ptsd Question On Mental Status Exam

[Radio_Dog]

Can someone please give me insight on whay I should be expecting, my claim for PTSD & IBS was filled 10/03/2011, never had a C&P exam and still in gathering of eveidence on ebenifits. I downloaded my Blue Button from My healthy Vet site and stubled on this note made by my psy.

Mental Status Exam:

Apperance: Neatly groomed

Beahvior: No psychomotor agitation or retardation

Speech: Normal

Mood: "Down"

Affect: Constricted

Thought: Process Linear

Perception: No AVH

Insight/Judgment: Fair/Fair

Impulse Control: Fair

Continues to state: "32y/o male w/PTSD with contuned symtoms, patially stablized on medication, still awaiting SC decisions. No SI/HI

Axis I Clinical disorder: PTSD, Chronic

Axis ii Pwesonality dis: Deferred

Axis III Current medical conditions: None

AxisIV Current Psy Stressors: primary support group, social enviroment

Axis V GAF Score: 50

Continue Sertralin 100mg for PTSD

Cont. Temazepam 15mg qNight prn Insomnia

Supportive therapy and psy education

Patient does not meet LPS hold criteria

[john999]

Are you able to work? This is a big factor in rating PTSD. I cannot believe the VA will eliminate the GAF since it is a bedrock of their system of rating mental health.

John

[Radio_Dog]

I am currently working however I do alot of work from home

[sambo808]

Now that the new DSM-V is out, they eliminated the GAF when determining mental illnesses - will the VA be following the new DSM?

As it stands today and until September 30, 2013, VA will still be using DSM-IV when evaluating a mental health condition. The reason for this is that VA will have to change many of their regulations to reflect the new DSM-V, and that takes a lot of man hours to do.

Edited July 17, 2013 by sambo808

[sambo808]

Are you able to work? This is a big factor in rating PTSD. I cannot believe the VA will eliminate the GAF since it is a bedrock of their system of rating mental health.

John

GAF score was never a bedrock of VA's system of rating mental health. That is a myth. As a matter of fact VA often times put very little weight on person's GAF score because GAF score is a very unreliable indicator. One, GAF score is totally dependent on the person who is evaluating you, and so it is very subjective. Second, GAF score is very inconsistent, and can change from week to week. A person may have a GAF score of 30 this week given by one examiner and goes to seek treatment for mental health the following week and given a GAF score of 68 by another. VA focuses more on the impact of Veteran's mental health condition on their social and occupational functioning. Some examples of social functioning are: do they have friends or a loner, do attend social functions or avoid them, to they have hobbies, do they hangout with their friends and go hunting or tend to isolate themselves, do they have a good relationships with their siblings, spouse, children, relatives, do they get involved in legal issues, do they beat up their wives or children, do they have road rage, do they take illegal drugs, or engage in illegal activiites. And for occupational functioning some examples are: do they get along with their co-coworkers, do they get along with their supervisors, do they often receive disciplinary actions, have they been terminated due to bad behavior, do they have fight with their coworkers, do they yell or rude to customers or coworkers, are they often tardy or absent, can they finish the task on time or often behind schedule, do they move from jobs to jobs consistently. Again, these are just some of the examples and indicators that they look for in assigning the correct evaluation to any mental health disability.

Edited July 17, 2013 by sambo808

[john999]

All methods and measures of VA evaluation of mental disorders are subjective. The GAF is the Global Assessment of Functioning which takes into account all the things you are talking about. If one evaluation comes up with a GAF of 30 and one comes up with 68 then the GAF should be dumped I agree with that for sure. The only thing the VA ever asked me about work was "Are you working" and regarding social functioning was "Do you hear voices". Why not give all patients MMPI? This is about the best indicator of mental disorders we have. They never use it because it takes too long and is too reliable. Many years ago I was rated 10% based on evidence gathered from inpatient experience where doctor said I got on well with other mental patients. No mention of work or wider social adjustment. Please don't speak to me about VA's use of reliable measures for mental illness. You are a FNG here, but I am glad you know so much about VA mental health. I have been victim of that system for over 40 years.

[harleyman]

I find it amusing that the VA says they do not use the GAF score. However, the evaluation builder they mandate RVSRs use, bases everything on the PTSD DBQ form filled out by the examiner. The evaluation builder will not build WITHOUT a GAF score being entered.

So somebody thinks the GAF score is important. Besides, the Rater does not rate the PTSD claim, he simply enters what BOXES the doctor checked on the DBQ. Just saying, things are changing from the old ways when raters read the evidence, now not too much review of evidence as it seems it's all data entry and only the doctor is allowed to be subjective. Things are a changin' and not necessarily for the better. JMO