ptsd Thinking Of Filing A Claim For A Second Mental Condition

[betrayed]

Currently I am rated at 30% for Depression secondary to serious pain syndrome.

The following is what I wrote for appeal to my 30% rating, read it and you will see a 30% rating is lowballed in my case. Then I will show you what happened when I filled for PTSD another mental condition and how it has helped me.

MAJOR DEPRESIVE DISORDER

I suffer from Major Depression, I started treatment at the Ann Arbor VAMC on July 26th 2005 at which time XXXXXXXX Social Work Intern and XXXXXXXX MHC/HIOT Social Worker assigned a GAF Score of 35.

On September 22nd 2005 XXXXXXXX (Ann Arbor VAMC) diagnosed Major Depression and prescribed Effexor and Trazodone, and recommended psychotherapy.

On January 25th 2006 I had a C&P Physical at the Ann Arbor VAMV by XXXXXXXX M.D.

Dr XXXXXXXX diagnosed Major Depressive disorder secondary to pain syndrome with a GAF score of 40-45.

XXXXXXXX became my TRICARE Primary Care Manager in March 2006.

On March 14th, 2006 after waiting 6 months for the VAMC to contact me for psychotherapy (as recommended by Dr XXXXXXXX M.D. on 9/22/05) and fearing my depression was worsening I asked my NON VA Primary care manager (Dr XXXXXXXX ) for a mental health referral so I could receive psychotherapy.

On March 30th2006 I was seen by XXXXXXXX MSW LMSW at the OAKLAND PSYCHOLOGICAL CLINIC. XXXXXXXX completed a Comprehensive Assessment and diagnosed Major Depressive Disorder, Recurrent, Severe Without Psychotic Features 296.33. and generalized anxiety disorder 300.02 SEE ENCLOSURE ( ).

On APR 4, 2006 I was seen by XXXXXXXX . at the OAKLAND PSYCHOLOGICAL CLINIC. XXXXXXXX completed a Psychiatric Assessment and diagnosed Major Depressive Disorder, Recurrent, Severe Without Psychotic Features 296.33, Opioid Dependence 304.00 and indicated a GAF score of 45. SEE ENCLOSURE ( ).

I was not able to afford the weekly TRICARE co-pays, and subsequently unable to continue treatment at OAKLAND PSYCHOLOGICAL CLINIC.

On June 13th 2006 nine months after being recommended by Dr XXXXXXXX , I started psychotherapy with Dr XXXXXXXX at the Ann Arbor VAMC.

On July 11th 2006 XXXXXXXX administered a BDI2. In his progress notes Dr XXXXXXXX stated “scored in severe range of depression on BDI2 (29)”. I am continuing psychotherapy with XXXXXXXX .

On August 31st 2006 XXXXXXXX prescribed 20 mg of Citalopram Hydrobromide (Celexa) and continued my prescription for Trazodone.

I have been given GAF Scores from a low of 35 to a high of 45 by mental health professionals.

In accordance with DSM-IV: GAF scores from 41-50 indicate “ serious symptoms ( e.g., suicidal ideation, severe obsess ional rituals, frequent shoplifting) OR any serious impairment in social, occupational or school functioning ( e.g., no friends, unable to keep a job).” GAF scores from 31-40 indicate “Some impairment in reality testing communication (e.g., speech is at times illogical, obscure, or irrelevant) or major impairment in several areas, such as work or school, family relations, judgment, thinking or mood (e.g., depressed man avoids friends, neglects family, and is unable to work, child frequently beats up younger children, is defiant at home, and is failing at school).”

My Beck Depression Inventory score indicates I suffer from severe depression.

I do not believe my current rating of 30% for Depression is commensurate with the severity of my depression and pain I suffer. I believe my diagnosis, my symptoms, my GAF scores, and my Beck Depression Inventory score substantiate a much higher rating than 30%. You would be remiss not to consider the synergistic effect of the depression and chronic pain.

“CFR Title 38 § 4.126 Evaluation of disability from mental disorders. The rating agency shall assign an evaluation based on all the evidence of record that bears on occupational and social impairment rather than solely on the examiner's assessment of the level of disability at the moment of the examination. When evaluating the level of disability from a mental disorder, the rating agency will consider the extent of social impairment, but shall not assign an evaluation solely on the basis of social impairment.”

Under Major depressive Disorder the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) states “Severity is judged to be mild, moderate, or severe based on the number of criteria symptoms, the severity of the symptoms, and the degree of functional disability and distress.” “Episodes that are Severe without Psychotic Features are characterized by the presence of most of the criteria symptoms and clear-cut, observable disability (e.g., inability to work or care for children).”

Under the criteria for Severity for current (or most recent) Major Depressive Episode the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) states “.x3-Severe Without Psychotic Features: Several Symptoms in excess of those required to make the diagnosis, and symptoms markedly interfere with occupational functioning or with usual social activities or relationships with others.”

The evidence of record clearly demonstrates I suffer from severe depression and chronic pain. On 3/11/05 Dr XXXXXXXX noted in his records (previously submitted to the VA) that I was suffering from work related anxiety and prescribed Klonopin. Two months later I was fired from that job.

In the past few years my health has deteriorated and my physical and mental pain has increased to the point that it has caused severe depression. In May of this year I was diagnosed with Coronary Artery Disease and in June I underwent heart catherization with stent placement, which caused my depression to worsen to a level that has destroyed my emotional functioning on a daily basis.

Due to chronic pain, sadness, hopelessness, frustration, unprovoked irritability and anxiety on a daily basis I have been transformed from a professional with the occupational abilities to manage departments of more than two hundred personnel to a person who has problems managing a household. In the last two years I have been fired from two jobs one of which (Brighton Harley Davidson) was a dream come true. After my Heart Disease diagnosis I was unable to cope with the stress of delivering pizzas 12 hours a week and quit. My memory is pretty much non existent, during my time as a pizza delivery person I would often forget where I was going or I would become confused to where I was, and this is in my hometown where I grew up. Often times in the middle of a conversation I will forget what I am talking about or what I was going to say, this has caused major embarrassment and frustration on more times than I can count.

My mood on a daily basis is hopelessness. I have suicidal ideations, which are documented within the evidence of record (VAMC records and those records from OAKLAND PSYCHOLOGICAL CLINIC). I suffer from sleep problems, significant worry, panic attacks and anxiety. I have been treated for anxiety by Dr XXXXXXXX with Klonopin, Dr XXXXXXXX with Oxazepam, and Dr XXXXXXXX with Xanax ER. The only one that seems to control my anxiety is the Xanax ER, unfortunately it makes me into a zombie.

I have no friends; I don’t socialize with anyone except my spouse and her daughter. My relationship with my only child has become estranged and consists of a monthly email. My ever-changing moods have put a stress on the relationship with my spouse, although she understands that I am ill, it is very frustrating to her. I no longer ride motorcycles, go fishing or hunting, the loss of strength and coordination in my hands prevent me from wood carving, I no longer have the desire to do anything.

The following are excerpts from a Statement in Support of Claim completed by my spouse on July 17th, 2006 and provided to the VA on July 18th 2006.

“His depression is scary, I have seen my husband loose his temper and fly into a fit of rage, and then three seconds later breakdown in a uncontrollable crying episode. His moods are ever changing. He and I have talked about suicide. This conversation was when we were just friends. He told me that the chronic pain is a terrible thing to live with and sometimes he just doesn’t want to deal with it any more. I was brought up catholic so I don’t believe in suicide. But I know my husband feels different. He has told me repeatedly if it wasn’t for me he would of killed himself by now. I completely understand what my husband is going through, but I do worry a great deal about his frame of mind. I also know he has nightmares, I know he has seen some death and doesn’t like to talk about it, but I know it sometimes bothers him when he remembers certain things. I believe all of the stress and stuff is the reason my husband lost the jobs he had since retiring from active duty. I personally know that he told both of his bosses off, and was fired for it. He says he can’t stand incompetent people, and isn’t going to take crap from incompetent people. His memory is pretty much non-existent, he will forget something in three seconds, or in a middle of a conversation forget what he was talking about.”

“My husband has become a recluse. He does not socialize with anyone except my daughter and myself. He rarely talks to his siblings or his son. He rarely leaves the house. He is obsessed with locking everything up. The doors, the garage, the vehicles, everything and anything he can lock up he does. He carries his keys on his belt like a janitor. He says its cause he was a cop and all the stuff he saw people loose. He doesn’t trust anyone, and he thinks most people are crooks or dirt bags as he calls them.”

"I filled a claim for PTSD against the advice of my DAV VSO, he said you would never win. I recently had my C&P Exam and the doctor stated in her report

" The prognosis for improvement is deemed poor in light of the veterans deteriorating Health. His Capacity for employment is felt to be poor in light of his overall impaired functional and emotional status."

Had I never filled for PTSD I would have never got a statement like that, which is one powerful statement on a C&P Exam.

So my point is what have you got to loose by filling for a second mental disability? I gained a hell of allot IMO

[betrayed]

PS (for FLHRCI): AXIS I - for me included two diagnosis: 1) being PTSD-Chronic, and 2) Major Depressive Disorder.... both NEXUS to combat military action, 1968, but I did not claim both, just PTSD. Texas Veterans Commision, my SO, said it is a waste of time to file for both since VA will only rate on one of the mental problems. Hmmmm?????? Maybe the SO is wrong?

I'm done with this thread, the below will be my last posting in it. If you want to ask then send me a private message.

On my second claim I filed for depression and got lowballed big time. My VAMC doctors told me I exhibited PTSD symptoms. I filed a third claim it was for PTSD, I had three verifiable stressors at that time, one was a collision at sea, second was the recovery of a body from a wrecked F18, the third was the murder of a member of my unit. I got the unfortunate duty of taking custody of her apartment, which was the crime scene. I got to watch the police remove the blood soaked portion of the carpet with a razor knife and the padding under the carpet and see the divet in the concrete from the cross bow bolt (she was shot throught the heart while she lay sleeping on the floor with her child). I then spent everyday for the next eight days in that apartment inventorying everything that was in the apartment from her skivies to her childrens toys and preparing for house hold goods to come pack out the house. Everyday walking by the blood soaked concrete numerous times a day. I knew here, she was a friend. I collected her uniform for her body, I attended her funeral.

These three stressors were submitted with the claim. I then wrote the records center who research's these incidents for ptsd claims, never heard from them. I then submitted other stressor letters and buddy statements from other incidents (like fatal car accidents including children and infants, suicides, and the case of a woman who shot a intruder in the chest with a 12 gauge shotgun at a distance of 12 inches, I saw his back stuck to the wall and his body laying in the floor in a big pool of blood with his eyes open. During my career I voluntered community service as a auxiliary police officer and a reserve deputy sherrif, I did this for five years. You name it I saw it. It may have been during off duty hours but that doesnt matter does it! If you think it does than think of a female getting rapped during her liberty time and tell me that doesnt matter either.

As I stated in this thread before, under the development of a ptsd claim The M1 says do not schedule a C&P until the stressors have been verified. A year later I get a date for the C&P and attend. I posted the results on this board and thats my story.

My point in saying that filing a second mental claim cant hurt is that the doctor who did my PTSD Exam wrote a 7 page report which states I cant work and I have serious employment/industrial and social impairments, and that I will not get better. Where as the doc who did my depression C&P wrote a three page report and didnt say squat and I got 30%.

All I am trying to say is in my case I think I came out ahead, we shall see soon!