Chronic Adjustment Disorder Conversion To PTSD Question

[militarynurse]

I had read in Mil.Times that:  "According to the psychiatric manual used to diagnose mental health issues, the DSM-IV, adjustment disorder occurs when someone has difficulty dealing with a life event, such as a new job or a divorce, or after someone has been exposed to a traumatic event. The symptoms can be the same as for post-traumatic stress disorder: flashbacks, nightmares, sleeplessness, irritability, anger and avoidance. According to military and Veterans Affairs Department policy, if those symptoms last longer than six months, the diagnosis should be changed to PTSD."

Has anyone seen where a SC'd "chronic adjustment disorder" diagnosis for longer than 6 months or more in duration was changed to a diagnosis of PTSD?

Thank you.  

 

Edited September 8, 2015 by militarynurse

[bluevet]

I had read in Mil.Times that:  "According to the psychiatric manual used to diagnose mental health issues, the DSM-IV, adjustment disorder occurs when someone has difficulty dealing with a life event, such as a new job or a divorce, or after someone has been exposed to a traumatic event. The symptoms can be the same as for post-traumatic stress disorder: flashbacks, nightmares, sleeplessness, irritability, anger and avoidance. According to military and Veterans Affairs Department policy, if those symptoms last longer than six months, the diagnosis should be changed to PTSD."

Has anyone seen where a SC'd "chronic adjustment disorder" diagnosis for longer than 6 months or more in duration was changed to a diagnosis of PTSD?

Thank you.  

 

The DSM-V which is now in effect includes the following specifiers to "Adjustment Disorder" as follows:

"Specify as Acute" if the disturbance lasts less than 6 months"

"Specify as Chronic" if the disturbance lasts more than 6 months"

There is no automatic change in diagnosis from adjustment disorder to another diagnosis. Chronic adjustment disorder is service connectable under diagnostic code 9440 and the rating schedule is identical to that of PTSD. It might help to answer your question if you tell us a bit about what it is that you are hoping to accomplish. 

I believe the article you are referring to is here:  http://archive.militarytimes.com/article/20131011/NEWS/310110027/Adjustment-disorder-may-now-net-disability-pay

It does talk about a bill mandating additional screening for other MH disorders for veterans who have been discharged with an "Adjustment Disorder" diagnosis Since 2001. I'm not sure if that bill was enacted, but there was a change in DOD policy regarding service connection for "Adjustment Disorder".

Edited September 8, 2015 by bluevet

[militarynurse]

Bluevet, Thank you for the reply. The article that quote came can be found at the following link: http://archive.armytimes.com/article/20100812/NEWS/8120325/

A fellow I know just had his C&P exam with the as likely as not diagnosis of "adjustment disorder with anxiety and depressed mood." Not "chronic adjustment disorder", however, it appears nowadays it doesn't make any difference. He was not assigned a GAF score.

While PTSD is linked to a number of secondary conditions ( which he is aiming for ), I'm not sure that an "adjustment disorder"....chronic or otherwise...is. Anyone know?

 

[Mikemmlj]

If you can make the case that it's a valid secondary you're good. But you're right I don't know that there is precedent for it.

[Buck52]

I agree with bluevet

The code diagnostic code for Chronic Adjustment Disorder is 9440 and the code for PTSD is 9411

in the CFR'S  It mentions ratings under diagnostic codes 9201  to 9440....> 9440 being the code for(Chronic Adjustment Disorder)

will be evaluated using the  general  rating formula for mental health disorders.

so they both rate the same.

so it depends on how bad they rate your symptoms as for as your rating percentage! 

 

jmo

 

.....Buck

Edited September 11, 2015 by Buck52

[Buck52]

 

General Rating Formula for Mental Disorders

	Rating
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

 

[Buck52]

 ''Personal Assault'' This is the only one I know of to service connected ptsd be  secondary to personal assualt..However they possible could be more  its just the only one I know of

  

 

STATEMENT IN SUPPORT OF CLAIM FOR SERVICE CONNECTION FOR POST-TRAUMATIC STRESS DISORDER (PTSD) SECONDARY TO PERSONAL ASSAULT

 

 

http://www.vba.va.gov/pubs/forms/VBA-21-0781a-ARE.pdf

 

per: Ms Carlie

 

 

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

 

 

 

Edited September 11, 2015 by Buck52