VA

[OCDMarine]

I am a Service connected Vet of the Marine Corps.  20% for Spondylolisthesis L5-S1 and Disk Herniation (loss of forward flexion) 10 Percent for Patellofemoral Left Knee (loss of flexion), Patellofemoral Right Knee (loss of flexion).  November 2015 I submitted a VA claim for increases on these respective disabilities, as well as for Anxiety and Depression as secondary to the chronic pain and loss of function from these Disabilities.  I was diagnosed by my VA Psychiatrist and Private Psychiatrist as having Anxiety (GAD) and Depression Major Depressive Disorder (MDD) Moderate.  Both Psychiatrists reference that the cause of my Aniety and Depression is the Chronic pain I am in, and the stress of not being able to work/provide like I once could.  I have Insomnia, Fatigue, Myalgia, Irritability,trouble concentrating, OCD ritualistic behavior, flat affect racing and unwanted thoughts.......  My VA MD opined that mt Anxiety and Depression is "Most Likely" from my chronic pain syndrome from my military disabilities.  I have worked as a letter carrier for 11 years and have deteriorated mentally and physically.  Do you guys think I have a legitimate claim with the Va for an increase from 40 percent?  Do I have enough to claim Anxiety/Depression??  any help is so appreciated.  Thank you

[iceturkee]

you know the back is based on either range of motion or prescribed (in writing) bed rest.

i am 40 percent for my back. i have 5 herniated discs, 2 torn discs, a slipped vertabrae, spinal and foraminal stenosis, an abnormal lordatic curve and arthritis. my guess (without knowing your range of motion) that you would stay at 20 percent for your back. my 2 cents.

[brokensoldier244th]

You have a claim for depression but your claim for back is going to be based on range of motion and 40% is less than 35* flexion. If you have less than 35degrees of motion, then go for it. The anxiety depression diagnosis you have is similar to mine, though the degree to which it impedes your daily behavior would depend on your interview with the C&P doc and your notes from routine treatment. I was actively working with a 50% rating but similar symptoms as you. Once one gets higher their work life and relationships and ability to deal with people usually starts to fall apart pretty heavily. Not knowing your duration of treatment or tendencies in daily living we can't guess as to a rating, but as far as a claim goes  your notes say pretty much what they need to say to successfully claim it. Better if you have been treated for a while so you have a lot of notes from consistent treatment to support the claim. 

[Andyman73]

See, now here is what really gets my goat.  OCDMarine, you said your VA MH doc referenced your chronic pain as a major cause of your MDD.  May I ask when you first got hurt, when did the time line of "chronic pain" begin for you?  I sure could have used your VA MH for my C&P exam last fall!
 

I was DXd with MDD this past July by who is now my treating VA MH therapist.  At that time I don't recall that he directly linked it to any of my pain issues.  Now here is a quick little back story on me.  I fell down a flight of stairs on November 21st, 1992...which was only the 5th day of USMC boot camp for me.  I went on to serve all 6 years of my enlistment, and received SCDs of 10% low back pain/sprain/strain(depends on what day of the week it is) and 10% bilateral patella-femoral pain syndrom.  Also 10% for pain/residuals L ankle injury.  All which were treated during my AD years.  I have been receiving prescription NSAIDS and non-NSAIDs from the VA ever since. 

Last year I got the back increased to 40% and the knees each an additional 10%, and 30% for pes cavus w/plantar fasciitis bilateral as well.  All lead back to injuries that were treated while on AD.  I am in the process of a claim for cervical spine w/radiculapathy from the same fall. 

Last fall I filed for depression secondary to chronic pain.  The examiner opined that my MDD was more due to other issues, to include chronic sleep issues, and not my chronic pain...which was very well documented, I might add.  Even the RO told me that she could not go with the physical medical evidence and grant me the MDD secondary, since the examiner chose to ignore the evidence.  I guess over 23 years wasn't chronic enough in my claim.

OCDMarine, I wish you all the success!

Semper Fi.

Andyman

[broncovet]

Well, yes, according to your posts the doctor opined your MDD is secondary to service connected conditions.

If service connected, your MDD (or other applicable mental health issues) you will be rated on symptoms.  

Are you currently working?  If not, consider both applying for an increase and TDIU at the same time. 

To get TDIU you will likely need a doctor opine that your SC conditions prevent you from being able to maintain substantial gainful employment.  

Also, if you served in wartime, you can apply for NSC pension as long as you dont have a lot of family income, since pension is a needs based program.  Its possible, or even likely for you to get pension while you are waiting on VA to grant service connection for TDIU/depression/other increases.  

[broncovet]

Depending upon your number of dependents, NSC pension will be a big raise for you over your current 40 percent rating.  You can look it up for yourself based upon your number of dependents, but its "about" 1000 per month if you have little or no other family income, which is proabably about double what you are now getting with your 40%.  

[brokensoldier244th]

1 hour ago, Andyman73 said:

See, now here is what really gets my goat.  OCDMarine, you said your VA MH doc referenced your chronic pain as a major cause of your MDD.  May I ask when you first got hurt, when did the time line of "chronic pain" begin for you?  I sure could have used your VA MH for my C&P exam last fall!
 

I was DXd with MDD this past July by who is now my treating VA MH therapist.  At that time I don't recall that he directly linked it to any of my pain issues.  Now here is a quick little back story on me.  I fell down a flight of stairs on November 21st, 1992...which was only the 5th day of USMC boot camp for me.  I went on to serve all 6 years of my enlistment, and received SCDs of 10% low back pain/sprain/strain(depends on what day of the week it is) and 10% bilateral patella-femoral pain syndrom.  Also 10% for pain/residuals L ankle injury.  All which were treated during my AD years.  I have been receiving prescription NSAIDS and non-NSAIDs from the VA ever since. 

Last year I got the back increased to 40% and the knees each an additional 10%, and 30% for pes cavus w/plantar fasciitis bilateral as well.  All lead back to injuries that were treated while on AD.  I am in the process of a claim for cervical spine w/radiculapathy from the same fall. 

Last fall I filed for depression secondary to chronic pain.  The examiner opined that my MDD was more due to other issues, to include chronic sleep issues, and not my chronic pain...which was very well documented, I might add.  Even the RO told me that she could not go with the physical medical evidence and grant me the MDD secondary, since the examiner chose to ignore the evidence.  I guess over 23 years wasn't chronic enough in my claim.

OCDMarine, I wish you all the success!

Semper Fi.

Andyman

Whether they link it to chronic sleep or chronic pain is moot (unless your chronic sleep isn't SC, but if you are in constant pain it probably should be) Chonic pain is a pretty well accepted driver of depression, but then so is chronic sleep disorders and apnea. My particular situation is such that I complained of pain from the incident forward and at one point was almost docked some pay because I had a verbal out with my top about my constant sick calls. This was in AIT. Once he got to know me a bit as a non-maligerer and I talked to him more about what happened to me he helped me talk to the acting CO at the time so I could get my MEB/PEB started. 

 

The pain, for me, was always in my file from the outset, along with the peripheral numbness in my toes and feet. Years later when I started my MH treatment and was finally diagnosed with MDD I was able to show to my counselor the long continuing connection so that she didnt have to do much. It came out as a fixture over about 7 sessions, too, so there was a clinical history narrative that I had built with her. 

 

If your sleep issues are already SC then having it tied to that rather than pain really shouldn't matter. Sleep, pain, and MDD all go together, too, so it could just be a matter of having to sort it out over some sessions. If its causing you employment issues tell your doc. 'Soft skills' and 'nuanced behavior' issues are part of MDD and can cause severe issues in employment. A history of failing performance, a downward trend in efficiency, write ups, co worker opinions of you being difficult to work with- all of this will contribute towards that. Threats of firing help, too (though, not so much with the MDD issues- those just get exacerbated due to increased stress from the employment problems)

Edited March 5, 2016 by brokensoldier244th