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Unwanted provisional diagnosis


Mover1993

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 I was diagnosed recently with some sleep disorders and anxiety issues through a private psych. Because i'm a vet I was administered a PTSD questionnaire. Now, I'm in no way claiming PTSD but a subclinical "provisional" diagnosis is on my sheet. If I submit a claim for mental health disorders will they make me go to a VA PTSD exam? My issues are sleeping and anxiety/depression.

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4 hours ago, Mover1993 said:

 I was diagnosed recently with some sleep disorders and anxiety issues through a private psych. Because i'm a vet I was administered a PTSD questionnaire. Now, I'm in no way claiming PTSD but a subclinical "provisional" diagnosis is on my sheet. If I submit a claim for mental health disorders will they make me go to a VA PTSD exam? My issues are sleeping and anxiety/depression.

If you are clearly diagnosed right now;with Anxiety/Depression then that is what you will be allowed to claim. If you are also diagnosed with insomnia, insomnia is considered a mental health issue. The provisional diagnosis is a temporary diagnosis. Your private psych doc administered a PTSD questionnaire, possibly to provided due diligence to you. Especially, if you mentioned a combat/non-combat trauma stressor that you don't recall mentioning. 

I would stick to your clear diagnosis to claim Anxiety/Depression. You'll be sent to a Mental Health C&P exam. FYI, all mental health disorders are rated the same.

The majority of mental conditions are rated on the following schedule. Each rating has 5 main categories of symptoms/circumstances. Not every single symptom or circumstance has to be present in order to be assigned the rating, but the rating that most closely defines the condition should always be used.

 

100% rating: This rating will have the majority of the following circumstances and symptoms:

The Ability to Care for Yourself: This individual cannot take care of himself at all. Constant or near-constant hospitalization and one-on-one supervision is required.

Medications: This individual requires psychiatric medication at all times.

Symptoms: Some or all of the following symptoms will be present.

– Regular or constant delusions or hallucinations and the inability to tell fact from fiction
– Completely inappropriate behavior (like drooling, mumbling, shouting, etc.)
– There is constant danger of hurting self or others (including suicidal tendencies)
– Significant memory loss, including not being able to remember names of close friends, family, or self, and other important information
– The individual cannot understand the idea of time or place
– The individual cannot properly reason, think or communicate logically
– Constant anxiety, fear, suspicion

The Ability to Work: This individual cannot work at all.

Social Relationships: This individual cannot participate in any relationships. In other words, they cannot interact or build a relationship with another person. Family members may care for them, but it is only a one-way relationship. They cannot seek, invite, or encourage any relationships.

70% rating: This rating will have the majority of the following circumstances and symptoms:

The Ability to Care for Yourself: This individual cannot take care of himself most of the time. He is in the hospital or a care facility or is being taken care of by family members all of the time, and requires one-on-one supervision 50% of the time. This person cannot take care of his own personal hygiene.

Medications: This individual requires psychiatric medication at all times.

Symptoms: Some or all of the following symptoms will be present.

– There is the regular possibility of hurting self or others (including suicidal tendencies)
– This individual often cannot communicate logically
– This individual is actively psychotic, but may have intermittent contact with reality
– Obssessive-compulsive behavior that causes repetitive physical actions that interfere completely with daily necessary activities
– Severe, constant anxiety
– Mood often changes radically, without warning.
– Almost constant severe depression or panic, with the inability to function at all in stressful situations
– This individual cannot control impulsive actions like anger, violence, etc.
– Often disoriented to time and place

The Ability to Work: This individual may not be able to work at all or may be severely under-employed (such as a former intelligence analyst now working part time as a custodian).

Social Relationships: This individual cannot participate in any relationships most of the time. In other words, they cannot interact or build a relationship with another person. Family members may care for them, but it is normally only a one-way relationship. They cannot seek, invite, or encourage any relationships the majority of the time.

50% rating: This rating will have the majority of the following circumstances and symptoms:

The Ability to Care for Yourself: This individual is occasionally hospitalized, but can mostly take care of the basic personal needs like bathing or going to the bathroom, although their personal hygiene may not be kept up regularly. They may also be able to function in areas like shopping, driving, cleaning, etc.

Medications: This individual requires psychiatric medication at all times.

Symptoms: Some or all of the following symptoms will be present.

– Trouble expressing or showing emotions (This doesn’t mean that they are just reserved. It basically means that they are completely blank the majority of the time), or shows the wrong or inappropriate emotion for the situation
– Always shows significant signs of anxiety
– Regularly gives unnecessary or unrelated details when communicating
– Two or more panic attacks a week
– Trouble understanding complex directions
– Trouble remembering things (forgetting to complete tasks, etc.)
– Trouble thinking logically and often has poor judgment
– A serious lack of, or a seriously increased, mood or motivation
– Occasional delusions or hallucinations
– Regular to nightly trouble sleeping (nightmares, insomnia, anxiety, etc.)
– Complaints of physical symptoms, like pain, that do not have a physical cause
– Suicidal thoughts, but no definite plan to hurt himself

The Ability to Work: This individual may try to work, but will not be able to hold a job for more than 3 or 4 months because of their inability to remember or follow all directions or other similar reasons based on the symptoms or circumstances described under this rating. (In other words, they wouldn’t lose their job simply because they have anger issues and would regularly get in fights. A person like that could also not hold a job more than 3 or 4 months, but they would still be considered able to work). This individual would only be hired for jobs like cleaning, picking up trash, or other simple-task jobs.

Social Relationships: Like his ability to work, this individual may try to build and engage in relationships, but these relationships would not last long in most situations. Divorce or other breaks in relationships and friendships could occur due to his inability to properly participate in a relationship.

30% rating: This rating will have the majority of the following circumstances and symptoms:

The Ability to Care for Yourself: This individual may have occasional, short hospitalizations, but can entirely take care of himself most of the time.

Medications: This individual usually requires medication to function normally.

Symptoms: Some or all of the following symptoms will be present.

– Spikes or drops in mood, like depression
– Often anxious or becomes easily stressed
– Panic attacks occur, but no more than once a week
– Difficulty sleeping (nightmares, insomnia, anxiety, etc.)
– Mild memory loss could include regularly forgetting names or directions
– Often suspicious of other people, particularly ones he does not know

The Ability to Work: This individual will be able to work and will usually function normally. There may, however, be occasional times where he is unable to properly fulfill all job requirements. This could result in occasionally losing his job.

Social Relationships: Like his ability to work, this individual will normally have fairly stable relationships. These relationships, however, will not be great and will often be strained by the symptoms of his condition. Divorce or breakups could occur, but not in every case.

10% rating: This rating will have the majority of the following circumstances and symptoms:

The Ability to Care for Yourself: This individual will always be able to take care of himself and will very rarely, if ever, be hospitalized.

Medications: This individual may or may not be taking medication. Meds may be taken all the time, or only during stressful times. They satisfactorily keep all symptoms under control.

Symptoms: Some or all of the following symptoms will be present, but only during times of significant stress. The majority of the time there are no symptoms.

– Mild depression or other mood changes
– Mild to moderate anxiety
– Mild panic attacks may occur, but very rarely
– Occasional difficulty sleeping (nightmares, insomnia, anxiety, etc.)
– A range of other, very mild symptoms, which could include suspiciousness of strangers and hyperarousalhyperarousal.bmp

The Ability to Work: This individual will be fully employable and will very rarely have any problems at work that are caused by the mental condition.

Social Relationships: This individual will have full, functional relationships with only occasional, mild stresses that are caused by the condition.

0% rating: If a mental condition has been diagnosed but there are no symptoms that impair social or occupational functioning or require medication, then it is rated 0%.

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PTSD is anxiety and can include sleep disturbances, they will probably screen you.  They may list you only for depression but you need an in service event, continuing issue, and a nexus between the two.  Are you against a PTSD diagnosis?

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16 hours ago, doc25 said:

If you are clearly diagnosed right now;with Anxiety/Depression then that is what you will be allowed to claim. If you are also diagnosed with insomnia, insomnia is considered a mental health issue. The provisional diagnosis is a temporary diagnosis. Your private psych doc administered a PTSD questionnaire, possibly to provided due diligence to you. Especially, if you mentioned a combat/non-combat trauma stressor that you don't recall mentioning. 

I would stick to your clear diagnosis to claim Anxiety/Depression. You'll be sent to a Mental Health C&P exam. FYI, all mental health disorders are rated the same.

The majority of mental conditions are rated on the following schedule. Each rating has 5 main categories of symptoms/circumstances. Not every single symptom or circumstance has to be present in order to be assigned the rating, but the rating that most closely defines the condition should always be used.

 

100% rating: This rating will have the majority of the following circumstances and symptoms:

The Ability to Care for Yourself: This individual cannot take care of himself at all. Constant or near-constant hospitalization and one-on-one supervision is required.

Medications: This individual requires psychiatric medication at all times.

Symptoms: Some or all of the following symptoms will be present.

– Regular or constant delusions or hallucinations and the inability to tell fact from fiction
– Completely inappropriate behavior (like drooling, mumbling, shouting, etc.)
– There is constant danger of hurting self or others (including suicidal tendencies)
– Significant memory loss, including not being able to remember names of close friends, family, or self, and other important information
– The individual cannot understand the idea of time or place
– The individual cannot properly reason, think or communicate logically
– Constant anxiety, fear, suspicion

The Ability to Work: This individual cannot work at all.

Social Relationships: This individual cannot participate in any relationships. In other words, they cannot interact or build a relationship with another person. Family members may care for them, but it is only a one-way relationship. They cannot seek, invite, or encourage any relationships.

70% rating: This rating will have the majority of the following circumstances and symptoms:

The Ability to Care for Yourself: This individual cannot take care of himself most of the time. He is in the hospital or a care facility or is being taken care of by family members all of the time, and requires one-on-one supervision 50% of the time. This person cannot take care of his own personal hygiene.

Medications: This individual requires psychiatric medication at all times.

Symptoms: Some or all of the following symptoms will be present.

– There is the regular possibility of hurting self or others (including suicidal tendencies)
– This individual often cannot communicate logically
– This individual is actively psychotic, but may have intermittent contact with reality
– Obssessive-compulsive behavior that causes repetitive physical actions that interfere completely with daily necessary activities
– Severe, constant anxiety
– Mood often changes radically, without warning.
– Almost constant severe depression or panic, with the inability to function at all in stressful situations
– This individual cannot control impulsive actions like anger, violence, etc.
– Often disoriented to time and place

The Ability to Work: This individual may not be able to work at all or may be severely under-employed (such as a former intelligence analyst now working part time as a custodian).

Social Relationships: This individual cannot participate in any relationships most of the time. In other words, they cannot interact or build a relationship with another person. Family members may care for them, but it is normally only a one-way relationship. They cannot seek, invite, or encourage any relationships the majority of the time.

50% rating: This rating will have the majority of the following circumstances and symptoms:

The Ability to Care for Yourself: This individual is occasionally hospitalized, but can mostly take care of the basic personal needs like bathing or going to the bathroom, although their personal hygiene may not be kept up regularly. They may also be able to function in areas like shopping, driving, cleaning, etc.

Medications: This individual requires psychiatric medication at all times.

Symptoms: Some or all of the following symptoms will be present.

– Trouble expressing or showing emotions (This doesn’t mean that they are just reserved. It basically means that they are completely blank the majority of the time), or shows the wrong or inappropriate emotion for the situation
– Always shows significant signs of anxiety
– Regularly gives unnecessary or unrelated details when communicating
– Two or more panic attacks a week
– Trouble understanding complex directions
– Trouble remembering things (forgetting to complete tasks, etc.)
– Trouble thinking logically and often has poor judgment
– A serious lack of, or a seriously increased, mood or motivation
– Occasional delusions or hallucinations
– Regular to nightly trouble sleeping (nightmares, insomnia, anxiety, etc.)
– Complaints of physical symptoms, like pain, that do not have a physical cause
– Suicidal thoughts, but no definite plan to hurt himself

The Ability to Work: This individual may try to work, but will not be able to hold a job for more than 3 or 4 months because of their inability to remember or follow all directions or other similar reasons based on the symptoms or circumstances described under this rating. (In other words, they wouldn’t lose their job simply because they have anger issues and would regularly get in fights. A person like that could also not hold a job more than 3 or 4 months, but they would still be considered able to work). This individual would only be hired for jobs like cleaning, picking up trash, or other simple-task jobs.

Social Relationships: Like his ability to work, this individual may try to build and engage in relationships, but these relationships would not last long in most situations. Divorce or other breaks in relationships and friendships could occur due to his inability to properly participate in a relationship.

30% rating: This rating will have the majority of the following circumstances and symptoms:

The Ability to Care for Yourself: This individual may have occasional, short hospitalizations, but can entirely take care of himself most of the time.

Medications: This individual usually requires medication to function normally.

Symptoms: Some or all of the following symptoms will be present.

– Spikes or drops in mood, like depression
– Often anxious or becomes easily stressed
– Panic attacks occur, but no more than once a week
– Difficulty sleeping (nightmares, insomnia, anxiety, etc.)
– Mild memory loss could include regularly forgetting names or directions
– Often suspicious of other people, particularly ones he does not know

The Ability to Work: This individual will be able to work and will usually function normally. There may, however, be occasional times where he is unable to properly fulfill all job requirements. This could result in occasionally losing his job.

Social Relationships: Like his ability to work, this individual will normally have fairly stable relationships. These relationships, however, will not be great and will often be strained by the symptoms of his condition. Divorce or breakups could occur, but not in every case.

10% rating: This rating will have the majority of the following circumstances and symptoms:

The Ability to Care for Yourself: This individual will always be able to take care of himself and will very rarely, if ever, be hospitalized.

Medications: This individual may or may not be taking medication. Meds may be taken all the time, or only during stressful times. They satisfactorily keep all symptoms under control.

Symptoms: Some or all of the following symptoms will be present, but only during times of significant stress. The majority of the time there are no symptoms.

– Mild depression or other mood changes
– Mild to moderate anxiety
– Mild panic attacks may occur, but very rarely
– Occasional difficulty sleeping (nightmares, insomnia, anxiety, etc.)
– A range of other, very mild symptoms, which could include suspiciousness of strangers and hyperarousalhyperarousal.bmp

The Ability to Work: This individual will be fully employable and will very rarely have any problems at work that are caused by the mental condition.

Social Relationships: This individual will have full, functional relationships with only occasional, mild stresses that are caused by the condition.

0% rating: If a mental condition has been diagnosed but there are no symptoms that impair social or occupational functioning or require medication, then it is rated 0%.

Okay thank you. Do you have to specifically claim PTSD to get a PTSD exam? Because I'm planning on stating "mental disorder secondary to tinnitus" as I have an adjustment disorder and sleep disorder diagnosis 

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1 hour ago, Mover1993 said:

Because I'm planning on stating "mental disorder secondary to tinnitus" as I have an adjustment disorder and sleep disorder diagnosis 

@Mover1993

I am curious why you would not claim the "mental disorder" as secondary to the sleep disorder? lack of sleep, including apnea, is a dangerous situation and has a strong medical tie to anxiety, depression, and a host of other mental disorders. Lack of sleep can exacerbate things like BiPolar disorder types I and II, Mania, Manic Depression, and even trigger psychosis.

Tinnitus is a non-existent sound created by brain to fill a void it expects to be filled. In other words, your brain thinks your ears are always hearing stuff so when it doesn't it can make you think you are hearing something. It can be loud, annoying, constant and yes can cause a lack of sleep and affect mental health. The caveat is that all of us with Tinnitus typically "Get used to it", meaning we can fall asleep and can, to some point, ignore the noise and function in the real world doing things like work, play and other socializing.

I don't know your history, but wouldn't it be a stronger claim under the sleep disorder? just something to think about.

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@GeekySquid

Hello, Because i'm service connected for tinnitus and it also causes me the most problems. I don't think I belong to that demographoc of getting used to it. I feel as though its a vicious cycle for me. I can't sleep because of the ringing and when the ringing occurs I start getting really nervous and get panic attacks. 

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I agree  with Mover1993

He can claim his tinnitus is related or caused the other conditions  to include Anxiety Depression also PTSD , Also Sleep disorders   ..read this BVA CASE about a Veteran that claimed his tinnitus caused his other mental  conditions secondary to tinnitus .

he will be denied for tinnitus increase  because its only a 10% rating  but as the Regs state any condition that is rated 10% or higher can be used as a secondary rating for another if that condition causes it or related to it  in this case its his tinnitus   to  conditions ptsd depression anxinety  ect,,ect,,

check out this link about a veteran filed for mental disorders caused by his tinnitus.  it includes MH Disorders and also OSA.

https://www.va.gov/vetapp16/Files3/1618626.txt

''An initial rating in excess of 10 percent for tinnitus is denied. Service connection for both PTSD and an acquired psychiatric disorder, currently diagnosed as anxiety and depression, as secondary to tinnitus is granted.''

Edited by Buck52 (see edit history)
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3 minutes ago, Buck52 said:

I agree  with Mover1993

@Buck52

I am not disagreeing with him, just curious considering the strong evidence a mental health claim supporting his contention would have versus a tinnitus claim. He can certainly choose any valid path he wants too.

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Roger that GeekySquid  you make a great point there  I agree also.

You should read that BVA Case I link above   ..its interesting as to how this veteran was rated  PTSD /Depression Disrders  Anxinety  secondary   to his 10% tinnitus

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1 minute ago, Buck52 said:

Roger that GeekySquid  you make a great point there  I agree also.

You should read that BVA Case I link above   ..its interesting as to how this veteran was rated  PTSD /Depression Disrders  Anxinety  secondary   to his 10% tinnitus

will do the reading... right now digging around on Fergoogle....

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1 hour ago, Mover1993 said:

i'm service connected for tinnitus and it also causes me the most problems

@Mover1993

I read your post as already being SC for mental health. My bad.

The case Buck52 links to is interesting and may help you. I hope it does and I hope your case is adjudicated in your favor. Please let us know the outcome.

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1 hour ago, Mover1993 said:

@GeekySquid

Hello, Because i'm service connected for tinnitus and it also causes me the most problems. I don't think I belong to that demographoc of getting used to it. I feel as though its a vicious cycle for me. I can't sleep because of the ringing and when the ringing occurs I start getting really nervous and get panic attacks. 

Tinnitus can be severe or debilitating enough that it can cause secondary mental health disorders, particularly insomnia; anxiety; depression. Insomnia is considered a mental health condition. The VA will most likely combine all three to avoid pyramiding mental health conditions. Tinnitus article1.pdf

 

Do you suffer from migraine headaches? Because if you are diagnosed with Migraine headaches that would be a seperate secondary condition that is rated seperately.

Here is a BVA decision that would look similar to your claim. Read through it word for word to see how this veteran was able to get his claim granted.

https://www.va.gov/vetapp15/Files3/1524859.txt

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