MST/PTSD Claim and medication

[Michigander]

What impact do you think my MST/PTSD claim will have because I am not on any meds for anxiety or depression.  The only medication I was on was Xanax for my anxiety and panic attacks and my neurologist told me to stop taking my Xanax because I have such severe memory and concentration issues.  I am on a very low dose which he knows and that I needed to take the meds because it is the only thing to this point that helps my panic attacks or recover more quickly from one.  I am not on any depression meds. because I will not take them due to having suicidal thoughts when I tried them two times in my past.  I did think of killing myself...I had and "urge" to kill myself and that was the scariest thing to fight off for almost two days until my meds wore off.  I vowed I would never take those meds again (or any other class of the meds) I'd rather have my anxiety and depression than to kill myself and my children have to live with that the rest of their lives.  

Now that I am filing for MST/PTSD I see the DBQ has many questions surrounding medications and it looks like in my situation the yes and no answers does not allow for the explanation above and my claim may be rejected despite my many issues I deal with daily that I am now in therapy for.  

Any advice on what to do to address this preemptively for my claim??

[broncovet]

YOUR TREATMENT for PTSD/MST is something you discuss with your Doctor, and you 2 decide on what treatment is best.  

VA does not say, "You have to be taking 200 milligrams of Xanax, 500 Miligrams of Prozac, etc.  to get benefits for these conditions."  

Medications are prescribed by a doctor who knows your conditions, what you are allergic to, and hopefully, the course of treatment that has the best outcome for you.  

Once service connected, the VA rates your conditions on "symptoms", not on the milligrams of x or y medication you take.  

Your doctor may prescribe therapy, such as talking it out, or other stuff.  While many PTSD/MST Vets are on medications, it is not one of the criteria for VA to rate you with the conditions on the number of or type of meds you take. 

Unless the criteria says that your rating will be determined "after taking medications", then your rating will be based on your symptoms without meds.  

In other words, if taking Prozac or Xanax means you dont have panic attacks anymore, but you had panic attacks prior to being medicated for them, then you still get compensated for panic attacks, as a symptom of PTSD or MST.  

The VA can not reduce you because meds help you UNLESS the critieria for your condition specifically so states.  One of the reasons for this is because meds often no longer work over time, and you need to try other meds.  

Think about it.  VA fits you with a wooden leg, and you can walk.  So the VA says, "Gee, we arent going to compensate you for a missing leg, you seem to be walking just fine on the wooden one we gave you."  They cant do that, you still have a missing leg, and you would likely prefer your own to that wooden leg.  

Diabetes is an example.  You may be treated with diet, pills, shots, etc.  Your diabetes will be based on your symptoms, not on the medication you are on.   You still have diabetes even when medicated.  Your doctor can/will change the meds based on your insulin levels and other things.  That does not mean you get reduced because one day your sugar was good.  

Edited July 24, 2017 by broncovet
incomplete.

[Michigander]

Thank you Broncovet ...like I said the DBQ seems so focused on the medications as if they directly signal how bad a vet's condition is and like you said there are many other factors why a vet takes or  not takes Meds.

Can you tell me what, when and where a DBQ comes in during the claim process?

Does everyone eventually get or need a DBQ filled out?

 

 

[broncovet]

DBQ is not mandantory, Caluza elements are.  Caluza elements are 

1.  Current diagnosis

2.  In service event or aggravation.

3.  Nexus or medical link that numbers one and two are related.  

       Focus on the 3 requirements above.  Once service connected, your disabilities will be rated on "symptoms" in the criteria.  If your doctor, somewhere in your exams did not provide you these three Caluza elements, then take action to get all 3 or you will be denied.  One or two wont do, you must have all 3 Caluza elements.  Read your doctors reports, dont guess on what you think the doc said.  

     AFTER you read your file and see that you have all three Caluza elements, then you can read your file again and try to pick out the symptoms you have documented.  

 

Quote

 

38 CFR 4.130 - Schedule of ratings - Mental disorders.

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§ 4.130 Schedule of ratings - Mental disorders.

The nomenclature employed in this portion of the rating schedule is based upon the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) (see § 4.125 for availability information). Rating agencies must be thoroughly familiar with this manual to properly implement the directives in § 4.125through § 4.129 and to apply the general rating formula for mental disorders in § 4.130. The schedule for rating for mental disorders is set forth as follows:

9201 Schizophrenia

9202 [Removed]

9203 [Removed]

9204 [Removed]

9205 [Removed]

9208 Delusional disorder

9210 Other specified and unspecified schizophrenia spectrum and other psychotic disorders

9211 Schizoaffective disorder

9300 Delirium

9301 Major or mild neurocognitive disorder due to HIV or other infections

9304 Major or mild neurocognitive disorder due to traumatic brain injury

9305 Major or mild vascular neurocognitive disorder

9310 Unspecified neurocognitive disorder

9312 Major or mild neurocognitive disorder due to Alzheimer's disease

9326 Major or mild neurocognitive disorder due to another medical condition or substance/medication-induced major or mild neurocognitive disorder

9327 [Removed]

9400 Generalized anxiety disorder

9403 Specific phobia; social anxiety disorder (social phobia)

9404 Obsessive compulsive disorder

9410 Other specified anxiety disorder

9411 Posttraumatic stress disorder

9412 Panic disorder and/or agoraphobia

9413 Unspecified anxiety disorder

9416 Dissociative amnesia; dissociative identity disorder

9417 Depersonalization/Derealization disorder

9421 Somatic symptom disorder

9422 Other specified somatic symptom and related disorder

9423 Unspecified somatic symptom and related disorder

9424 Conversion disorder (functional neurological symptom disorder)

9425 Illness anxiety disorder

9431 Cyclothymic disorder

9432 Bipolar disorder

9433 Persistent depressive disorder (dysthymia)

9434 Major depressive disorder

9435 Unspecified depressive disorder

9440 Chronic adjustment disorder

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

 

 

[Andyman73]

BroncoVet nailed it! I was going to say same, but in more simple terms as befitting my level of understanding and education.  

As for DBQ question, I didn't have one filled out for my claim or during exam either...which I thought was unusual. Same for not answering all those questions regarding how my symptoms effect my day to day activities. Seems most do, which makes me feel odd for being singled out. 

Continue wishing you complete success with your claim.

[Buck52]

Most VA Dr's will not fill out a DBQ...Some will but most won't

Its a trust/bond type oath they take when employed by the VA.

their mind set is focused on being pro VA.

I Learn not to ask them to fill one out.  

Just my opinion But

 the VA relies on the C&P EXAMINERS to examine & read the veterans medical records that pertain to the claim/or claims and give his/her opinion as what they think the veterans severity of the symptoms will be. 

Then the raters will make the decision based off this C&P Report.

However its also the raters responsibility to read the veterans records  too but a lot of times they fail to do that.

The Veteran needs familiarize him/her self with the rating criteria broncovet put up.

As to the correct ratings given.

Edited July 24, 2017 by Buck52