Dsm Iv Or Dsm-V - Are C & P & Ro Raters Required To Use Year Claim Filed ?

[fatheryabueloDE9]

Good day fellow Vets,

It appears many C & P exam results posted the last few months are quoting the use of DSM IV, some DSM-V.

I filed my claim in May 2014. My C & P exam was in March 2015. The VA Psych examiner official results quoted using DSM-V.

Since Feb. 2014, my primary CBOC, MH practitioner (a contracted LCSW) exclusively used DSM-IV.

Most of his notes about my visits from Feb. 2014 through Sept. 2014 quote DSM-IV terminology; all have a GAF of 45. (None recently.

He was on medical leave from late Oct until this month)

Recently, in April 2015, my Regular meeting with my 2nd MH person was changed at the last minute. Upon my CBOC arrival,
I had a tele-conference with a MD/Psychiatrict at the VA's W. Palm Beach Regional Center.

Her notes of my "visit" quoted I was at a GAF of 55.

Btw, my Claim closed about 2 weeks ago.

A few days ago, my VSO stated the VA's RC Raters are suppose to be using the DSM in effect when a claim is filed. He has been a VSO for 15 years.

A few days ago, the VSO and I met about the 30% rating I recently was given by the FL Regional Office.
I am filing NOD but not specificially about the DSM issue.

I am confused !

Can I please have guidance on what is correct VA rater policy?

Thanks for any clarification.

A Nam Vet

[Navy4life]

The DSM-5 replaced the DSM-4 because the DSM-4 was making it harder for Vet's to be S/C for PTSD. The DSM-5 allows more Vets to get S/C now for PTSD....

It is really irrelevant to your claim b/c the C/P exam performed used the DSM-5 which is the most recent one.

I had my C/P exam in OCT 2014 and they used the DSM-5

Why are you filing an NOD? Did you read your C/P notes to see what was provided to you regarding your s/c 30% rating? The DSM-5 will not be an issue for you to file the NOD.....

PTSD has a break down as to what each % represents - look at the below and then read your C/P exam...I am pretty sure the language for 30% is in your C/P exam.

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

Occupational and social impairment with occasional decrease in work

efficiency and intermittent periods of inability to perform occupational

tasks (although generally functioning satisfactorily, with routine

behavior, self-care, and conversation normal), due to such symptoms

as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or

less often), chronic sleep impairment, mild memory loss (such as

forgetting names, directions, recent events) ....................................................... 30

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 continuous medication .................................................................................. 10

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.................................................. 0

[Philip Rogers]

If the rule changes during the claims process, the VA is supposed to use the rule that is most favorable to the claimant. In your case, they can use the DSM- IV(if the DSM-IV was being used on the date your claim was filed). If the DSM-V was in effect then they must use that. Back when they awarded me(1999) my 100%, for PTSD, the rules had changed and they had to use the one most favorable to me. It worked out well for me!

pr

[Tbird]

Well I think I found this reference you are looking for. Had a heck of a time finding it.

Had to put it in PDF the source is listed below and when you click you have to download a word document first, but when trying to copy and paste it screwed up the formatting so I made it into a PDF for you.

Section A. Examination Requests - Veterans Benefits - United States Department of Veterans Affairs

M21-1MRIII_iv_3_secA (1)-ptsd-dsm-5.pdf

[Navy4life]

Good post Tbird!

That is why the examiner used the DSM V vs. the DSM IV b/c of the C/P exam was in 2015... They used the correct DSM - fatheryabueloDE9

I hope that helped!

[fatheryabueloDE9]

The DSM-5 replaced the DSM-4 because the DSM-4 was making it harder for Vet's to be S/C for PTSD. The DSM-5 allows more Vets to get S/C now for PTSD....

It is really irrelevant to your claim b/c the C/P exam performed used the DSM-5 which is the most recent one.

I had my C/P exam in OCT 2014 and they used the DSM-5

Why are you filing an NOD? Did you read your C/P notes to see what was provided to you regarding your s/c 30% rating? The DSM-5 will not be an issue for you to file the NOD.....

PTSD has a break down as to what each % represents - look at the below and then read your C/P exam...I am pretty sure the language for 30% is in your C/P exam.

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

Occupational and social impairment with occasional decrease in work

efficiency and intermittent periods of inability to perform occupational

tasks (although generally functioning satisfactorily, with routine

behavior, self-care, and conversation normal), due to such symptoms

as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or

less often), chronic sleep impairment, mild memory loss (such as

forgetting names, directions, recent events) ....................................................... 30

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 continuous medication .................................................................................. 10

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.................................................. 0

Hi Navyforlife,

Yes, my C & P did have section about the s/c 30% rating. His narrative also did not fitI disagreed right away.

Three days after my exam, I saw and copied my C & P results from my HealtheVet, I disagreed.

The year plus of notes by the MH team had the wording which fits the 50% criteria rather than the former one.

Last Friday, I met with the VSO about my Rating results. He concurred I should file the NOD and get a DRO.

He is away on VA updates/training this week. We will get together to prepare the NOD upon his return.

A Nam Vet

[fatheryabueloDE9]

If the rule changes during the claims process, the VA is supposed to use the rule that is most favorable to the claimant. In your case, they can use the DSM- IV(if the DSM-IV was being used on the date your claim was filed). If the DSM-V was in effect then they must use that. Back when they awarded me(1999) my 100%, for PTSD, the rules had changed and they had to use the one most favorable to me. It worked out well for me!

pr

pr,

I appreciate your reply.

In May 2014 when I filed my PTSD claim, the DSM-IV was used in the MH persons notes exclusively.

To my knowledge, right or wrong, it changed in Oct. 2014 for new Claims.

It makes sense if the DSM-IV was consistently used by my CBOC MH team then to be consistent the same would hold true for the VA's C & P Psychologist and the St. Petersburg Florida RO Rater .

Maybe that would have benefited me more.

How does a lay person as myself determine which DSM, IV or V favors me?

A Nam Vet