Copy of DBQ. Looking for insight?

[chriscond]

Im currently service connected at 50% for panic with anxiety and depression. This is for an increased rating. I'm not working right now and receive SSDI. I applied for an increase in 2016 and was kept at 50%. I didn't pursue it further because I felt like their reasoning was sound. This time I know things have gotten worse and will appeal it to the full extent necessary. Any thoughts would be helpful.

 

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Axis 1: Panic Disorder, Bipolar II disorder
Axis 2: None
Axis 3: Chronic Pain due to facial trauma
Axis 4: Problems in realtionships
Axis 5: 32

Occupational and Social Impairment:
Occupational and social impairment with deficincies in most areas

Symptoms:
The ones that were checked are Depressed Mood, Anxiety. Suspiciousness, Panic Attacks more than once a week, Impaired Judgment, Disturbances of motivation and mood, Difficulty establishing and maintaining effective work and social relationships. difficulty adapting to stressful circumstances including work or its setting, suicidal ideation, persistent danger of hurting self or others, neglect of personal appearance and hygiene, intermittent ability to perform activities of daily living, including maintenance of minimal personal hygiene.

The notes were very thorough throughout the DBQ as well. In the remarks section there is a lot of writing but basically says that I'm currently unable to show stabilization in mood, frequently depressed with avoidance of family friends and self care. Instability due to panic affect ability to participate at times in public events and pursuing work due to high levels of agitation and panic when overwhelmed. Periods of SI with one SA. Self harm, Impulsiveness, Lack of emotional regulation leads to weekly and at times daily conflict with partner and others.

[chriscond]

4 hours ago, Gastone said:

Did you file a New Secondary Claim linking the TBI & Residuals to you SC MH condition?

Hmm.. No, I havent but it did cross my mind. I didn't think it would be a legitimate thing to claim though. I mean yes, I have major anxiety and I was doing 'exposure therapy" when it happened but I would feel kind of bad to make that a claim. Though I do have chronic pain and permanent jaw clicking and popping now. 

I'm just grateful the VA paid for the surgery. Do you think that it would be something that they would reasonably service connect?

 

[chriscond]

Since I will be sending in my request for increase this week along with all of my records, DBQ, results of the MMCI-III examination, I decided to write a letter to the rater. I started this a couple of months ago and have been working on it when I have the energy to do so. I wrote about the Jaw/TBI/TMJ issues in it today. I didn't directly ask for a New claim for Secondary service connection but I figured mentioning the surrounding details would give them something to render future (if any) decisions upon.
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Dear Sir or Madam,

Below is a Basis of Reasoning for Rating Increase:

I have been rated at 50% since August 2010 for Anxiety Disorder. I applied for increased rating in 2013 and had a C&P exam in 2014 and the decision was to maintain 50%. I filed a DRO review because I still believed my service connected disability had increased. I had a subsequent C&P exam in early 2016 and the decision was to maintain my current rating at 50%. At that point I decided not to pursue it further because I felt that the decision was based on sound reasoning (although I did disagree with the last C&P examiners report, I was too mentally drained to argue against it or fight it at the next level).

Since that time my mental health has invariably gotten worse. I had a comprehensive mental health examination done in August 2017 and the results were that I have suffer from  Major Depressive Disorder and severe Anxiety and Panic disorder. The Licened Mental Health Provider that I see once weekly now believes I suffer from Bipolar II disorder superimposed upon the Anxiety/Major Depressive Disorder/Panic Disorder. Regardless of diagnosis and labels put forth, this is my life and the far reaching limitations caused by my disability are what ultimately matter.

Extreme weight changes due to appetite shifts, extremely diminished sexual desire, groggy and spaced out during the day, not sleeping for 2 to 3 days at a time, isolation from family and everyone else by being alone majority of the time, then getting irritable beyond belief about trivial things.  So now on top of being anxious and depressed almost continuously I have to deal with the aforementioned issues. On top of that, in June of 2016 while doing exposure therapy in a public setting at the suggestion of my Psychologist at the time, something I did not want to do and had to be talked into it by my girlfriend because I was adamant on going home, I was physically assaulted. Due to that assault I suffered a TBI and massive facial trauma. I received surgery at the Seattle VA and now have permanent titanium plates and screws inserted into my lower jaw and had my mouth wired shut for six weeks. Since that incident i have chronic pain, jaw stiffness, clicking and popping and an inability to open my mouth too wide. That event and the residuals thereof have greatly hindered any progress in therapy which led to feelings of hopelessness, being hostile and suspicious of people, irritability and isolation and feeling more anxious and depressed than before.

Both my VA provider and private mental health provider have stated at this time I am unable to pursue work due to service connected disabilities, namely: Generalized Anxiety Disorder, Panic Disorder and Major Depressive Disorder although otherwise characterized as Bipolar II disorder. I realize that all mental health ratings are covered under one scope and the degree of disability is determined by the relevant symptomology.

Therefore, based on the VA's own statutes and criterion I believe the mental health records will support my contentions for an increased rating. My private mental health provider has filled out a DBQ and printed records, of which  were noted and signed under review of a Doctorate level Psychologist. On top of that the comprehensive 4 hour Mental Health Evaluation performed by said Psychologist (Dr. T****) is included.

As I feel this is a Decision Ready Claim,  I do hope this will bypass a C&P exam but I will attend one if scheduled. I seek the maximum benefit allowed by law. 

Thank you for your time.

US Army Veteran (my name)

[Berta]

Do you get SSDI solely for the service connected SC issue you now get 50% for?

[chriscond]

3 hours ago, Berta said:

Do you get SSDI solely for the service connected SC issue you now get 50% for?

Yes.

[Berta]

"Im currently service connected at 50% for panic with anxiety and depression."

Any SSDI award, if solely for the same SC disability, is Golden!

Make sure the VA knows of this award and authorize them to get your SSDI records.You can certainy send that letter to the rater but notification of your SSDI award will be far more probative.

VA took my 30% SC PTSD husband up to 100% when they finally got his SSDI records. SSDI is ,in essense, an independent medical opinion.

They based their SSA award solely on his VA medical and MH records.

SSA took mere months to award the PTSD...it took VA 5 years to award the 100% ,because he died 2 years after filing the SC higher rating claim.

 

 

[Buck52]

I think you have a good chance for increase to 70% on the PTSD & with your other conditions if S.C.?

they may give you the IU based on you can't work and that letter from SSA Ms Berta is right on.

  SSA is a Totally disabled benefit  so that will be a tremendous help.

As Gastone pointed out the VA is reluctant to the private Docs for MH Issues  but mostly for the Dx of a MH Conditions ,  the letter from your private psychologist & SSA should help.

If your not working a letter from your employer should help detailing why you can't work why they let you go  ect,,,ect,,, for the IU