Posting entire mental health C&P questionnaire. Does this look like they will raise from 10%?
SECTION I:
----------
1. Diagnosis
------------
a. Does the Veteran now have or has he/she ever been diagnosed with a
mental
disorder(s)?
[X] Yes[ ] No
NOTE: If the Veteran has a diagnosis of an eating disorder, complete
the
Eating Disorders Questionnaire in lieu of this Questionnaire.
NOTE: If the Veteran has a diagnosis of PTSD, the Initial PTSD
Questionnaire
must be completed by a VHA staff or contract examiner in lieu of
this
Questionnaire.
If the Veteran currently has one or more mental disorders that conform
to
DSM-IV criteria, provide all diagnoses:
Diagnosis #1: Diagnosis #1: Adjustment Disorder with Mixed Anxiety and Depressed
Mood,
chronic
ICD code:
Indicate the Axis category:
[X] Axis I [ ] Axis II
Comments, if any:
Veteran's anxiety and depression appear to be chronic
reactions to
psychosocial stressors, representing chronic adjustment
problems.
ICD code:
Indicate the Axis category:
[X] Axis I [ ] Axis II
Comments, if any:
Veteran's anxiety and depression appear to be chronic
reactions to
psychosocial stressors, representing chronic adjustment
problems.
Diagnosis #2:
ICD code:
Indicate the Axis category:
[ ] Axis I [ ] Axis II
Comments, if any:
Diagnosis #3:
ICD code:
Indicate the Axis category:
[ ] Axis I [ ] Axis II
Comments, if any:
If additional diagnoses that pertain to mental health disorders,
list
using above format:
b. Axis III - medical diagnoses (to include TBI): Emphysema,
migraines,
stroke, dizziness, dyslipidemia, essential hypertension, paresis
ICD code:
Comments, if any:
c. Axis IV - Psychosocial and Environmental Problems (describe, if
any):
Limited social support, chronic medical problems, physical
disability
d. Axis V - Current global assessment of functioning (GAF) score: 55
Comments, if any:
GAF reflects moderate symptoms (i.e. frequent, moderate
depressed
mood, anxiety, insomnia, and irritability) and moderate
difficulty
in social functioning (i.e. few friends).
2. Differentiation of symptoms
------------------------------
a. Does the Veteran have more than one mental disorder diagnosed?
[ ] Yes[X] No
If yes, complete the following question:
b. Is it possible to differentiate what symptom(s) is/are attributable
to
each diagnosis?
[ ] Yes[ ] No[ ] Not applicable (N/A)
If no, provide reason that it is not possible to differentiate
what
portion of each symptom is attributable to each diagnosis:
If yes, list which symptoms are attributable to each diagnosis:
c. Does the Veteran have a diagnosed traumatic brain injury (TBI)?
[ ] Yes[X] No[ ] Not shown in records reviewed
Comments, if any:
If yes, complete the following question:
d. Is it possible to differentiate what symptom(s) is/are attributable
to
each diagnosis?
[ ] Yes[ ] No[ ] Not applicable (N/A)
If no, provide reason that it is not possible to differentiate
what
portion of each symptom is attributable to each diagnosis:
If yes, list which symptoms are attributable to each diagnosis:
3. Occupational and social impairment
-------------------------------------
a. Which of the following best summarizes the Veteran's level of
occupational
and social impairment with regards to all mental diagnoses? (Check
only
one)
[ ] No mental disorder diagnosis
[ ] A mental condition has been formally diagnosed, but symptoms
are not
severe enough either to interfere with occupational and social
functioning or to require continuous medication
[ ] Occupational and social impairment due to mild or transient
symptoms
which decrease work efficiency and ability to perform
occupational
tasks only during periods of significant stress, or; symptoms
controlled by medication
[ ] Occupational and social impairment with occasional decrease in
work
efficiency and intermittent periods of inability to perform
occupational tasks, although generally functioning
satisfactorily,
with normal routine behavior, self-care and conversation
[X] Occupational and social impairment with reduced reliability and
productivity
[ ] Occupational and social impairment with deficiencies in most
areas,
such as work, school, family relations, judgment, thinking
and/or mood
[ ] Total occupational and social impairment
b. For the indicated level of occupational and social impairment, is
it
possible to differentiate what portion of the occupational and
social
impairment indicated above is caused by each mental disorder?
[ ] Yes[ ] No[X] No other mental disorder has been diagnosed
If no, provide reason that it is not possible to differentiate
what
portion of the indicated level of occupational and social
impairment
is attributable to each diagnosis:
If yes, list which portion of the indicated level of
occupational and
social impairment is attributable to each diagnosis:
c. If a diagnosis of TBI exists, is it possible to differentiate what
portion
of the occupational and social impairment indicated above is caused
by the
TBI?
[ ] Yes[ ] No[X] No diagnosis of TBI
If no, provide reason that it is not possible to differentiate
what
portion of the indicated level of occupational and social
impairment
is attributable to each diagnosis:
If yes, list which portion of the indicated level of
occupational and
social impairment is attributable to each diagnosis:
SECTION II:
-----------
Clinical Findings:
------------------
1. Evidence review
------------------
If any records (evidence) were reviewed, please list here:
C-file was reviewed.
CPRS medical records were reviewed.
Veteran was administered the BAI and BDI-II.
2. History
----------
NOTE: Initial examinations require pre-military, military, and
post-military
history. If this is a review examination only indicate any
relevant
history since prior exam.
a. Relevant Social/Marital/Family history (pre-military, military, and
post-military):
Pre-military: Veteran was raised by a single mom in a good
environment. His parents separated when Veteran was 6 years old,
and he
did not see his father after that time; however, he was close to
his
maternal uncles. He had one older sister and two younger
paternal
half-sisters. He had friends, enjoyed socializing, played sports
and
attended YMCA day camps.
Military: Veteran went downtown in Germany with other people
in the
service.
Post-military: Veteran has been married to his wife for 7
years, and
they have been together for 13 years. He has been married once
before.
He has a daughter and son by his first wife. He was a single
father for
his daughter and son beginning when they were older children. He
has
problems becoming impatient and irritable in public when he
deems other
people to be behaving in a stupid manner, and his wife and
daughter
have had to intervene discreetly at times. He has "no patience
for
people," is sometimes anxious around people, and does not like
being
around people, and this has been the case for a little over a
year. He
used to have patience issues with his wife, but his mental
health
treatment provider has helped him to improve that. He has very
few
friends. He tends to his garden and plays with his dog.
b. Relevant Occupational and Educational history (pre-military,
military, and
post-military):
Pre-military: Veteran earned C's in high school. He worked in a
gas
station as a mechanic. Per records, Veteran reported he earned
D/F
grades and completed his GED.
Military: Veteran joined the Army at the age of 17 and served
8/1973-1/1975. He was stationed in Germany and was never in a
combat
zone. He was a communications center specialist. He was
discharged due
to a "blow up" at his first sergeant, and he received a "general
under
honorable conditions' discharge with an E2 rank. He also had an
Article
15 because he was late after posting guards at various locations
all
night.
Post-military: Veteran worked as a bouncer at a bar for a couple
of
years before working in installation and caulking. He worked for
Nellis
Air Force Base for 26 years as a heavy equipment mechanic, and
then
spent the last 6 years running the shop. He receives social
security
disability and is considered totally disabled due to physical
problems.
He denied any history of occupational problems.
c. Relevant Mental Health history, to include prescribed medications
and
family mental health (pre-military, military, and post-military):
Pre-military: No problems reported.
Military: Veteran was nervous working in a small space in
which various
radios were going off and on all the time. He learned he had
hypertension.
Post-military: Per record 10/2012, Veteran reported that his top
three
concerns were anger/irritability, thoughts of harming someone
else, and
panic or anxiety attacks. His goal for treatment was to "be
calmer,
more tolerant." Veteran is frustrated and irritated that he
can't do
certain things he was able to do before due to physical
problems.
Little things make him upset (e.g. he dropped his truck off at a
mechanic and was taken to a rental car facility, but was asked
"50
million" questions and finally asked the person to call him a
cab).
Veteran wakes up drenched in sweat nightly, but has no
nightmares. He
experiences "a little" of depression and anxiety. He has always
been
anxious but his depression is more recent. He takes melatonin
for
sleep, and some nights are good and some are bad. He will sleep
through
the night or get up at 1 a.m. and not be able to fall back
asleep. He
is tired during the day and tries not to take naps, but if he
does he
will have a bad night. Veteran has had increased problems with
memory
and attention/concentration for the past 9 months, according to
his
wife. Veteran's score of 32 on the BAI is in the severe range
for
anxiety and his score on the BDI-II is in the severe range for
depression.
Veteran was prescribed buspirone by his primary care physician
for a
long time, and began seeing a psychiatrist last year at the Reno
VA
mental health clinic. He was taken off buspirone, which made a
marked
improvement. Currently he is prescribed sertraline, propranolol,
and
Wellbutrin. Before that he received treatment 2008/2009 by a
psychologist. He was prescribed psychiatric medication in 1975
for
anxiety. STRs show diagnoses of "anxiety reaction" and "nervous
condition" in 1975, with reported symptoms of shaking,
nervousness, and
insomnia since 1/1975.
Regarding suicidal ideation, Veteran commented, "Sometimes I
feel like
stepping back and saying you know what screw it." Veteran is
"not going
to give up" but said "sometimes I feel like it." He denied any
history
of suicide attempts.
d. Relevant Legal and Behavioral history (pre-military, military, and
post-military):
Pre-military: No problems reported. Per records, Veteran
reported that
he was arrested prior to the age of 19 for possession of
alcohol/drugs.
Military: See above.
Post-military: Veteran was arrested late 1975 or early 1976
for
possession of marijuana. He was arrested for assault as bouncer
in 1978
or 1979 but the charges were dismissed. The last time he was in
a fight
was 7 years ago.
Veteran denied any history of homicidal ideation or attempts.
e. Relevant Substance abuse history (pre-military, military, and
post-military):
Pre-military: No usage reported.
Military: Veteran drank 1-2 beers on weekends, smoked hashish
sometimes, and smoked cigarettes.
Post-military: Veteran's alcohol use increased for a while
until the
early 1980's when he learned he was going to become a father and
quit
using it. He was smoking marijuana in the evening on days he did
not
have to go to work the next day, and stopped using it when he
stopped
alcohol use. He stopped smoking cigarettes 4/2013 when he
learned he
had emphysema. Per records, Veteran reported that he may have a
couple
of beers a month.
f. Sentinel Event(s) (other than stressors):
In February 2012 it was determined that Veteran had had a
mini-stroke,
which caused him significant distress. He learned he had
emphysema
3/2013.
g. Other, if any:
3. Symptoms
-----------
For VA rating purposes, check all symptoms that apply to the Veteran's
diagnoses:
[X] Depressed mood
[X] Anxiety
[ ] Suspiciousness
[ ] Panic attacks that occur weekly or less often
[ ] Panic attacks more than once a week
[ ] Near-continuous panic or depression affecting the ability to
function
independently, appropriately and effectively
[X] Chronic sleep impairment
[X] Mild memory loss, such as forgetting names, directions or
recent
events
[ ] Impairment of short- and long-term memory, for example,
retention of
only highly learned material, while forgetting to complete
tasks
[ ] Memory loss for names of close relatives, own occupation, or
own name
[ ] Flattened affect
[ ] Circumstantial, circumlocutory or stereotyped speech
[ ] Speech intermittently illogical, obscure, or irrelevant
[ ] Difficulty in understanding complex commands
[ ] Impaired judgment
[ ] Impaired abstract thinking
[ ] Gross impairment in thought processes or communication
[X] Disturbances of motivation and mood
[ ] Difficulty in establishing and maintaining effective work and
social
relationships
[ ] Difficulty in adapting to stressful circumstances, including
work or a
worklike setting
[ ] Inability to establish and maintain effective relationships
[ ] Suicidal ideation
[ ] Obsessional rituals which interfere with routine activities
[ ] Impaired impulse control, such as unprovoked irritability with
periods
of violence
[ ] Spatial disorientation
[ ] Persistent delusions or hallucinations
[ ] Grossly inappropriate behavior
[ ] Persistent danger of hurting self or others
[ ] Neglect of personal appearance and hygiene
[ ] Intermittent inability to perform activities of daily living,
including maintenance of minimal personal hygiene
[ ] Disorientation to time or place
4. Other symptoms
-----------------
Does the Veteran have any other symptoms attributable to mental
disorders
that are not listed above?
[X] Yes[ ] No
If yes, describe:
Veteran has some problems controlling his irritability in
public,
but is not violent or inappropriate.
5. Competency
-------------
Is the Veteran capable of managing his or her financial affairs?
[X] Yes[ ] No
If no, explain:
6. Remarks, if any:
-------------------
NOTE: VA may request additional medical information, including
additional
examinations if necessary to complete VA's review of the
Veteran's
application.
THIS DOCUMENT WAS ORIGINALLY INITIATED BY: FRANCIS,JEANETTE E
/es/ ELIZABETH MOSCO, PHD
Clinical Psychologist
Signed: 06/20/2013 15:27
Question
bobz
Posting entire mental health C&P questionnaire. Does this look like they will raise from 10%?
SECTION I:
----------
1. Diagnosis
------------
a. Does the Veteran now have or has he/she ever been diagnosed with a
mental
disorder(s)?
[X] Yes[ ] No
NOTE: If the Veteran has a diagnosis of an eating disorder, complete
the
Eating Disorders Questionnaire in lieu of this Questionnaire.
NOTE: If the Veteran has a diagnosis of PTSD, the Initial PTSD
Questionnaire
must be completed by a VHA staff or contract examiner in lieu of
this
Questionnaire.
If the Veteran currently has one or more mental disorders that conform
to
DSM-IV criteria, provide all diagnoses:
Diagnosis #1: Diagnosis #1: Adjustment Disorder with Mixed Anxiety and Depressed
Mood,
chronic
ICD code:
Indicate the Axis category:
[X] Axis I [ ] Axis II
Comments, if any:
Veteran's anxiety and depression appear to be chronic
reactions to
psychosocial stressors, representing chronic adjustment
problems.
ICD code:
Indicate the Axis category:
[X] Axis I [ ] Axis II
Comments, if any:
Veteran's anxiety and depression appear to be chronic
reactions to
psychosocial stressors, representing chronic adjustment
problems.
Diagnosis #2:
ICD code:
Indicate the Axis category:
[ ] Axis I [ ] Axis II
Comments, if any:
Diagnosis #3:
ICD code:
Indicate the Axis category:
[ ] Axis I [ ] Axis II
Comments, if any:
If additional diagnoses that pertain to mental health disorders,
list
using above format:
b. Axis III - medical diagnoses (to include TBI): Emphysema,
migraines,
stroke, dizziness, dyslipidemia, essential hypertension, paresis
ICD code:
Comments, if any:
c. Axis IV - Psychosocial and Environmental Problems (describe, if
any):
Limited social support, chronic medical problems, physical
disability
d. Axis V - Current global assessment of functioning (GAF) score: 55
Comments, if any:
GAF reflects moderate symptoms (i.e. frequent, moderate
depressed
mood, anxiety, insomnia, and irritability) and moderate
difficulty
in social functioning (i.e. few friends).
2. Differentiation of symptoms
------------------------------
a. Does the Veteran have more than one mental disorder diagnosed?
[ ] Yes[X] No
If yes, complete the following question:
b. Is it possible to differentiate what symptom(s) is/are attributable
to
each diagnosis?
[ ] Yes[ ] No[ ] Not applicable (N/A)
If no, provide reason that it is not possible to differentiate
what
portion of each symptom is attributable to each diagnosis:
If yes, list which symptoms are attributable to each diagnosis:
c. Does the Veteran have a diagnosed traumatic brain injury (TBI)?
[ ] Yes[X] No[ ] Not shown in records reviewed
Comments, if any:
If yes, complete the following question:
d. Is it possible to differentiate what symptom(s) is/are attributable
to
each diagnosis?
[ ] Yes[ ] No[ ] Not applicable (N/A)
If no, provide reason that it is not possible to differentiate
what
portion of each symptom is attributable to each diagnosis:
If yes, list which symptoms are attributable to each diagnosis:
3. Occupational and social impairment
-------------------------------------
a. Which of the following best summarizes the Veteran's level of
occupational
and social impairment with regards to all mental diagnoses? (Check
only
one)
[ ] No mental disorder diagnosis
[ ] A mental condition has been formally diagnosed, but symptoms
are not
severe enough either to interfere with occupational and social
functioning or to require continuous medication
[ ] Occupational and social impairment due to mild or transient
symptoms
which decrease work efficiency and ability to perform
occupational
tasks only during periods of significant stress, or; symptoms
controlled by medication
[ ] Occupational and social impairment with occasional decrease in
work
efficiency and intermittent periods of inability to perform
occupational tasks, although generally functioning
satisfactorily,
with normal routine behavior, self-care and conversation
[X] Occupational and social impairment with reduced reliability and
productivity
[ ] Occupational and social impairment with deficiencies in most
areas,
such as work, school, family relations, judgment, thinking
and/or mood
[ ] Total occupational and social impairment
b. For the indicated level of occupational and social impairment, is
it
possible to differentiate what portion of the occupational and
social
impairment indicated above is caused by each mental disorder?
[ ] Yes[ ] No[X] No other mental disorder has been diagnosed
If no, provide reason that it is not possible to differentiate
what
portion of the indicated level of occupational and social
impairment
is attributable to each diagnosis:
If yes, list which portion of the indicated level of
occupational and
social impairment is attributable to each diagnosis:
c. If a diagnosis of TBI exists, is it possible to differentiate what
portion
of the occupational and social impairment indicated above is caused
by the
TBI?
[ ] Yes[ ] No[X] No diagnosis of TBI
If no, provide reason that it is not possible to differentiate
what
portion of the indicated level of occupational and social
impairment
is attributable to each diagnosis:
If yes, list which portion of the indicated level of
occupational and
social impairment is attributable to each diagnosis:
SECTION II:
-----------
Clinical Findings:
------------------
1. Evidence review
------------------
If any records (evidence) were reviewed, please list here:
C-file was reviewed.
CPRS medical records were reviewed.
Veteran was administered the BAI and BDI-II.
2. History
----------
NOTE: Initial examinations require pre-military, military, and
post-military
history. If this is a review examination only indicate any
relevant
history since prior exam.
a. Relevant Social/Marital/Family history (pre-military, military, and
post-military):
Pre-military: Veteran was raised by a single mom in a good
environment. His parents separated when Veteran was 6 years old,
and he
did not see his father after that time; however, he was close to
his
maternal uncles. He had one older sister and two younger
paternal
half-sisters. He had friends, enjoyed socializing, played sports
and
attended YMCA day camps.
Military: Veteran went downtown in Germany with other people
in the
service.
Post-military: Veteran has been married to his wife for 7
years, and
they have been together for 13 years. He has been married once
before.
He has a daughter and son by his first wife. He was a single
father for
his daughter and son beginning when they were older children. He
has
problems becoming impatient and irritable in public when he
deems other
people to be behaving in a stupid manner, and his wife and
daughter
have had to intervene discreetly at times. He has "no patience
for
people," is sometimes anxious around people, and does not like
being
around people, and this has been the case for a little over a
year. He
used to have patience issues with his wife, but his mental
health
treatment provider has helped him to improve that. He has very
few
friends. He tends to his garden and plays with his dog.
b. Relevant Occupational and Educational history (pre-military,
military, and
post-military):
Pre-military: Veteran earned C's in high school. He worked in a
gas
station as a mechanic. Per records, Veteran reported he earned
D/F
grades and completed his GED.
Military: Veteran joined the Army at the age of 17 and served
8/1973-1/1975. He was stationed in Germany and was never in a
combat
zone. He was a communications center specialist. He was
discharged due
to a "blow up" at his first sergeant, and he received a "general
under
honorable conditions' discharge with an E2 rank. He also had an
Article
15 because he was late after posting guards at various locations
all
night.
Post-military: Veteran worked as a bouncer at a bar for a couple
of
years before working in installation and caulking. He worked for
Nellis
Air Force Base for 26 years as a heavy equipment mechanic, and
then
spent the last 6 years running the shop. He receives social
security
disability and is considered totally disabled due to physical
problems.
He denied any history of occupational problems.
c. Relevant Mental Health history, to include prescribed medications
and
family mental health (pre-military, military, and post-military):
Pre-military: No problems reported.
Military: Veteran was nervous working in a small space in
which various
radios were going off and on all the time. He learned he had
hypertension.
Post-military: Per record 10/2012, Veteran reported that his top
three
concerns were anger/irritability, thoughts of harming someone
else, and
panic or anxiety attacks. His goal for treatment was to "be
calmer,
more tolerant." Veteran is frustrated and irritated that he
can't do
certain things he was able to do before due to physical
problems.
Little things make him upset (e.g. he dropped his truck off at a
mechanic and was taken to a rental car facility, but was asked
"50
million" questions and finally asked the person to call him a
cab).
Veteran wakes up drenched in sweat nightly, but has no
nightmares. He
experiences "a little" of depression and anxiety. He has always
been
anxious but his depression is more recent. He takes melatonin
for
sleep, and some nights are good and some are bad. He will sleep
through
the night or get up at 1 a.m. and not be able to fall back
asleep. He
is tired during the day and tries not to take naps, but if he
does he
will have a bad night. Veteran has had increased problems with
memory
and attention/concentration for the past 9 months, according to
his
wife. Veteran's score of 32 on the BAI is in the severe range
for
anxiety and his score on the BDI-II is in the severe range for
depression.
Veteran was prescribed buspirone by his primary care physician
for a
long time, and began seeing a psychiatrist last year at the Reno
VA
mental health clinic. He was taken off buspirone, which made a
marked
improvement. Currently he is prescribed sertraline, propranolol,
and
Wellbutrin. Before that he received treatment 2008/2009 by a
psychologist. He was prescribed psychiatric medication in 1975
for
anxiety. STRs show diagnoses of "anxiety reaction" and "nervous
condition" in 1975, with reported symptoms of shaking,
nervousness, and
insomnia since 1/1975.
Regarding suicidal ideation, Veteran commented, "Sometimes I
feel like
stepping back and saying you know what screw it." Veteran is
"not going
to give up" but said "sometimes I feel like it." He denied any
history
of suicide attempts.
d. Relevant Legal and Behavioral history (pre-military, military, and
post-military):
Pre-military: No problems reported. Per records, Veteran
reported that
he was arrested prior to the age of 19 for possession of
alcohol/drugs.
Military: See above.
Post-military: Veteran was arrested late 1975 or early 1976
for
possession of marijuana. He was arrested for assault as bouncer
in 1978
or 1979 but the charges were dismissed. The last time he was in
a fight
was 7 years ago.
Veteran denied any history of homicidal ideation or attempts.
e. Relevant Substance abuse history (pre-military, military, and
post-military):
Pre-military: No usage reported.
Military: Veteran drank 1-2 beers on weekends, smoked hashish
sometimes, and smoked cigarettes.
Post-military: Veteran's alcohol use increased for a while
until the
early 1980's when he learned he was going to become a father and
quit
using it. He was smoking marijuana in the evening on days he did
not
have to go to work the next day, and stopped using it when he
stopped
alcohol use. He stopped smoking cigarettes 4/2013 when he
learned he
had emphysema. Per records, Veteran reported that he may have a
couple
of beers a month.
f. Sentinel Event(s) (other than stressors):
In February 2012 it was determined that Veteran had had a
mini-stroke,
which caused him significant distress. He learned he had
emphysema
3/2013.
g. Other, if any:
3. Symptoms
-----------
For VA rating purposes, check all symptoms that apply to the Veteran's
diagnoses:
[X] Depressed mood
[X] Anxiety
[ ] Suspiciousness
[ ] Panic attacks that occur weekly or less often
[ ] Panic attacks more than once a week
[ ] Near-continuous panic or depression affecting the ability to
function
independently, appropriately and effectively
[X] Chronic sleep impairment
[X] Mild memory loss, such as forgetting names, directions or
recent
events
[ ] Impairment of short- and long-term memory, for example,
retention of
only highly learned material, while forgetting to complete
tasks
[ ] Memory loss for names of close relatives, own occupation, or
own name
[ ] Flattened affect
[ ] Circumstantial, circumlocutory or stereotyped speech
[ ] Speech intermittently illogical, obscure, or irrelevant
[ ] Difficulty in understanding complex commands
[ ] Impaired judgment
[ ] Impaired abstract thinking
[ ] Gross impairment in thought processes or communication
[X] Disturbances of motivation and mood
[ ] Difficulty in establishing and maintaining effective work and
social
relationships
[ ] Difficulty in adapting to stressful circumstances, including
work or a
worklike setting
[ ] Inability to establish and maintain effective relationships
[ ] Suicidal ideation
[ ] Obsessional rituals which interfere with routine activities
[ ] Impaired impulse control, such as unprovoked irritability with
periods
of violence
[ ] Spatial disorientation
[ ] Persistent delusions or hallucinations
[ ] Grossly inappropriate behavior
[ ] Persistent danger of hurting self or others
[ ] Neglect of personal appearance and hygiene
[ ] Intermittent inability to perform activities of daily living,
including maintenance of minimal personal hygiene
[ ] Disorientation to time or place
4. Other symptoms
-----------------
Does the Veteran have any other symptoms attributable to mental
disorders
that are not listed above?
[X] Yes[ ] No
If yes, describe:
Veteran has some problems controlling his irritability in
public,
but is not violent or inappropriate.
5. Competency
-------------
Is the Veteran capable of managing his or her financial affairs?
[X] Yes[ ] No
If no, explain:
6. Remarks, if any:
-------------------
NOTE: VA may request additional medical information, including
additional
examinations if necessary to complete VA's review of the
Veteran's
application.
THIS DOCUMENT WAS ORIGINALLY INITIATED BY: FRANCIS,JEANETTE E
/es/ ELIZABETH MOSCO, PHD
Clinical Psychologist
Signed: 06/20/2013 15:27
Link to comment
Share on other sites
Top Posters For This Question
6
2
2
1
Popular Days
Jun 26
4
Jun 28
3
Jun 27
1
Jul 4
1
Top Posters For This Question
bobz 6 posts
john999 2 posts
Veldrina 2 posts
cham1968 1 post
Popular Days
Jun 26 2013
4 posts
Jun 28 2013
3 posts
Jun 27 2013
1 post
Jul 4 2013
1 post
10 answers to this question
Recommended Posts
Create an account or sign in to comment
You need to be a member in order to leave a comment
Create an account
Sign up for a new account in our community. It's easy!
Register a new accountSign in
Already have an account? Sign in here.
Sign In Now