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Adding Ptsd To Bipolar Adjustment Disorder

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lynnga

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Hello all, new here. Have questions. I've already opened a new claim and am awaiting my exam, so I think I have to wait to open a new claim after this one closes for an increase in rating for bipolar adjustment disorder w/ anxiety and depressed mood (also claimed as sleep disorder) which I'm service connected disabled with rating of 30%. This was given after I was honorably discharged in 2007 when enlistment was up after 4 years. My mental health has gotten so much worse. I'm seeing a marriage counselor, private therapist, va psych and my insurance psych (all have release of info to talk to eachother). Anyway I have not worked since 2012, my va dr wrote a letter stating she didn't think I could work due to panic attacks and such.

enlisted weight at age of 20 and no kids was 135

Same when I got out with one child

NOW after 3 kids (youngest will be 2 next month) 104lbs.

I don't eat, I get hardly sleep, anxious, panic attacks, no longer talk to friends and rarely see family outside of my home.

I was also diagnosed ADHD jan 2014 3 months after my 8 year old was when I realized I had all the symptoms they told us in his two week evaluation of ADHD. VA Dr aware.

Also before I enlisted I had to tell the military about my prior sexual abuse as a child by my father. I had no symptoms of anxiety and such prior to military. However, I got married a year in and found out my husband cheated on me and was coming back and forth between us and I was devastated and couldn't handle the emotional roller coaster and the feelings of the guilt and shame associated after I'd have sex with him and he'd leave to go see her. I was admitted into a mental facility for 4-5 days and that's when the above diagnosis was made. But I'm thinking that I could suffer from PTSD because of my childhood and when my ex cheated and used me for sex and then left me, it brought many flashbacks and memories of my childhood and I'm not sure if I can link a claim for PTSD to the mental health comp listed above. Like I said military was aware of sexual abuse prior to service and yes I turned my dad in and he went to jail and have never seen him again.

please help?

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  • Founder

PTSD is a hard claim to win with the best evidence. Since you state your PTSD is documented in your records as coming from childhood I don't think you would be successful with a claim. However, you may want to talk to your psych doc and get screened for it you can still be treated for it. If you are service connected for depression you can go for an increase, depression and ptsd pay the same and you already are rated for depression so I think that is the way to go.

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Mental health disorders (PTSD, Bipolar, MDD, etc.) are all rated on "symptoms". It wont matter much if you get diagnosed with another mental health disorder, you will only get compensated for symptoms "once". Its explained here:

§4.126 Evaluation of disability from mental disorders.

(a) When evaluating a mental disorder, the rating agency shall consider the frequency, severity, and duration of psychiatric symptoms, the length of remissions, and the veteran’s capacity for adjustment during periods of remission. The rating agency shall assign an evaluation based on all the evidence of record that bears on occupational and social impairment rather than solely on the examiner’s assessment of the level of disability at the moment of the examination.

(b) When evaluating the level of disability from a mental disorder, the rating agency will consider the extent of social impairment, but shall not assign an evaluation solely on the basis of social impairment.

© Neurocognitive disorders shall be evaluated under the general rating formula for mental disorders; neurologic deficits or other impairments stemming from the same etiology (e.g., a head injury) shall be evaluated separately and combined with the evaluation for neurocognitive disorders (see § 4.25).

(d) When a single disability has been diagnosed both as a physical condition and as a mental disorder, the rating agency shall evaluate it using a diagnostic code which represents the dominant (more disabling) aspect of the condition (see §4.14). (Authority: 38 U.S.C. 1155)

The mental disorders are rated here:

9400 Generalized anxiety disorder

9403 Specific (simple) phobia; social phobia

9404 Obsessive compulsive disorder

9410 Other and unspecified neurosis

9411 Posttraumatic stress disorder

9412 Panic disorder and/or agoraphobia

9413 Anxiety disorder, not otherwise specified

dissociative disorders

9416 Dissociative amnesia; dissociative fugue; dissociative identity disorder (multiple

personality disorder)

9417 Depersonalization disorder

somatoform disorders

9421 Somatization disorder

9422 Pain disorder

9423 Undifferentiated somatoform disorder

9424 Conversion disorder

9425 Hypochondriasis

mood disorders

9431 Cyclothymic disorder

9432 Bipolar disorder

9433 Dysthymic disorder

9434 Major depressive disorder

9435 Mood disorder, not otherwise specified

chronic adjustment disorder

9440 Chronic adjustment disorder

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

eating disorders

9520 Anorexia nervosa

9521 Bulimia nervosa

Rating Formula for Eating Disorders:

Self-induced weight loss to less than 80 percent of expected minimum

weight, with incapacitating episodes of at least six weeks total duration

per year, and requiring hospitalization more than twice a year for

parenteral nutrition or tube feeding 100

Self-induced weight loss to less than 85 percent of expected minimum

weight with incapacitating episodes of six or more weeks total

duration per year 60

Self-induced weight loss to less than 85 percent of expected minimum

weight with incapacitating episodes of more than two but less than

six weeks total duration per year 30

Binge eating followed by self-induced vomiting or other measures to

prevent weight gain, or resistance to weight gain even when below

expected minimum weight, with diagnosis of an eating disorder and

incapacitating episodes of up to two weeks total duration per year 10

Binge eating followed by self-induced vomiting or other measures to

prevent weight gain, or resistance to weight gain even when below

expected minimum weight, with diagnosis of an eating disorder

but without incapacitating episodes 0

Note: An incapacitating episode is a period during which bed rest and treatment by a physician are required. (Authority: 38 U.S.C. 1155)

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Also, ADHD is not rateable, it may actually hurt your case. I had to put out one of my troops a few years ago at 12 years as a NCO and multiple deployment OIF / OEF Vet. No compensation is allowed because they have marked it as something you are born with and cannot acquire. Therefore, they will not give you a disability rating. Except for gender identity issues, I think it is the only MH item tagged this way. I believe you could say the same thing about bipolar and any number of things, but ADHD not rateable while others are. He was given an opportunity to crosstrain from aviation into another MOS / AFSC, but that was at CC discretion and he did not get the job he wanted, so he was separated.

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Right but I was diagnosed bipolar while on active duty.

However the more I look into PTSD and MST (military sexual trauma). and my childhood abuse being "agitated" or made worse while on active duty. I am thinking of getting evaluated. Because I never thought I was bipolar, and many drs I've seen agree that I don't have the characteristics for it and the only medication I ever received for it was depakote that was given in hospital and maybe a week later. Because I already have a mental adjustment disorder I can file to open a claim for PTSD. These relate to the stalking/harassment and emotional stress my ex put on me (I won't go into details), but I did report his stalking and cheating while married to his supervisor who did nothing. Almost every MST PTSD symptom relates to me. I believe the military trauma I endured brought out ptsd from my childhood because the emotional feelings of love and betrayal mixed with guilt, shame felt the same. I have been in marriage counseling for a year and a half and my husband feels I don't let him "get close" emotionally or physically. I don't trust men because every man has ultimately hurt me.

PTSD is often misdiagnosed as bipolar II which is what they diagnosed me. However all my medical treatments after service have been for anxiety, insomnia, depressed mood, and adhd. No bipolar meds or treatment.

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  • Founder

lynnga as far as disability compensation ratings it's like broncovet says as far as the law and what the pay you it's all the same.

if you want to get your diagnosis changed from bipolar to ptsd or major depression you have to get seen and diagnosed. then you can pursue the claim.

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Lynn

I dont think I got my point across. Getting SC for another mental health disorder, is unlikely to get you any more compensation. VA does not pay based on diagnosis. They compensate you for SYMPTOMS. I could have 5 different mental health disorders diagnosed, but the VA will still pay ONLY ONCE for each symptom. If you WERE diagnosed with PTSD, MST, Depression, Bipolar, and schizo, you wont get paid but for ONE set of symptoms. All mental health disorders are rated, above, like I posted. "Pyramiding" prevents VA from paying you for PTSD symptoms, and, again, for the same symptoms for MST, and again for depression, etc.

If you dont feel VA is compensating you for ALL of your symptoms, then you can/should appeal. Compare your symptoms with those in the criteria, above.

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