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sparkle

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Hi all, and thank you for your service. I put in for iu and depression second to tbi. Will give some info of what my examiner stated. Hope this is not to long.

1. Diagnosis

a. vet ever been diagnosed with menta disorders? yes

Diagnosis-Mood Disorder, nos

icd code 296.90

axis

Comments

The diagnosis Mood d/o, nos is continuation/progression of her already sc diagnosis of major depression disorder. Symptoms have presented intermittently, often in response to significant stressors (e.g. difficulty coping with health problems such as headaches since tb suffered durig military service, divorce/husband leaving, sexual assaults. She has been diagnosis and treated in the va for many years, with current diagnosis of bipolar d/o, ptsd, and alcohol abuse. Regarding current mood symptoms, the veteran described persistently depressed mood for the past "few years" with sadness, anhedonia, irritability, fear of negative evaluation and low self-esteem, rumination, sleep disruption, feeling of worrthless, and passive thoughts of her own death (absent of intent/plan to harm herself). Based on her performance on objective psychological testing , it is likely that she endorsed a greater severity of symptoms of mood disruption than objectivety exist. Today, vet endored "servere" range symtoms of depression and anxiety on self-report measures.

Social impairment associated with depression: difficulty making/sustaining social relationship due to mood lability and irritability, fear of negative evaluations/low self-esteem results in persistent reassurance seeking that is difficult for others to tolerate,strainted relationship with children.

Occupational im

pairment associated with depression: Symptoms of depression (i.e. irritability,low self-esteem, sleep disruption d/t rumination and related fatigue, emotional lability.reactivity,and low energy level) are likely to cause mild to moderate impairment in work functining should she pursue gainful employment . She has quit or been terminated from various jobs over the past 20 years, reportedly due to difficulty getting along with others, memory/concentration diffculty. and irritability/agitation.

Diagnosis #2: Personality Disorder, NOS

icd code: 301.9

axis II

Veteran demonstrated various personality disorder (cluster B) features, including: fear of abandoment, changes in self-image, affect, and behavior in response to threats of separation/abandoment (e.g., comments regarding suicidality or worsening depression). A tendency to feel victimized.

While the vet's axis I diagnosis (primary current concern of depression s/t tbi with headaches), is likely to cause mild to moderate impartent in occupational and social functioning, impairment is signifcantly compounded by axsis II concerns, it is likely that axis II symptoms described above cause moderate to severe impairment in both social and occupational functioning, as these symptoms would causeadditional impairment in her ability to cope with/adjust to changes, and would make it difficult for her to develop/maintain sound interpersonal relationships required to function appropriatly in social and work settings

Diagnosis # 3; If additional diagnosis that pertain to mental health disorders,list using axis format:

Axis III-medical diagnoses (to include tbi)

Axis IV-Psychosocial and Environmental Problems: Limited social support; poor coping skills financial stress; psychological symptoms interfering with social/family and occupational functioning, personality features causing significant difficulty in concentration.

Axis V- Current globel assessment of functioning (GAF) score: 50

I feel mood disorder axis I, nos and the nsc axis II personality disorder is going to cause me not to get my iu and increase. I know this is long, but i felt in order to get some good eyes on my concern it was needed.

Thanks

Sparkle

BTW-My Psychiatrist gave me 45 for my GAF

Edited by sparkle
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Yeah......

"While the vet's axis I diagnosis (primary
current concern of depression s/t tbi with headaches), is likely to
cause mild to moderate impartent in occupational and social functioning,
impairment is signifcantly compounded by axsis II concerns, it is
likely that axis II symptoms described above cause moderate to severe
impairment in both social and occupational functioning, as these
symptoms would causeadditional impairment in her ability to cope
with/adjust to changes, and would make it difficult for her to
develop/maintain sound interpersonal relationships required to function
appropriatly in social and work settings
"

Please read the proosed new TBI regs I posted here and better yet comment on them at the Regulations web site if you can.......

PD NOS Compounded my butt (a way out for VA).............the TBI is more then likely causing personality changes.....

I think this can go OK for you........that new TBI reg has to get into 38 USC and CFR....... Please listen to the SVR show we did last week with Dr. Bash

here in Archives.... I talked about this reg on the show 25 minutes in and at the end of the show.....

Dr. Bash can prepare excellent TBI IMOs because he is a Neuro Radiologist and this is all in his field of expertise.

Best to see what VA says first however....they might do the right thing knowing the TBI regs will be changing.....(if the ROs know that???)

This sounds like a QTC exam or was it done by VA?

Edited by Berta
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I agree. When did that personality disorder appear?? Was it by the military at discharge??

pr

Yes, PR the personality disorder was done at discharge, just a way for the va to hold down my sc rating. So with that being said do you think I could as less get my increase if not iu, and what would you think (off the top of sweet little head tee heebiggrin.png !) that would be.

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Yeah......

"While the vet's axis I diagnosis (primary

current concern of depression s/t tbi with headaches), is likely to

cause mild to moderate impartent in occupational and social functioning,

impairment is signifcantly compounded by axsis II concerns, it is

likely that axis II symptoms described above cause moderate to severe

impairment in both social and occupational functioning, as these

symptoms would causeadditional impairment in her ability to cope

with/adjust to changes, and would make it difficult for her to

develop/maintain sound interpersonal relationships required to function

appropriatly in social and work settings"

Please read the proosed new TBI regs I posted here and better yet comment on them at the Regulations web site if you can.......

PD NOS Compounded my butt (a way out for VA).............the TBI is more then likely causing personality changes.....

I think this can go OK for you........that new TBI reg has to get into 38 USC and CFR....... Please listen to the SVR show we did last week with Dr. Bash

here in Archives.... I talked about this reg on the show 25 minutes in and at the end of the show.....

Dr. Bash can prepare excellent TBI IMOs because he is a Neuro Radiologist and this is all in his field of expertise.

Best to see what VA says first however....they might do the right thing knowing the TBI regs will be changing.....(if the ROs know that???)

This sounds like a QTC exam or was it done by VA?

Berta, who would know better than you about all the tricks the va play on vet's, with all the crap you have been taking from them. I will listen to the SVR show from Dr. Bash, I must say I really love the show and try to down load them so I can go back later and listen with my dog winston buttin in trying to made his move on the dog in the back ground (remember that show) having a dog stoke rolleyes.gif !!!. I feel IU will not come my way because of some of the things she put in my exam. I sure hope the new regs will work in my favor. Like you said it's best to wait and see what va says first. At this point my claim is at the raters desk waiting to be sent for a appoval. Berta just off the top of your head, do and what would I be looking at for %. Thanks for all you do to help all vets. Oh, btw, do you think that I could get Dr. Bash to take my case if I need a IMO. I know cost will be high but Iam willing to go that route.

Thanks in advance,

*Sparkle

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"Oh, btw, do you think that I could get Dr. Bash to take my case if I
need a IMO. I know cost will be high but Iam willing to go that route."

Yes I do."

"I put in for iu and depression second to tbi"

I expect them to award the TDIU with depression as secondary.to TBI.

That might well set you up for SMC too at some point.....but I hesitate to go there yet..... we just never know what the VA will do...

If you consider the IMO ,and Dr. Bash needs to contact an MH professional on the depression, he has many MH contacts for that.

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"Oh, btw, do you think that I could get Dr. Bash to take my case if I

need a IMO. I know cost will be high but Iam willing to go that route."

Yes I do."

"I put in for iu and depression second to tbi"

I expect them to award the TDIU with depression as secondary.to TBI.

That might well set you up for SMC too at some point.....but I hesitate to go there yet..... we just never know what the VA will do...

If you consider the IMO ,and Dr. Bash needs to contact an MH professional on the depression, he has many MH contacts for that.

Thanks Berta, I did as you said and read the new regs for TBI. As you know Iam sc for TBI and headaches and Major depression secondary to TBI. It said that "if a veteran who has a service-connected TBI also has one of these diagnosable

illnesses, then that illness will be considered service connected as secondary to the TBI. Depression (which also was associated with mild TBI); and diseases of hormone deficiency that may result from hypothalamo-pituitary changes. Berta, I checked my medical records and found out I was diagnosis with Axis III Hypreprolactinemia TBI s/p fall, which is a growth on my pituitary that cause hypothalamo-pituitary changes, which cause a butt load of other things (boy do I have some) that had to be fee bases out to my area medical center which put me in the hospital for a week in Oct. 2012 and had to go back this Jan. 2013 and have a second because of the first. Part of all this came from depression med's. All is stated in my IMO and VA notes. So as you said I'II just wait and see what my RO say, in hope I get that TDIU. 2 hospitalization in 3 months, and still may need more he said, but will have to wait 6mos. Berta, you are a blessing and believe it or not you have givin me some hope that the va will do the right thing. If anyone could pick this crap I posted from my exam you could and once more I thank you and all others That has helped (Phil, Carlie, John, etc.)me. Have to go having one of my momentsmad.gif the va has done a good job of F------ me up. Sorry guys, just need to vent.

*Sparkle

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