degenerative arthritis Mental Health C&P, can you tell me if it'll be SC and rating?

[BklynVet]

Hi,
I just had a C&P for mental health.  Can you look at this and tell me if you think they'll give me a rating and what it might be?

Examination Results: It is in this Psychologist's opinion that the Veteran meets the criteria for Somatic Symptom Disorder with Predominant Pain.  Veteran's psychiatric symptoms are severe and have a significant impact on his overall functioning.

Section 1:
1. Diagnosis
a. Does the Veteran now have or has he/she ever been diagnosed with a mental disorder (s)?  (X) Yes
If the Veteran has one or more mental disorders that conform to DSM-5 criteria provide all diagnoses:  Mental Disorder Siagnosis #1: Somatic Symptom Disorder with Predominant Pain
b.  Medical diagnosis relevant to the understanding or management of the Mental Health Disorder (to include TBI): paralysis of anterior tibial nerve, degenerative arthritis of spine

Section 3: Occupational and social impairment:
a.  Which of the following best summarizes the Veteran's level of occupational and social impairment with regards to all mental diagnoses?  (Check only one)
(X) Occupational and social impairment with reduced relaibility and productivity.
b.  For the indicated level of occupational and social impairment, is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by each mental disorder? (X) No other mental disorder has been diagnosed.

Section II: Clinical Findings:
1. Evidence Review
a. Medical Records review:
Was the Veteran's VA e-Folder (VBMS or Virtual VA) reviewed? Yes
Was the Veteran's VA claims file reviewed? No
If no, check all records reviewed:
(X) Military service treatment records
(X) Military Service Personnel records
(X) Veteran's Health Administration medical records (VA Treatment records)
b. Was pertinent information from collateral sources reviewed? No

2. History
a. Relevant social/Marital/Family History (pre-military, military, and post-military):  Reports growing up in Brooklyn with is parents and four younger siblings. Describes childhood as great and says he had many friends, played sports.  Veteran states he was very outgoing and active prior to/during the military.  He says he bacame more withdrawn folling his injury in the miltary.  Reports feeling miserable after this injury, says he was embarassed that he was no longer able to be physically active.  Veteran says his chronic pain impacted his first marriage significantly.  He describes becoming physically abusive toward his aife after after worrying that she was "pitying" him or his pain.  Veteran says this pity made him feel"like less of a man".  Discribes his divorce as "miserable" and he and his ex fought over everthing.  Reports having one daughter from this marriage, says he does not see her often as she lives with is ex wife. Veteran says he moved back to NYC from Maryland following his divorce and remarried.  Veteran says that although his wife is understanding of his pain, he is concerned that his marriage may be affected by his conrnic pain in teh future.  For example, he observes that his wife has commented on his lack of socialization more often recently.  Veteran says he isolates himself from others because he fels ashamed of his physical condition.  He reports limiting his overall activity level for fear of having a back spasm in public.  For instance, veteran says he takes the bus 5 blocks to the subway entrance because he worries about having a back spasm on his walk to the subway.

b. Relevant occupational and educational history (pre-military, military, and post military): Denies academic impairment prior to the miltiary.  Veteran says he graduated from a Catholic high school and attended XXXXX University for one year before leaving to complete the USMC Officer's Candidate School.  Veteran states he then transferred to XXXXX College, where he earned his BA in XXXX XXXXXX. Veteran describes feelign extreme disappointment when he was discharged from the AF.  He states, "I felt like the Air Force was telling me I'm broken." Post -military, veteran says he went to work as a contractor for the government in Washington DC.  He describes significant occupational impairment over the years.  For example, veteran says he has fought with supervisors and co workers at various departments and has noticed a decrease in productivity due to his chronic pain.  Veteran states that he works from home three days a week currently in order to limit the amount of time he spends working alongside his supervisor, with who he has experienced significant conflict.  Describes isolating from co workers, adds that, "no one understands (him)" regarding his chronic pain.  Veteran shares his disappointment that he has not been able to work towards promotions in his career due to his chronic pain.  

c. Relevant mental health history, to includ prescribed medications and family mental health (pre-military, military, post-military): Denies mental health history prior to/during military.  Post military veteran reports experiencing significant ruminations about his back injury/pain.  He describes feeling depressed, anxious and irritable.  Veteran also reports the following symptoms: emotional detachment, suspiciousness/mistrust, isolation, anhedonia, impulsivity, avoidance of most physical activities, por sleep and shame. Veteran says he has questioned the adequacy of his medial treatment adnd states his wife has commented on his "doctor shopping".  Reports he began an outpatient MH group for the treatment of his chronic pain at the Brooklyn VA in 2015.  Also reports attending outpatient marriage counseling sessions with his ex-wife in early 2000s. Denies use of psychiatric medications.

d. Relevant legal and behavioral history (pre-military, military and post -mlitary): Reports his ex wife applied for an order of protection against him over 10 years ago.  Veteran says he was arrested for arguing with police officers after he voilated the terms of this order, but he was let go the next day with no charges.

e.  Relevant substance abuse history (pre-military, military and post military): Denies useabuse of ETOH/other substances prior to/during military.  Post military, veteran reports significant use of narcotic medications to help manage chronic pain.  He says he has not taken any non-VA prescribed medications since early 2015.

3. Symptoms
For VA rating purposes, check all symptoms that apply to the Veteran's diagnosis:
(X) Depressed mood
(X) Anxiety
(X) Suspiciousness
(X) Panic attacks that occur weekly or less often
(X) Chronic sleep impairment
(X) Flattened affect
(X) Impaired judgement
(X) Disturbances of motivation and mood
(X) Difficulty in establishing and maintaining effective work and social relationships
(X) Difficulty in adaptming to stressful circumstances, including work or a work like setting
(X) Inability to establish and maintain effective relationships
(X) Impaired impulse control, such as unprovoked irritablity with period of violence

Behavioral observations: Veteran arrived on time and presented as well groomed and oriented x3 with depressed mood and congruent affect. Thought process was clear and goal oriented.  Speech was within normal limits.  Eye contact was appropriate.  

4.  Other symptoms
Does the Veteran has any other symptoms attributable to mental disorders that are not listed above? (X) No

5. Competancy
Is the Veteran capable of managing his or her financial affairs? (X) Yes

6 Remarks (include any testing results), if any: It is in this Psychologist's opinion that the Veteran meets the criteria for Somatic Symptom Disorder with Predominant Pain.  Veteran's psychiatric symptoms are severe and have a significant impact on his overall functioning.
 

[BklynVet]

My service connected disabilities are:
20% - Degenerative disc disease, lower back L4-L5-S1
10% - Right L5 Radiculopathy
0% - Left L5 Radiculopathy
10% - tinnitus
0% - chronic epididymitis
0% - Chronic Prostatitis
0% - Bilateral patellofemoral pain syndrome

I'm currently at 40% total

[DevilDog12]

Wow...almost my C&P word for word.  I am rated at 30% for MDD.  Filed an appeal for increase to 50%.  Good luck!

[ArNG11]

This is just my take and just my opinion so bare with me.  All situations are unique but from what you wrote and just going from that I would appeal the 30%.  With the social and professional difficulties that you mentioned, those are in the realm of 50-70%.  Again this is just my opinion.

I am basing this on my exam and results.  However, please remember each claim is unique and don't know what evidence the rater is going by.  Circumstances and factual history, documented history, should and would come in to play.

Don't just take my word for it though.  Match up your symptoms with the rating criteria and be honest with yourself.  I think that may give you a better  inkling of where you should be.  The kicker will be to back up your assessment with a doctor's opinion stating the same. Best if it were a medical professional say like a licensed psychiatrist or psychologist who has reviewed your service medical records.  

 

[Navy04]

Looks like SC will be granted at 0-30%. Good luck and God Bless

[ArNG11]

You're going to have to wait for a decision. The decision letter will answer many of your questions.  I wrote prematurely, however, 

no sense getting all worked up if you haven't received a decision yet.  

Hurry up and wait status gets underneath my skin as well.  But positive thoughts.  The main thing right now is service connection.  Then you will have a better understanding of where to go.  Good luck.

[Vync]

You're going to have to wait for a decision. The decision letter will answer many of your questions.  I wrote prematurely, however, 

no sense getting all worked up if you haven't received a decision yet.  

Hurry up and wait status gets underneath my skin as well.  But positive thoughts.  The main thing right now is service connection.  Then you will have a better understanding of where to go.  Good luck.

Yep, I agree. It seems that some things which existed in the military also exist in the VA system as well...