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VES called for appointment - Insomnia, Anxiety, and Depression - What to expect?


Foxhound6

Question

I was just contacted by VES regarding my secondary claim of anxiety and depression due to my SC left knee. I had used my DX of insomnia from my STR in my statement I submitted with the claim to link to the time frame of my knee issue.

The VA seems to have added in Insomnia to the anxiety and depression claim? Not sure how that will go, but I am just waiting on the paperwork in the mail to tell me the date and time of appointment now.

The last time I did any C&P exam was in 2012 or so at the local VA hospital. This VES contractor is new for me. Anything I should know/bring going in? Thanks!

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  • HadIt.com Elder

It is pretty common for the VA to merge some conditions together. Insomnia is a symptom that can be found on the mental health rating criteria. However, it is possible that it could be a sleep disorder that is found to be completely separate.

Consider taking a look at the VA's Disability Questionnaires (DBQ's): 
https://www.benefits.va.gov/compensation/dbq_listbydbqformname.asp

They contain the questions that the C&P examiners will ask. It is always a good idea to read through the questionnaires to get in idea of what to expect for each condition.

The depression/anxiety DBQ's are here and separated accordingly:

Mental Disorders (other than PTSD)
Review Post Traumatic Stress Disorder (PTSD)

 

If you have any non-VA treatment records, get copies and bring them with you. Never give them your only copy or originals. The C&P examiner may not always accept the records (wanted you to be aware of that).
 

Don't be late. If you have a very legitimate reason you cannot make the appointment, contact them as soon as possible and request to be rescheduled.

Look/search here on hadit.com for other C&P advice.

 

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  • HadIt.com Elder

@Foxhound6 That sounds correct: depression/anxiety as secondary and insomnia as new, but they could change it at some point after processing everything.

The rating criteria for mental health disorders is here: §4.130   Schedule of ratings—Mental disorders.

The VA will only assign a single mental health rating regardless of your diagnosis. They rate it based on symptoms indicated in the criteria.

VES will have access to your STRs, everything you can access via MHV's blue button, plus your entire claims file. Some examiners may go through all that before your visit and others afterwards. Sometimes both. It never hurts to bring them along with your profile statements, but don't expect the examiner to go through them while you are in their office. They normally don't have time for that. They are there to fill out the DBQ and render an opinion.

One more thing. If you happen to have any non-VA treatment records which are pertinent to your claim, be sure to provide a signed release of medical information authorization form. That way the examiner can look at copies you provide plus they can request them directly from the non-VA doc (for verification). If you don't provide the authorization form at the same time, they VA will have to mail the authorization form to you and wait for you to send it back before being able to request copies directly.

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Vync

I was thinking they may just be merging a condition into it as I pointed them to the insomnia in my STR. The odd thing I find is how it is listed in the claim. My depression and anxiety show as "SECONDARY" while the Insomnia says "NEW" as if I was attempting a SC for it. Could just be that they added it so it displays as "NEW" but I am not sure.

I have looked over the DBQ for the other than PTSD. I need to take a peek at the rating formula itself still but will do so soon.

I will also bring my STR, profiles that support claim, and my Health E Vet Blue button report that will have my VA treatment records over the years.

They technically should have everything I am bringing but on the off chance they don't, I will have them all with me.

I'm just waiting for the packet to come in the mail with the appointment info. Thanks for replying! I appreciate it. It helps to know I am doing the right steps.

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UPDATE: Had the exam yesterday. I feel it went well (but based on readings here, that generally means nothing lol). Talked for about a full hour. Didn't give any negative details on history or anything of that nature. She also didn't dig into any of the history details, just asked the question. She did dive into my issues and how they relate to home, social, and work life which I felt was good. At the end she even told me she felt she could opine in support of the claim, connecting it to my SC knee injury without trouble. I will keep an eye in the mail box for a decision letter and update again once I do. Thanks for everyone who has helped me. I plan on upgrading my Sub to the yearly and donating once I have an award to show my appreciation!

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On 11/13/2019 at 2:03 PM, Vync said:

One more thing. If you happen to have any non-VA treatment records which are pertinent to your claim, be sure to provide a signed release of medical information authorization form. That way the examiner can look at copies you provide plus they can request them directly from the non-VA doc (for verification). If you don't provide the authorization form at the same time, they VA will have to mail the authorization form to you and wait for you to send it back before being able to request copies directly.

Vync

Is this the 21-4142 form? If so, do I need the 21-4142a with it or can I just fill out the 21-4142, sign it and bring it with me to my exam? I have an exam coming up on 9 DEC to which I have an MRI report that the VA does not have yet. I had sent in the supplemental before the report was made available to me from my provider. Thanks!

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  • HadIt.com Elder

Sometimes MH exams could take quite a while, especially if there is not much of a MH history in their records.

MH ratings are a bit strange though. It's not the number of MH diagnoses you have. It's how they impact your social and occupational life. If you get SC, they will give you a single MH rating. Here's a link to the MH rating table.
§4.130   Schedule of ratings—Mental disorders. You don't have to have every symptom to qualify for each tier.

 

When the VA starts working on a claim, if they need you to sign a release to get the medical records from a non-VA provider, they will send you the form before scheduling you for an exam. I would probably go with this one because it covers both forms (4 pages vs. 2 pages)
https://www.vba.va.gov/pubs/forms/VBA-21-4142-ARE.pdf

Bring that MRI report with you. If you can get a disc containing the images, that can be helpful. Make a copy of the disc and keep at home. The VA may want the original with the proper labeling. Sometimes docs want both, while some just care about the report. 
  Sometimes they may want to request the report and disc directly from the location that made it. That's where the 21-4142 comes in handy.

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