Anxiety - am I doing this right?

[USMCNASA]

Brand new here.  I'm posting because I'm so confused and unsure if I'm doing the right stuff, or if I should be doing it at all.

I'm hoping to find answers on how to file a claim for GAD/Major depression.  Here's my story.

1996-2000 high school captain of soccer and baseball teams.  Captain of Snare Drum line in marching band.

2000 - enlist in USMC, squad leader in boot camp, meritoriously promoted to PFC at graduation.

2001 - Class leader in A school

2002 - PCS to Japan (Iwakuni) volunteer for secondary school, awarded Microminiature soldering credentials.  Perform extra duties and awarded Meritorious Mast for going above and beyond.  Compete in meritorious board for Cpl, and win.

2002 cont. While celebrating the win (but not yet actually promoted) engage in arm wrestling match, and lose, terribly.  Suffer spiral fracture which requires evacuation to naval hospital for surgery - internal fixation (plate and 8 screws).  Require months of rehab, and continuous wear of mechanical brace and continued light duty for months.

Ok, this is where things get hairy.

2002 cont. PCS back stateside (NY) while still wearing mechanical brace and on light duty.  Within 1 week of reporting, promotion ceremony is held.  I had to be promoted while wearing a brace and a sling, no "pinning" of rank and no "earning" of blood stripe.  From this point on, I'm pretty much viewed as a punk, and a melingerer.  I stop volunteering for extra duties or assignments, motivation drops, etc.

2003 - Drink heavily.  Merry an awful woman who is into drugs.

2004 - pop on piss test.  Before NJP, I make Sergeant due to previous meritorious promotions and excellent pro/con, rifle, PFT scores.  This infuriates most Marines in my squadron, and further solidifies my reputation as a shitbird, because I am a piss-popped mellinger who made Sergeant before most people.

2004 cont. NJPed, busted down to Cpl. Result of NJP is that I will not be discharged, based on demonstration of excellent performance earlier in service, but will not be allowed to re-enlist.  During a PT session I fall and get a class III AC joint separation, which again requires light duty and use of a sling.  Anyone who didn't think I was a melingerer before, starts thinking/calling me one now.

2005 - EAS.

2005 - Civilian diagnosed with everything from ADHD, to GAD, to MDD, to bipolar.  Various medications do not improve mental performance or fatigue.  

2013 - buddy talks me in to visiting VA for disability due to arm.  Awarded 30%, feel like I don't deserve it because of NJP.

2019 - visit VA mental health clinic, diagnosed with GAD and MDD.  Therapist suggests sleep study.  Just got results.  I have mild sleep apnea.

 

I have decided to file a claim for GAD/MDD and sleep apnea.  I have buddy statements on the official VA forms from Marines who served with me from boot camp through Japan stating I was a stellar Marine.  I have statements from Marines who served with me in NY stating I was not at all stellar, and performed poorly.  I have statements from civilian coworkers stating I had performance issues, was fired from a job, and was on the chopping block at another.

I have medical records from Naval hospitals for all my injuries.

So, from other service members, does it sound like I have any chance at a case? How should I file? I have an appointment with my previous Psych. Nurse Practitioner in 2 months from now, to request a nexus letter.  I don't know if she will write one, but based on our prior treatment session discussions, I believe she agrees my GAD and MDD or related to my service.

Where do I go from here?  Should I even be filing a case at all?

[Berta]

You said:

"All of my reading has been online, and I haven't discussed any of this process with other vets who have gone through this process.  I thought I read that PTSD needs an in service "event or injury" but other mental issues don't need that.  Is that true, or will the VA still want me to pinpoint a specific "thing" that caused it. "

They will definitely want a specific event in service, that is the link to the depression, or anxiety, etc, or any other MH issue that you claim.

Maybe these cases below will help you understand how important an established link is:

Since 1992 there have been 134,881 decisions at the BVA due to being denied at the RO level ,for claims that included anxiety and depression, and other MH issues such as PTSD.

Many have been denied.
Here is one of them from 2021:

"Based upon a longitudinal review of the evidence of record, the Board concludes that the Veteran’s current acquired psychiatric disorder, alternatively diagnosed as unspecified depressive disorder with anxious distress, unspecified anxiety disorder, and adjustment disorder with anxiety, did not begin during his military service and  is not otherwise related to any specific in-service event, injury or disease."

https://www.va.gov/vetapp21/files3/21015738.txt

This recent case also was denied :

 Entitlement to service connection for an acquired psychiatric disorder, to include depressive disorder, is denied. 

"Service connection is not warranted for this claim because while there is a current disability of a depressive disorder, it has not been linked to active duty or to a service connected disability.  The mental disorder has been linked to the non-service connected problems with the Veteran's knees and feet."
https://www.va.gov/vetapp21/files3/a21006382.txt
   

You mentioned you are seeing a Therapist-perhaps you revealed a possible nexus or  link in those therapy records. For the Nurse Practitioner to make a nexus statement, they will need a nexus of some sort and that will have to be proven.

Perhaps the loss of rank  and status with your fellow Marines could certainly cause depression ,-but I am not a doctor and I have no idea. And I have no idea if the VA would even accept that as a servie connectable claim.

We are not saying dont file the MH claim, but I know it will be denied without a solid proven nexus, as to an inservice cause.

 

 

[Buck52]

6 hours ago, USMCNASA said:

Buck52,

I had Marines and coworkers and family complete statements on VBA-21-4138-ARE.  Is the 21-526EZ the same as the online stuff at VA.gov or is it an actual paper form I need to fill out?

You can file 2 ways  file the 21-526 ez paper form  and mail it to the VA Claims Intake Center Janesville Wi, make copies of your buddy letter attach them in with your evidence or as your evidence  ect,,,ect,,,

or use VA.gov   and file your claim electronically, upload your evidence and send that in at the time you send in your claim

Attach buddy letters 21-4138 to your paper claim or upload and send it with your electronic claim  the electronic claim is much faster   just pay sharp attention when you file electronically at VA.gov

Remember you don't need to be a combat Veteran to file a claim for PTSD  OR MDD. BUT YOU DO NEED A STRESSOR AND PROOF OF IT   THE STRESSOR CAN BE ANYTHING  THAT TRAUMATIZE YOU  ...YOU SEEN SOMEONE GET KILLED (CAR ACCIDENT)  (SOMEONE YOU KNEW DROWN) A FIRE THAT KILLED PEOPLE )  you witness a Murder)ecdt,,ect,, YOU SEEN SOMETHING THAT WAS TRAUMATIZING TO YOU THAT  YOU CAN USE AS EVIDENCE AS A STRESSOR ,  YOU JUST NEED TO PROVE THE TRUMA HAPPEN AND DATE AND LOCATION  AND ANYONE THAT WITNESS THE EVENT WITH YOU THAT CAUSED YOU TO BE TRAUMATIZED.

They (VA) will check out your story and if they find it to be of merit  then they should go on and maybe send you to a C&P Exam.

to check your symptoms of your Depression or they may convert it over to PTSD ?

sometimes the MH Doc make mistakes on diagnosing and the C&P Examiner may diagnose you with PTSD and not MDD?

They will need to differentiate the two

[USMCNASA]

I just had an appointment with my VA therapist.  She confirmed again that her and the VA Psych N.P I see both don't get involved in nexus letters at all, which is fine since I plan on seeing the civilian N.P. I used to see.  Here is my question:

I read online that nexus letters should come from experts in their field.  The non VA civilian N.P. I saw is a Family Nurse Practitioner who does mental health.  I never asked the question when I saw her previously.  I was her patient for about a year and a half, and she was good, she provided therapy and also prescribed medications.  If she writes a nexus letter, will it matter to the VA that she is not specifically a Psychiatric N.P.?

I did also see a clinical psychologist several years ago, who administered some testing, but he was in a different practice from the most recent Family N.P. I plan on asking for the letter.  I planned on asking the Family N.P. because I have seen her more recently.  I am so confused with all of this.  I would like to do it myself, and not pay $$$$ to have a firm do it all, but I'm wondering if that is a better route to go?  I'm afraid of going that route, because I don't know which firms are legit and which ones are just out for Vets' money.  Some sites look OK, but others look like they could just as easily be snake oil sales sites.

[GBArmy]

USMCNASA We need a little more info on your situation. Do you currently have any VA disabilities?  Are any of them for MH, like depression, anxiety or PTSD? I am assuming that you don't currently have any MH disabilities as service-connected and you are going for a new rating. If that is the case, it doesn't sound like your NP is certified for MH, but is knowledgeable in the MH field. The VA is going to do the eval on you using their own MH professionals. Your NP can provide a "buddy letter"  form 21-10210, but IMHO it won't provide much support. Your other doc info is more probative. You may want to see if he could provide support for your symptems. If on the other hand, this is for an increase, then your NP would provide acceptable evidence. If you don't have strong evidence going in for a diagnosis, your claim is difficult unless the VA docs have it in your file. 

[USMCNASA]

GBArmy,

Correct, I am going for a new MH rating; I have never had a mental health rating.  I have a 30% combined rating for my arm.  It seems really fristrating to me that the VA clinic MH providers won't provide nexus letters.  

My health report from myhealthEvet (I think it the blue ribbon report?) has my diagnosis as GAD and MDD, but they are not currently service connected.  I have 2 buddy statements from Marines who knew me in high school, and who also served with me prior to symptoms (to provide evidence that I haven't always been this way), 1 of them is from boot camp and the other is from Japan prior to my arm being broken, as well as both also playing high school sports with me.  I also have 2 buddy statements from Marines I served with back stateside after symptoms started (to provide evidence of in-service symptoms).  I also have 1 statement from a Marine I didn't serve with, but who tried to get me to go back to the gym after I got out of the service, and his statement talks about how I wouldn't do certain exercises or on certain things I would only do low weight because I was afraid of hurting my arm again, and eventually I stopped going to the gym with him because I was worried about my arm.  I have statements from 2 prior coworkers from different jobs (to provide evidence of ongoing symptoms and severity, aggression, forgetfulness, sporadic poor performance), and I have statements from family (to provide evidence of all the nitty gritty that only family knows).

It's clear to me and family that my anxiety and depression are related to my time in the Marines, and I get why it is a difficult process to get things service connected after leaving the service, I just don't understand why the VA provides a mental health service to vets but won't give a statement on their opinion of service connection - they are the ones who would know best.  

I *think* I have the 2 of the three requirements covered pretty well, but would appreciate any suggestions on if I need to do more.

1.  Current diagnosis - I have this, from the VA clinic I regularly visit

2. In service event - I have this from buddy statements

3. Medical nexus - This one I need to get, and really wish I could get it from the VA.  I don't know how to approach the clinical psychologist I saw 5 years ago about a nexus letter.  I didn't have a therapy relationship with him, he only did testing for ADHD and depression.

 

I really appreciate all the comments and help with this.  I wish the process was easier.

Edited June 3, 2021 by USMCNASA

[GBArmy]

USMCNASA Your buddy letters are good; shows before and after. You have continuity. Diagnostic codes for MH are all lumped together. If you are granted s-c, then it is 0, 10, 30, 50, 70, and 100%. If you get 0 or 10% you are getting low balled and it may be fairly easy to appeal with your evidence and get at least 30% (or higher.) So it is a decent add to your already 30%, so a combined might get to 50% or better. But you're right; you need a pro to opine that it is from service. I would look at it as an investment. A few grand from a psych for an IMO and dbq would pay for itself in a couple of months. If you need to go thru a lawyer, there are several good ones, such as CC&K, Woods & Woods, Hill & Ponton, etc.  But understand, it is a lot easier to go for an increase on an existing s-c disability than to get an approval on a previously denied disability IMHO. I would make the investment myself.