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Can I lose benefits if testosterone cures my depression?


abarrus

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Hi, All.

Just a couple weeks ago I had my testosterone levels checked after suspecting I had low levels since before I served. The levels are abnormally low. I begin testosterone replacement therapy this week. I've been 70% disabled for depression for 10 years. I became clinically depressed just months after returning from Iraq 14 years ago. I've been on medication for depression for all that time.

I'm now suspecting that getting my testosterone to normal levels (currently at 60, the normal range for men of 35 is about 600) will cure my depression, as it tends to have that effect. My hypogonadism isn't eligible for anything close to 70%. I'm looking forward to an improvement in my quality of life. I'm not looking forward to the possibility of losing $20k per year of tax-free income, which pays for my house and cars. It supported me without the need to work when I lived abroad after college.

I'm getting my testosterone replacement therapy from the VA. If I begin to report that the testosterone is working very well, will the VA benefits people see those medical records and decide that my depression has improved and give me a rate of less than 70%?

 

I'm excited about my life changing, but should I just go outside the VA for this? I'm not sure how the VA works. Worried for my family's financial security.

 

Thank you in advance for your input.

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Relax.  Read the criteria for reductions.  It says, once you are p and t or "over 5 years" SC, they cant reduce your benefits UNLESS you have "actual improvement under ordinary conditions of life".  

I have been here over 10 years and not have heard of that happening.  It would be like:

"Ok, you lost your leg.  Well, we gave you a wooden one, and now you are "good to go" so we are gonna drop your compensation because you can walk ok with your wooden leg."  NO!!!!

    I fractured my leg in service, and eventually I needed a total knee replacement.  Actually, Im doing well on my new knee.  Im not the slightest bit concerned about a reduction because I have a new plastic/metal knee that helps me get around with less pain and increased ROM.  

    If they even TRY to do such an insane thing (reduce my comp because I get around better with a plastic/metal surgically implanted knee) I have an attorney who will be on that like white on rice.  Its true VA has done some wild shennanigans, but there is some stuff that they just wont touch.  

    There is a M21 that says that they cant give you a C and P reduction exam if you are over 55 years old.  I think it happened to ONE Vet, and they contacted them, pointing out they were over 55 and the reduction c and p exam got quashed.  

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  • HadIt.com Elder

I have hypogonadism as well, and receive testosterone from the VA. Im 42 (ugh). While its not had much effect on my depression over all in the last 2 yrs, it has helped my energy levels through the day so Im not completely exhausted from mundane tasks. Quality of life is important but its not a cure all. I self inject, incidentally, its not that difficult once you get the hang of it, and they provide the needles and syringes. I would recommend drawing your dose with a larger needle, like a 20 gauge (still pretty small), then switching needle tips on the syringe and using a 22 gauge to inject. Reason being is that piercing the top of the container to draw out your dose dulls the tip of the needle just a bit, and its noticable when you use the same needle to draw and then inject. Trust me on this. VA used to give me sets of both gauges, for awhile, then they stopped. Not sure why, but in any case you can, for about 20.00 a box of 100, get syringes and needles for self injecting from Amazon without a pharmaceutical license or anything like that. That way I am still able to draw with 1 needle and inject with another. Its pretty simple. 

I have not had benefits reduced, but depression is long term treatment resistant type so it depends on what yours is and its cause. If  you go outside VA it will be at your cost and I don't know what that costs. I get my dosages 2 to a bottle, and I reorder from VA pharmacy online. I take shots once a week. If you have insurance that will cover it, why not, but if you can get it for free from the VA, I would. You'll have to go in every three months or so for the first year so they can monitor your doses and make sure you are compliant with injections (basically, that your levels are static) and that you aren't having any other issues. Keep in mind that if you start taking testosterone your testes will stop making it and it will basically render you sterile. Not 100%, but your S count will drop to the point of being unable to have kids if that is a concern. Your doc should fill you in on all this, too. 

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TYVM brokensoldier244th,

I guess I may be having a paranoid overreaction, especially since I have lived off my disability in Mexico, and like to always keep that option in my back pocket. I'm 35, I've got a 2 year old and a 7 month old. I've been asking my wife to let me get my nuts nipped. She's 37 and wants to have another one at 40. I guess this can protect against accidents, and I hear that the erections and orgasms will get better, so that may be really handy. We don't have any help where we live, and 1 baby per parent keeps us too busy as it is.

I just now talked to a DAV rep. He told me that the only way they will look at reducing my depression/anxiety comp is if I ask for an increase, which I have before. I know better than to do that now. To get more than 70% one needs to be perpetually psychotic, which I'm not, thank god. I have a wonderful home life, i love my job, and love my city. Seems that fixing the low T is a big thing missing that's missing in my life. I certainly can use more energy, mental agility, focus, to help me at work and with the kids.

thanks everyone for your great advice.

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does anyone know if getting "snipped" can prevent smc for ED and low t SC? 

thanks in advance

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@blahsaysme2uGetting snipped should have no impact testosterone levels. It merely disconnects and clamps the plumbing from the testes so sperm goes nowhere, otherwise your hydraulics continue functioning as before the procedure. One thing to keep in mind is that after undergoing the procedure, you'll need to have a semen analysis some point after you have healed to verify the count is actually zero. Just because you got snipped does not mean that the provider who performed the procedure did their job right. If you do get snipped, I highly recommend getting several bags of frozen peas because you will need them afterwards to ice down the area.

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They will reduce your benefits!! That’s why they review your records if you are not T&P! Also if you are T&P they could reduce you rating.

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7 hours ago, Vync said:

@blahsaysme2uGetting snipped should have no impact testosterone levels. It merely disconnects and clamps the plumbing from the testes so sperm goes nowhere, otherwise your hydraulics continue functioning as before the procedure. One thing to keep in mind is that after undergoing the procedure, you'll need to have a semen analysis some point after you have healed to verify the count is actually zero. Just because you got snipped does not mean that the provider who performed the procedure did their job right. If you do get snipped, I highly recommend getting several bags of frozen peas because you will need them afterwards to ice down the area.

i actually already had the procedure done. va doc did it and seemed to go well. was couple years ago now. 

But what my ED and low t issues i was hoping to get Erectile Dysfunction is assigned a 0% service connected VA rating under Special Monthly Compensation (SMC) Category (K) or SMC-K, for “Loss of Use of a Creative Organ.” but didnt know if that was possible since i been snipped? 

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  • HadIt.com Elder

There is no cure for depression that I have heard of so far.  If you are prone to depression you take certain drugs to control it.  I never heard of testosterone as a "cure" for depression.

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low T is cause of many different issues...depression just being one. 

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You posted:

Quote

I just now talked to a DAV rep. He told me that the only way they will look at reducing my depression/anxiety comp is if I ask for an increase, which I have before.

Your DAV is wrong and should be tarred and feathered!  Reductions "are not" dependent upon "whether or not you apply for increase".  This myth is propogated by lazy, uninformed, or just plain malicious VSO's.  

Instead, "there is" a criteria for reduction, and not one word says anything close to "applying for increase".  To the contrary, apply for and seek all the benefits you deserve.  You can be reduced AT ANY TIME, whether or not you are seeking an increase, but only if you meet the following criteria:

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38 CFR § 3.344 - Stabilization of disability evaluations.

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§ 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.

 

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15 hours ago, blahsaysme2u said:

i actually already had the procedure done. va doc did it and seemed to go well. was couple years ago now. 

But what my ED and low t issues i was hoping to get Erectile Dysfunction is assigned a 0% service connected VA rating under Special Monthly Compensation (SMC) Category (K) or SMC-K, for “Loss of Use of a Creative Organ.” but didnt know if that was possible since i been snipped? 

There are a lot of causes of ED from side effects of medications to other hormones. I know my urologist always checks my thyroid when I go in for a checkup. Might be worth looking up your most recent labs and comparing any abnormal values to known side effects of meds you take to treat your SC disabilities. Ironically, some psychotropic meds used to treat depression like prozac can actually cause decreased libido.

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I don't think I understand this question?

 Can I lose benefits if testosterone cures my depression? if you ask for increase  for your depression as being worse  or another  another condition depression causes.

 

 AFTER HAVING DEPRESSION   &being service connected  and sa rating given  for 10 Years I doubt  they would take it away ,  they need to have good reason too  if you apply for increase  they may send you to a C&P  and The C&P Examiner can screw things up pretty much  and that may mess things up , 

I never heard of Testrone injections curing depression?  just the opsite I would think  but I am not a Doc.

you can have other conditions that depression can cause  heres is just a few 

Symptoms

Although depression may occur only once during your life, people typically have multiple episodes. During these episodes, symptoms occur most of the day, nearly every day and may include:

Feelings of sadness, tearfulness, emptiness or hopelessness

Angry outbursts, irritability or frustration, even over small matters

Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports

Sleep disturbances, including insomnia or sleeping too much

Tiredness and lack of energy, so even small tasks take extra effort

Reduced appetite and weight loss or increased cravings for food and weight gain

Anxiety, agitation or restlessness

Slowed thinking, speaking or body movements

Feelings of worthlessness or guilt, fixating on past failures or self-blame

Trouble thinking, concentrating, making decisions and remembering things

Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide

Unexplained physical problems, such as back pain or headaches

For many people with depression, symptoms usually are severe enough to cause noticeable problems in day-to-day activities, such as work, school, social activities or relationships with others. Some people may feel generally miserable or unhappy without really knowing why.

 

 

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14 hours ago, Buck52 said:

Can I lose benefits if testosterone cures my depression? if you ask for increase  for your depression as being worse  or another  another condition depression causes.

I think I understand what he's getting at. 

I want to file a claim for my central sleep apnea secondary to my DDD and compressed nerves in my neck. There is a lot of medical literature which suggests or states that sleep apnea can cause depression. My depression is rated at 70%.  Could VA rationalize a rating reduction of my depression while doing the rating for my central sleep apnea?

Anything is possible, but I can only assume that VBA can't play doctor and leap to conclusions where there is no specific diagnosis. Right?

 

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On 4/16/2019 at 5:34 PM, abarrus said:

I'm now suspecting that getting my testosterone to normal levels (currently at 60, the normal range for men of 35 is about 600) will cure my depression, as it tends to have that effect.

This post is almost too old to answer. I will answer for others out there researching this topic.  

In the instance where you are concerned about the possible direction of your existing claim, you want to keep an eye on the notes entered in MyHealth eVet medical records. MyHealth eVet is the main reason I keep all my care within the VA.

If you see doctor's notes that would tend to counter your existing claim, then you would want to do some damage control and think of a referral request that can counter those notes. Pain management, for instance, is a strong component of depression treatment. That would preserve your depression rating outside of any testosterone treatments.

The other way to help preserve your depression rating is to communicate what symptoms of depression you continue to experience, even after testosterone treatment. You may want to ask to try a different drug for depression because depression symptoms continue, etc. You communicate this in MyHealth eVet messaging, and that goes into the medical record that VBA can see.  

Depression is rated on symptoms, together with the psych tests.

Keep in mind there is a back end of internal doctors' notes that the patient can't see, but it serves the doctors primarily. I suppose we could call it the patient's charts, which are different than the patient records you can see.  When I worked at MyHealth eVet, I could see these back end charts on a patient only when my supervisor gave me access to process reports that the department needed for year end whatever.  These backend records can either hurt or help your claim. So, you want to pay attention to what records you can see, for instance when a doctor appears to be minimizing your condition or attributing it to a cause that doesn't make sense in the overall record.  I'll give you an example of that. I was diagnosed as having vascular dementia 4 years ago because of brain fog and inability to concentrate. The medical record doesn't support that, because if it did I would surely have had some follow up. No follow up occurred in all this time. Instead, the psychologists and psychiatrists agree that the brain fog is a symptom of my depression.

 

Edited by Rivet62 (see edit history)
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1 hour ago, Rivet62 said:

I think I understand what he's getting at. 

I want to file a claim for my central sleep apnea secondary to my DDD and compressed nerves in my neck. There is a lot of medical literature which suggests or states that sleep apnea can cause depression. My depression is rated at 70%.  Could VA rationalize a rating reduction of my depression while doing the rating for my central sleep apnea?

Anything is possible, but I can only assume that VBA can't play doctor and leap to conclusions where there is no specific diagnosis. Right?

 

Roger That!

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On 1/31/2022 at 11:58 PM, blahsaysme2u said:

i actually already had the procedure done. va doc did it and seemed to go well. was couple years ago now. 

But what my ED and low t issues i was hoping to get Erectile Dysfunction is assigned a 0% service connected VA rating under Special Monthly Compensation (SMC) Category (K) or SMC-K, for “Loss of Use of a Creative Organ.” but didnt know if that was possible since i been snipped? 

Once again there is confusion due to adding on an already old thread. As far as I know, there is no cure for depression.

As to you getting SMC (K) for loss of creative organ? The VA does not pay disability on an elective surgery. You elected to have the surgery and I don't see how your ED would change anything since your election already took away your creative option. 

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22 hours ago, broncovet said:

Your DAV is wrong and should be tarred and feathered!

as should most...especially DAV and VFW!! just saying hahahahahahaha

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21 hours ago, Vync said:

There are a lot of causes of ED from side effects of medications to other hormones. I know my urologist always checks my thyroid when I go in for a checkup. Might be worth looking up your most recent labs and comparing any abnormal values to known side effects of meds you take to treat your SC disabilities. Ironically, some psychotropic meds used to treat depression like prozac can actually cause decreased libido.

yeah i had my thyroid checked before i was put on TRT...i am on the patch...started 4 days ago. they DX me with hypogonadism

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33 minutes ago, pacmanx1 said:

As to you getting SMC (K) for loss of creative organ? The VA does not pay disability on an elective surgery. You elected to have the surgery and I don't see how your ED would change anything since your election already took away your creative option. 

oh no i have had ED since leaving...i am not sure what caused it...they snip was not related in any way to the ed....other than i know that the definition of creative organ is based on "creating babies"

so i didnt know if i elected to do the snip, would i still be able to get SMC-k for "loss of creative organ"

is it even worth trying..ED is embarrassing enough without going through VA hoops only to be told i dont qualify...

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1 hour ago, blahsaysme2u said:

so i didnt know if i elected to do the snip, would i still be able to get SMC-k for "loss of creative organ"

is it even worth trying..ED is embarrassing enough without going through VA hoops only to be told i dont qualify...

Now even more confusion, since you had ED why would you even think of being snipped? The VA would want to know your reasoning. It's bad enough that the VA wants to know just about everything in our lives but when we file a claim for compensation, you better believe someone will ask questions like a little kid. why, but why, but why, but why daddy, but why.

A straight uphill battle. 

Edited by pacmanx1 (see edit history)
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