ptsd Notes From My 3Rd Visit With My Psychologist

[asheth007]

I am service connected for inflammatory myopathy which is what polymyositis is. When I was doing my initial setup for my va and clams through PEB. The guy asked me if I wanted to claim adjustment disorder. I was like what is that? He said it means you have a hard time adjusting to stuff. I was like I don't know what that is. It wasn't a doctor just the IDES/VA guy setting up the paperwork for my claims. I didn't know in my medical records that I was diagnosed with adjustment disorder in 2009. I had just did a PDHRA and told them how I was feeling. I had another visit in 2010 and it states that my adjustment disorder isn't as bad. I had never looked over my medical records until recently so I didn't know it was even in there. There is isn't a claim for this in yet.

My mental health problem codes are:

Adjustment Reac W/Mixed Emotion (ICD-9-CM 309.28)

MDD, Single, Moderate (ICD-9-CM 296.22)

My Previous GAF was 53

Met with veteran for 55 minutes on 11/3/14 for scheduled follow-up to initial

MHARC assessment 10/9/14 for purposes of finalizing disposition.

Vet presents with his mother for the first 15 minutes, with whom vet continues

to live, and whom he relies on for caretaking as he continues to struggle with

mobility and ADL's due to Polymyositis. Today, vet presents as euthymic and

anxious, with full-range spontaneous affect, including tearfulness. He is

oriented, engaged, communicates clearly and is goal and future-directed. He

denies SI/HI.

Vet reports that he has started attending PT twice weekly through VA-outsourced

facility near his home. He has upcoming meeting with rheumatology later today to

prepare for rituximab injection therapy, scheduled to begin later this week. He

reports adherence to daily sertraline for mood and zolpidem for sleep as

directed. He is reminded about proper spacing of zolpidem doses. Vet now

ambulates using Rollator device, which vet reports is helpful in maintaining

better posture and balance. He has also been fitted with bilateral wrist splints

for carpal-tunnel related problems, which he reports is helpful for typing on

the computer, as he continues to progress with on-line college courses through

U. Phoenix in Business, toward Bachelor's degree.

Vet reports chronic LBP, rating 4 to 6 out of 10 on average, made worse by

rising from seated positions, He also complains of relatively new hip pain,

which he reports is ascribed to compensatory muscle behaviors.

Much of today's session is focused on accepting the uncertainty of his

condition and prognosis, and defusing from identification with his physical disability. He

is encouraged to maintain mental and physical structure, and he discusses

ambivalence about reconnecting with friends, as he has continued to isolate

socially.

Vet is informed that he will be contacted by Neurology/behavioral Medicine for

purposes of setting up individual therapy focused on adjustment issues related

to medical condition. He also needs to contact PP regarding setting up ongoing

psychotropic med mgmt, which is the location that he prefers.

Vet is encouraged to follow-up with this provider for any future

questions/referral needs.

Polymyosytis

Adjustment DO, Mixed

current GAF = 50

I am a little bit confused on the mental health claim process. I understand you can have multiple issues but you get one MH rating and it is usually the highest one rated since it is the most sever. Adjustment disorder is different than PTSD so I understand that. PTSD use to just be passed off as adjustment disorder. I have read something about the VA likes to give adjustment disorder diagnoses so that they can try to claim it happened prior to service. My mental health issues are all tied to my service connected disability. So I think I am good there.

So am I following along with how the VA looks at all this correctly so far? Do I need more evidence/visits with behavioral medicine/neurology and get there take on everything prior to submitting or do I have enough now? I have only been off active duty for 5 months

Edited November 6, 2014 by asheth007

[carlie]

Carlie, I stand corrected in my post, however, I was trying to state is that unless the personality disorder is tied to say a compensable condition, say depression, anxiety, or PTSD, then they will try to to mark it as a pre existing condition, and state it as a personality disorder which would be zero unless accompanied by other symtoms or rather as a result of. I can attest to this fact as it is happening to me of sorts. With any traumatic event or stressor I can assure you, your personality will be altered and changed. the ticket though is that it's has tied to a rateable service induced condition. Maybe I'm confusing the issue or making my argument muddy. My apologies.

No problem buddy - just trying to keep the info on personality disorder and SC correct per 38 USC and 38 CFR.

The VA has been in alot of hot water the last 4-5 years, for booting out service members with a

PD label, when they actually have PTSD.

VBA is having to re-do many claims that they previously denied,

I think you can do a search on it here at hadit.com

I believe in the past, Berta has posted quite a bit on this issue.

Hope this helps a vet.

[ArNG11]

I understand as they have tried that maneuver on me. I haven't gotten into the fighting on those claims for depression and anxiety yet. I have to wait on the decisions. Those claims actually have a projected completion date of 01/2016.

[asheth007]

Is it because you have so much evidence or submitted several claims at one time?

[carlie]

I understand as they have tried that maneuver on me. I haven't gotten into the fighting on those claims for depression and anxiety yet. I have to wait on the decisions. Those claims actually have a projected completion date of 01/2016.

2016 - Dang - Just put a bullet in my head - lol.

[ArNG11]

Is it because you have so much evidence or submitted several claims at one time?

I submitted those claims as a fully developed claim. I'm not surprised though. It will get worked out in the end, maybe just with a good deal of persuasion. : ) Edited November 11, 2014 by arng11

[ArNG11]

Oops quoted the wrong post but still that is the jest.