Depression, should I claim primary or secondary?

[Andyman73]

Hello,

I want to know, is it better to file for depression, my MH doc has DXd me with MDD, but didn't clarify as SC, or go for depression as secondary to chronic pain?  I have paper proof of NSAID usage since 1992 on AD and through the VA.  Thanks

 

Andy

[bluevet]

Matt H.,

Ok, so file for ptsd and use the alcohol related incident(that got me an NJP and outpatient treatment) as the nexus?  Still drink, mostly to help fall asleep now .  

Once I get to the point of a C&P exam do I mention the suicide attempt? Or that I regularly hear voices trying to convince me it's for the best? Do I even dare mention the demon that tried to kill me in my sleep? Or my sleep apnea w/cpap?

Thanks for chiming in, Matt. Your words are the answers to some questions I didn't know how to ask.

Semper Fi.

Andy

I would file for PTSD  being that the VA only rates one of the conditions & file the others separate at the same time.

That way you have your EED set on all your contentions & rather or not you get denied...you can always  Appeal.

 

jmo

 

................Buck

Why would you recommend that he file for PTSD when he never even mentioned PTSD in his question? He asked whether he should should file his diagnosed depression as a primary condition or secondary to chronic pain. Where did PTSD come from? A claim for PTSD will require a diagnosis of PTSD and a traumatic event in service at its cause. 

I believe; and I'm not 100% on this; that if you file it as primary and the VA finds it to be secondary, they will automatically assign it as such. Since you have some markers in you SMRs that you feel could be used to form a nexus, file for it as a primary condition. In this case, if I were you, I would get an IMO and nexus statement from a private doctor before I filed and make sure the private doctor has reviewed and listed all of the same records that the VA has. I say this because C&P examiners are not very astute at defining a nexus. Often, with much more direct evidence in the record, these examiners fail to opine service connection. Save yourself 2+ years of waiting for a DRO review, in which case you would need to get an IMO anyway and do it now instead. Good Luck

[Buck52]

Your right PTSD was not mention in his question, I mention PTSD because Depression is a form of PTSD and a lower possible rating, the VA likes veterans to do this, Its better than filing Deperssion primary /secondary to chronic pain IMO.

I am not sure Andyman has a VA Diagnose for PTSD  or not?  but I think he does just from his post, the night mares he has and the alcohol related problems since his service,sleeping problems ect,,ect,,The PTDS seems to carry more weight than MDD  AND The VA tends to low-ball veterans with depression (MDD).

Some veterans do have to prove an event stressor  but a combat veteran don't need to! with CIB (Combat Infantry Badge) or in fear of there life in a enemy hostile territory with service records as prof. or DD -214

sure they could turn it around and say he has depression Mild to Severe  and get maybe a 20/ 30%rating vs PTSD its at least a 50%rating or better 70/100%

I have a Diagnose for MDD  but I also have a diagnose for PTSD and to me its better to start out getting service connected for PTSD from the start  vs Depression.

This is just my opinion and I realize each veteran is different  I am just trying to help him get a better and higher % rate

Its what I was advised to do by some very experienced long time hadit members.

But a Veteran is entitled to file what he wants to file its his choice Depression or PTSD with a  VA diagnose for both.

 

 

...jmo

 

.............Buck

[Matthew Hill]

Bluevet-- 

My post was confusing on the mental diagnosis point.  I was just trying to explain what VA had been doing with diagnoses until the Clemons case.  Frankly, the actual diagnosis applied for does not matter because of Clemons.  I agree with you as well on the direct vs. secondary claim here.

Andy--

As far as what to tell the C&P doc, we need to back up first.  Those symptoms you are battling are serious and life threatening.  I would recommend first that you are telling your treating doctor about these.  Your health comes first.  Additionally, by telling your treating doc those symptoms should be marked in the file, which will help your claim.  As far as telling the C&P doc, you need to be as honest and forthright as possible.  Don't wait for him to ask the right question if there is important info he needs to know.  If there is a possibility that you are struggling with PTSD this is my post on PTSD and C&P exams.

 

 

[Andyman73]

Bluevet,

I appreciate your opinions.

Buck,

That's the problem I'm faced with, which way do I go. The only official thing I have is my brand new dx of MDD.  There is o e or two entries in my STRs mentioning that I was under a lot of stress at the time of the entry. And I suffered from TMJ pain symptoms for years, that the Dr's and dentists couldn't find any physical causes of it. Methinks it was/is caused by stress. I know I was constantly gritting my teeth.

I was a moderate bodybuilder for about ten years, during and after my service years. So I know about gritting my teeth. I would catch my self gritting my teeth all the time, usually at work. Or whenever military aircraft fly over. And I frequently caught myself holding my breath while trying to shrug my shoulders into my ears. Guess I was subconsciously waiting for the other shoe to drop.

Matt,

My doc has noted the suicidal thoughts, I've seen it on my visit notes through myhealthyvet.  And he asks me about it at every visit.  But I am too afraid to tell him that sometimes the voices are screaming in my head. I have nightmares about being locked away in a hospital type setting. I even get visions like that during the daytime.

Self preservation keeps me from talking about it.  My wife already thinks I'm wasting my time, and hers, with the VA in general. 

I will check out your link as soon as I post this.

Andy

[Buck52]

Andyman,

Try to get your PCP to make you an appointment with MH...there you should see either a social worker or a Psychiatrist MD  and then you tell them about your depression and some of the things that you feel  is the caused from prior military service, They usually ask you a lot of different questions  that pertain to your stressors and anything that traumatized you during your military service  they will go back to your childhood and make sure there was no trama back then.

or if your already seeing MH then bring up your prior military service &  the things that were of trauma to you (Bad things you seen and experinced)  that you think about today and makes your life a living hell..... not sleeping gritting your teeth, night mares and wake up sweating and if your paranoid about being around crowds   things like this  or things like other people out to get you  or you feel a numb feeling and have mixed emotions ect,,ect,,stressed out big time  ect,,ect,,Isolation,(like to be alone) think about suicide ...things like this.  all of this could be why  you consume alcohol (  if your are?) & its PTSD Related.

 if its from your military service  then you should get it Service Connected and a claim for compensation...the depression codes they don't give the veteran a high enough rating for depression  and  he ends up asking for increase.

  PTSD is different  thats just the way the VA is   actually its  hard to explain why...but from what I was told and research here on hadit  its better to claim the PTSD, But you need a VA Diagnose for it from the VA  this is why I mention to you to ask your PCP to see if she can contact MH (Recommend MH) to you So you can let them see you...they will write it all down and put it in the Notes...you must qualify with DSM 5 and meet the 4 out of the 5 I believe to get a PTSD Diagnoses PTSD Criteria.

  They will put it all in your VA Notes and you can see them 3 days later in ebenefits...or go to the Dept Medical Records at your VAMC and ask for copies...remember to go  3 days later. and if they think you have it pretty bad  they will want you to see a Therapist   which is a good thing  it helps you and helps you with your claim  its all documented  it depends on your symptoms as to how they rate you.

Hope this helps.

 

...................Buck

Edited September 4, 2015 by Buck52

[Buck52]

§4.129   Mental disorders due to traumatic stress.

When a mental disorder that develops in service as a result of a highly stressful event is severe enough to bring about the veteran's release from active military service, the rating agency shall assign an evaluation of not less than 50 percent and schedule an examination within the six month period following the veteran's discharge to determine whether a change in evaluation is warranted.

(Authority: 38 U.S.C. 1155) 

 

http://www.ecfr.gov/cgi-bin/text-idx?SID=407710e2bd86b436dacc7cd3aa7bcea5&mc=true&node=se38.1.4_1130&rgn=div8