they moved him one county over, so I don't know how to contact him, or if I should even contact him to ask for some kind of note in my file. Maybe he wrote something in there at the time, idk.

A cynic might say he said that looking for a reaction, but that would be pretty low.

I have not worked in 4 years time and have turned into a recluse. My employment record is pretty bad since 2002. My question is:

1. To apply for a rating increase, how do I begin? I just saw the post regarding the new form 21-5268. Thanks. I saved it.

-there is a VA medical clinic closeby, and the VAMC is 30 miles away. The front desk at the clinic isn't always that friendly. I assume the service officers are located at the VARO, 30miles away.

2. Is contacting that doctor something I should do? I think he is still connected to the same VAMC as this county, in a different clinic 100 miles away, but I never know how to contact VA doctors, they're busy every minute of the day.

3. Should I request my medical record and see what's in there? I don't want to, it's mostly psych stuff, and I'm ashamed of this problem. I don't know my GAF or Axis stuff.

How often does a former ratings doctor tell a veteran he was rated too low?. Now he's gone.

[john999]

If you are not working file for TDIU. Have you filed for SSDI? You need to download the official TDIU form and file it ASAP. I know procrastination is part of depression but it is costing you thousands of bucks. You can get one of the veteran service organizations to help you or even hire a lawyer, but get going on this before the end of May.

[thurston511]

thks john, but I was looking about going from 50% to 70%, after a former ratings doctor mentioned it to me. it appears tdiu is for 70% rating, and rarely on rule (b)

I'm at 50% for 11 years. out of work for 4 years. I haven't dealt with ratings stuff in 9 yrs, so I'm out of the loop.

ssi shuts out people who haven't earned enough work credits over the last 10 years.

btw, I'm over in pinellas county. the big vamc is down in bay pines. do i need to go down there to find a vso? i'm dav life member

[carlie]

I have not worked in 4 years time and have turned into a recluse. My employment record is pretty bad since 2002. My question is:

1. To apply for a rating increase, how do I begin? I just saw the post regarding the new form 21-5268. Thanks. I saved it.

-there is a VA medical clinic closeby, and the VAMC is 30 miles away. The front desk at the clinic isn't always that friendly. I assume the service officers are located at the VARO, 30miles away.

2. Is contacting that doctor something I should do? I think he is still connected to the same VAMC as this county, in a different clinic 100 miles away, but I never know how to contact VA doctors, they're busy every minute of the day.

3. Should I request my medical record and see what's in there? I don't want to, it's mostly psych stuff, and I'm ashamed of this problem. I don't know my GAF or Axis stuff.

How often does a former ratings doctor tell a veteran he was rated too low?. Now he's gone.

I think you need to do all of the below.

Plus - since you have only been out of the work force four years,

I would apply for SSDI as you may currently have plenty of work credit quarters.

JMHO

I would submit everything all together at one time

in person at the VARO and get a date stamped copy of

each item.

*** VETERAN'S SUPPLEMENTAL CLAIM FOR COMPENSATION

VA Form 21-526b

http://www.vba.va.go...21-526b-ARE.pdf

*** VETERAN'S APPLICATION FOR INCREASED

COMPENSATION BASED ON UNEMPLOYABILITY

VA Form 21-8940

http://www.vba.va.go...21-8940-are.pdf

The form just below - I would personally take to my prior

employer/s to see if they or HR can fill them out and

give them back to me - or mail them directly to me - not to the VARO.

*** REQUEST FOR EMPLOYMENT INFORMATION

IN CONNECTION WITH CLAIM FOR DISABILITY BENEFITS

VA Form 21- 4192

http://www.vba.va.go...21-4192-ARE.pdf

I would ask my current mental health provider if they would go thru my prior

treatment / progress notes along with current finding and fill out the DBW form

below for you.

BUT - If you seem to have a good relationship with this provider, prior to

talking with them about the DBQ Form I would print out the evaluation criteria

(for percentage levels) from 38 CFR - Part 4, and ask their medical opinion of

where they feel my condition and symptoms fall under.

(I will post the criteria for mental health evaluation percentages at the very bottom for you.)

*** MENTAL DISORDERS (OTHER THAN PTSD AND EATING DISORDERS)

DISABILITY BENEFITS QUESTIONNAIRE

VA FORM 21-0960P-2, DEC 2010

http://www.vba.va.go...0960P-2-ARE.pdf

I would go to the VAMC and do the next step below:

*** INDIVIDUALS' REQUEST FOR A COPY OF THEIR OWN HEALTH INFORMATION

VA Form 10-5345a

http://www.va.gov/va...-5345a-fill.pdf

Bay Pines VA Healthcare System

How to Request Information

To request a medical record, please print one of the forms listed in the column to the right, complete the requested information, sign the form, and mail it to the following address —

Bay Pines VA Healthcare System

Business Office Service

Release of Information (16A1)

PO Box 5005

Bay Pines, FL 33744

The Release of Information Office is located in the main hospital building, first floor, room 1E 303.

Because forms must contain an original signature, e-mailed forms cannot be accepted.

Requests for records will take approximately 10-14 days to process.

(the line above is not true and it will take longer.)

*** In block - DATES OF TREATMENT: I would put from start to finish dates,

example - 1999 thru May 2012.

I would check the box for COPY OF OUTPATIENT TREATMENT NOTE(S) and the box

for OTHER (Specify) and specify - all of my vamc medical and treatment records, to include

progress notes - inclusive of both physical and mental health.

*****Title 38: Pensions, Bonuses, and Veterans' Relief

PART 4—SCHEDULE FOR RATING DISABILITIES

Subpart B—Disability Ratings Mental Disorders

4.130 Schedule of ratings—mental disorders.

General Rating Formula for Mental Disorders:

Total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives,own occupation, or own name . . . 100

Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting);inability to establish and maintain effective relationships . . . 70

Occupational and social impairment with reduced reliability and productivity due to such symptoms as:

flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory

(e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment;

impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships . . . 50

[Bonzai]

Carlie's advice is GREAT!

I was originally awarded 10% for bipolar, and 5 years later they increased it their own to 30%. After struggling along for 4 more years, I applied for an increase and they awarded 50% - I felt I was at least 70%, and spoke with a NOVA attorney. He assisted me in filing my NOD, and I was awarded 100% P&T a couple of months later.

[donna68]

Thurston511,

You need to be proactive and go for what you deserve. Apply for SSDI and TDIU, and any other benefit you feel you deserve. Either you apply and get the benefit or you don't. If you dont apply, you will never get the benefit. If your records are with VAMC or private send a request for copies of them, you should keep copies of all evidence you have. If private records show that your condition was worse, VBA will go back one year. If the VAMC doctor 5 years ago determined that your condition was worse than a 50% and noted symptoms that warrant a 70% or 100%, VBA is required to take all federal records in consideration when granitng an increase, and if your VAMC records show that you were unemployable or a 70% 5 years ago they have to grant your new % back to when they had evidence that your condition worsened.

[carlie]

Thurston511,

You need to be proactive and go for what you deserve. Apply for SSDI and TDIU, and any other benefit you feel you deserve. Either you apply and get the benefit or you don't. If you dont apply, you will never get the benefit. If your records are with VAMC or private send a request for copies of them, you should keep copies of all evidence you have. If private records show that your condition was worse, VBA will go back one year.

If the VAMC doctor 5 years ago determined that your condition was worse than a 50% and noted symptoms that warrant a 70% or 100%, VBA is required to take all federal records in consideration when granitng an increase, and if your VAMC records show that you were unemployable or a 70% 5 years ago they have to grant your new % back to when they had evidence that your condition worsened.

donna,

I do not agree with the part of your pos,t that I bolded and underlined above.

Please provide a USC, CFR or anything that supports this, a link or anything

would be great.

Thanks