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Question about Meds?

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  • HadIt.com Elder

I was talking to my VA MH Therapist yesterday about alL the damn MH meds I been taking  along with other Dr's meds from the VA..

I ask him if it was necessary for me to take all these meds & could  one or another possibly conflict with the other so to speak

He said he would put in for me to see a  VA MH Pharmacist ,  he said they can look at all my meds and what there for and see if I can get off of a few.

 Ok after given this some thought (not that I'm paranoid eh)   >Now I'm not so sure I will do this...simply b/c when they take away your meds    the VA seems to think your condition has improved and R.O. Gets word of this  and they fire out that old letter  to propose a reduction b/c your S.C. has shown improvment.

Do I have a Valid point here  and I need to just leave well enough alone and suck up to the Meds?

This is a good example as to why a veteran needs to file for any CONDITIONS that can be S.C.  as soon a she/she gets out  of military rather or not he/she gets a rating  but to start the 20 year rule  safe period.

I got 5 more years yet.  be 69

Anybody care to comment?

Thanks

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

Edited by Buck52
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  • HadIt.com Elder

Bump bump:huh:

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  • Moderator

This is what I recommend:

Do a google search, first,  something close to :

"Buproprion and Lorazepam compatability".  (Subsititute your own meds, get the bottle to spell it if you have to.) 

Then repeat this search for all your meds.  You probably need to do them one at a time.  

If you find nothing, or no bad results, then you can continue.  

However, if the searches turn up more questions than answers, then YES, I would see the pharmicist.  

Personally, I take an "active role" in my meds.  For example, I was prescribed Gabapentin (spelling?) a couple years ago.  I looked it up, and it was doubtful.  Then, I tried it anyway, and felt like I came off a hangover after taking it, so I stopped it and told the doctor why.  

If you look up the regulations, Buck, you will see VA requires "continuity of SYMPTOMS" not continuity of TREATMENT.  The doctor can change your meds..many times..and they have changed mine.  Its important to give the doc feedback.   "This med made me sleepy"....That med upset my stomach...etc.    They call it a "medical PRACTICE" for a reason..and that reason is they dont know for sure how a pill will affect YOU, for sure, until you try it.  The pill may make things better, worse, or have no effect.  The doctor prescribing a pill that made you worse instead, and you discontinue using the pill is not a reason for VA to reduce your rating.  

All this said, if you get a big rating for a mental health disorder, then discontinue all treatment for 4 years, its gonna raise red flags.    I can actually see precisely that happening, too, in innocence.  It does not mean you are faking it, for you to decide you want to go to an outside doc for treatment that you can not get at VA.  It might be a good idea, tho, if VA gave you a big mental rating then you switched to a private practice doc, from VA, that yous should tell them.  Im not sure you have to release those records, however.  You may want to release the records to them in the event VA does a proposed reduction.  

I think the chances of you getting a reduction at age 69 and not working are near zero.  Remember, after you are 5 years OR P and T, the Va has to show "actual improvement under ordinary conditions of life".  And, this means actual improvement while working.    So, if you go back to work full time, then you would have something to worry about a reduction.  

 3.344 Stabilization of disability evaluations.

(a) Examination reports indicating improvement. Rating agencies will handle cases affected by change of medical findings or diagnosis, so as to produce the greatest degree of stability of disability evaluations consistent with the laws and Department of Veterans Affairs regulations governing disability compensation and pension. It is essential that the entire record of examinations and the medical-industrial history be reviewed to ascertain whether the recent examination is full and complete, including all special examinations indicated as a result of general examination and the entire case history. This applies to treatment of intercurrent diseases and exacerbations, including hospital reports, bedside examinations, examinations by designated physicians, and examinations in the absence of, or without taking full advantage of, laboratory facilities and the cooperation of specialists in related lines. Examinations less full and complete than those on which payments were authorized or continued will not be used as a basis of reduction. Ratings on account of diseases subject to temporary or episodic improvement, e.g., manic depressive or other psychotic reaction, epilepsy, psychoneurotic reaction, arteriosclerotic heart disease, bronchial asthma, gastric or duodenal ulcer, many skin diseases, etc., will not be reduced on any one examination, except in those instances where all the evidence of record clearly warrants the conclusion that sustained improvement has been demonstrated. Ratings on account of diseases which become comparatively symptom free (findings absent) after prolonged rest, e.g. residuals of phlebitis, arteriosclerotic heart disease, etc., will not be reduced on examinations reflecting the results of bed rest. Moreover, though material improvement in the physical or mental condition is clearly reflected the rating agency will consider whether the evidence makes it reasonably certain that the improvement will be maintained under the ordinary conditions of life. When syphilis of the central nervous system or alcoholic deterioration is diagnosed following a long prior history of psychosis, psychoneurosis, epilepsy, or the like, it is rarely possible to exclude persistence, in masked form, of the preceding innocently acquired manifestations. Rating boards encountering a change of diagnosis will exercise caution in the determination as to whether a change in diagnosis represents no more than a progression of an earlier diagnosis, an error in prior diagnosis or possibly a disease entity independent of the service-connected disability. When the new diagnosis reflects mental deficiency or personality disorder only, the possibility of only temporary remission of a super-imposed psychiatric disease will be borne in mind.

(b) Doubtful cases. If doubt remains, after according due consideration to all the evidence developed by the several items discussed in paragraph (a) of this section, the rating agency will continue the rating in effect, citing the former diagnosis with the new diagnosis in parentheses, and following the appropriate code there will be added the reference “Rating continued pending reexamination ___ months from this date, § 3.344.” The rating agency will determine on the basis of the facts in each individual case whether 18, 24 or 30 months will be allowed to elapse before the reexamination will be made.

(c) Disabilities which are likely to improve. The provisions of paragraphs (a) and (b) of this section apply to ratings which have continued for long periods at the same level (5 years or more). They do not apply to disabilities which have not become stabilized and are likely to improve. Reexaminations disclosing improvement, physical or mental, in these disabilities will warrant reduction in rating

end regulation quote.  

Section C, above, explains this does not apply to "temporary" ratings, but only those which are P and T OR have been stabalized after 5 years.  

In short, at your age 69, stop worrying about a reduction.  Worry, instead, about something more likely to happen like what you will do after you win the lottery and then spend all that money.  

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  • Moderator

IN summary, Buck:

Dont let the VA "bully" you into thinking you MUST keep taking meds that dont help you, or make you worse, in order to keep your benefits.  

If you want/need to drop one or more meds for your own health, then do so.  I do recommend you go off one med at a time, tho, so you can know for sure whether you got better or worse without that particular med.  

Personally, I think if you can not see some real positive benefit of taking a (psych) med, then dont take it.  If its a med like "blood pressure" meds, then you may not notice any difference whether you take it or not, but, if you have prescribed high blood pressure med, you should take it anyway, even if you dont notice a difference, because too high of blood pressure is very very bad for your health.  

 

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I suggest going to drugs.com.  They have a fantastic drug interactions checker that allows you to add all of your meds at once.  Then it provides potential interaction warnings and why.   Of course your provider/pharmacist is your first line of defense, but it still never hurts to be the best advocate for your own health and double check. 

Edited by Will01930
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  • Moderator

Also, I tell my doc.  "No, I quit taking Gabepentin because it made me feel like I had one very bad hangover after taking it."  

There is no regulation which supports the VA reducing your rating because YOU find that the risks of taking a med out weigh the rewards of taking it.  

This is always a judgement call YOU make.  Not your doc.  He can "advise" you, but its always your choice.  I wont allow VA or other doc to administer meds against my will.    My wife is a nurse, and when a patient refuses meds, they just write "refused".  (If you are a patient in a mental hospital  you may not have that choice).  

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