Doctor Must Give His Opinion If You Ask Him

[betrayed]

question: If a patient ask me to fill a form out for him in order to obtain a drivers license, or obtain SSN or VA benefits am I required to do this.

Answer: If you are asked to fill out a form to assit a patient in obtaining disability or pension benefits, you are required to provide a descriptive statement and opinion with respect to that patient's medical condition, employability, and degree of disability.

from

VHA Practitioner’s Guide to Information Law

http://www.vehu.med.va.gov/vehu/vehu2005/p...r-%20FinalA.pdf

Allan originally posted this in social chat and only 19 people have read it

During my last appointment with new a psychiatrist I wrote him a 6 page letter with my complete medical background, my vocational rehabilitation background. I ended the letter with this:

Even though I feel this may be unusual, I don’t feel it’s unfair to ask you your opinion; do I have the capacity to work? I don’t expect you to answer this immediately, I would like for you to take all the time necessary before coming to your conclusion. I also have to ask you consider the following:

Can you reasonably expect a man to work who has had 112 days in a medical facility in 2006, Can you reasonably expect employer to put up with this? Can you reasonably expect a man who is in chronic pain to work? Can you reasonably expect a man who is mentally incapacitated to work? Can you reasonably expect a man who has panic attacks and angina attacks every time he has stress or does any strenuous to work?

Can you reasonably expect a man who is under the influence of Fentanyl 75mcg/h twenty-four hours a day along with Oxycodone and Clonazepam to work? Can you reasonably expect a man to drive a vehicle to get back and forth as he is always under the influence and would be breaking the law?

When I got a copy of the progress notes from that visit, at the end of the progress note he noted the 6 page letter and stated he would address this at our next visit, and words to the effect he did not want this to become a dominant factor in my treatment. I will now print this entire manual out and take it to the doctor during my next visit. I will pull it out only if he does not answer my question.

Allan you have provided one hell of a piece of ammunition to use in our battles with the VA. When I was in the pysch ward last time I asked my doctor the same question and he stated that his opinion did not matter. I sure wish I had this document then.

directive_2000_029.pdf

practioners_guide_to_information_law.pdf

VA_HIPAATRAINpage17of26.pdf

Edited March 12, 2007 by Tbird

[betrayed]

The critical item on the GAF, provided that you have a mental disorder eligible for service connection on Axis I, is Axis V. Scores of 50 or below are candidates for 100% ratings, or at least for 70% ans IU for someone not working.

Alex

Thats a F&%$*&G joke, I have had numerous gafs in the thirtys and fouties and the highest its ever been is 50, and all I can get is a 30%SC rating. You GAF dont mean sh1t when it comes to SC% for depression.

[betrayed]

UPDATE:

I just received a telephone call from my VA treatment Psychiatrist. He denied my request for a formal GAF determination/testing. He said that during our February 21st session he assigned a GAF and that was all he was going to do. He said that he has nothing to do with a rating determination, but is for treatment only. I said that I do not want a rating determination from him, only a formal test with a complete test result in the form of a report. He said that he will not do so.... and will not provide anything for me in writing.

So...... my options are....... file a DVA Inspector General Complaint...... or, ? What other options ?

I am sure that this treatment doctor had received guidance from the VA Legal Office on this.... because of how much time it took for him to get back with me (almost 3 weeks). I believe this is nothing but bluff tactics. The only way to find out is to file a formal complaint.... and I will start developing it, today. This is BS.... period. Gotta fight fire with fire.

Comments, please ?

Thanks.

I would go with DVA Inspector General Complaint. Send me a PM

[sixthscents]

Army,

Probably you already know this but every VAMC has a psychiatrist on call for the Emergency room. I have seen many Vets who were feeling very depressed, and their spouses, loved ones etc were so concerned they felt it appropriate to take them to the ER. When the psyciatrist at the emergency room meets with you, as he has to do... he does a GAF... well he does the whole eval.. and assigns a GAF..

Interesting isn't it? Anyway, sorry to stick my nose in, but I didnt see it in the last few posts... so...thought I'd point it out as interesting.

Good luck

[john999]

If you go to the VA ER and the shrink sees you he will do a GAF and it will stick to you. My retro was based on the GAF I got at the ER when I was admitted in 2001. That was the date they used for the beginning of my IU and P&T. The ER GAF was very important to my claim.

[huskerfanfl]

1968 Army VV,

As I stated in a post over a week ago, the GAF is not a test, it is a score from 0 - 100 that is assigned based on interviewing and observations. There is no cummaltive score. The lowest area that is scored is supposed to be your GAF score.

From Wikipedia, the free encyclopedia

The Global Assessment of Functioning (GAF) is a numeric scale (0 through 100) used by mental health clinicians and doctors to rate the social, occupational and psychological functioning of adults. The scale is presented and described in the DSM-IV-TR on page 32. Children and adolescents under the age of 18 are evaluated on the Children’s Global Assessment Scale, or C-GAS.

91-100 Superior functioning in a wide range of activities, life's problems never seem to get out of hand, is sought out by others because of his or her many qualities. No symptoms.

81-90 Absent or minimal symptoms, good functioning in all areas, interested and involved in a wide range of activities, socially effective, generally satisfied with life, no more than everyday problems or concerns.

71-80 If symptoms are present they are transient and expectable reactions to psychosocial stresses; no more than slight impairment in social, occupational, or school functioning.

61-70 Some mild symptoms OR some difficulty in social, occupational, or school functioning, but generally functioning pretty well, has some meaningful interpersonal relationships.

51-60 Moderate symptoms OR any moderate difficulty in social, occupational, or school functioning.

41-50 Serious symptoms OR any serious impairment in social, occupational, or school functioning.

31-40 Some impairment in reality testing or communication OR major impairment in several areas, such as work or school, family relations, judgment, thinking, or mood.

21-30 Behavior is considered influenced by delusions or hallucinations OR serious impairment in communications or judgment OR inability to function in all areas.

11-20 Some danger of hurting self or others OR occasionally fails to maintain minimal personal hygiene OR gross impairment in communication.

1-10 Persistent danger of severely hurting self or others OR persistent inability to maintain minimum personal hygiene OR serious suicidal act with clear expectation of death.

0 Not enough information available to provide GAF.

[betrayed]

as I posted b4

this is what your talking about?

Patients’ baseline functioning and 1-year outcomes were assessed with respect to

eight indices: Three indices of psychological functioning focused on:

-emotional distress as assessed by responses on 5-point scales varying from “not

at all” to “extremely” to 12 items (such as “feelings of worthlessness”, “thoughts of

ending your life”, and “spells of terror or panic”) drawn from the Depression and

Anxiety Scales of the Brief Symptom Inventory (BSI; Derogatis, 1993);

-psychiatric symptoms as assessed by responses on comparable 5-point scales to

10 items (such as “feeling that you are watched or talked about by others”, and

“the idea that someone else can control your thoughts”) drawn from the BSI

Paranoid Ideation and Psychoticism Scales; and

-substance use problems, as assessed by 18 items rated on 4-point scales varying

from “never” to “frequently” reflecting a standard set of problems due specifically to

alcohol and/or drug use, such as “legal problems”, “problems with your job”, and

“problems with your neighbors.”

Three indices of social functioning focused on:

-residential stability as assessed by living in a stable setting in the community for

most of the past 12 months and never or seldom losing a place to live in the three

months prior to follow-up (yes/no);

-the number of friends with whom the patient felt at ease; and

-the quality of relationships with friends as measured by 5-point ratings on six items

drawn from the Life Stressors and Social Resources Inventory (Moos & Moos,

1994) such as “Do you confide in any of your friends?” and “Do your friends really

understand how you feel about things?”

In addition, we obtained information on two indices of occupational functioning: (1)

part-time or full-time employment status (yes/no), and (2) annual income.

I believe these are all functional test taken on one or two pages of paper, I just did one a little while ago a BDI-II (Beck Depression Inventory version 2) I scored in the very high depression range. I believe it covered these areas:

emotional distress as assessed by responses on 5-point scales varying from “not

at all” to “extremely” to 12 items (such as “feelings of worthlessness”, “thoughts of

ending your life”, and “spells of terror or panic”) drawn from the Depression and

Anxiety Scales of the Brief Symptom Inventory

So what I am getting from this you are asking your doctor to give you these three simple test and then arrive at a GAF from it? doesnt seem to hard to me, just a lazy doc

Edited March 10, 2007 by BETRAYED