hypertension Filling Out Form 9 For Depression Claim

[betrayed]

The below statement is taken from my PTSD C&P I think I can use this to get my depression SC30% raised. I think it is pertinent to my case I am just brain fried and asking you guys are you seeing a relationship between ptsd and depression in the doctors statement?

First I am going to post just part of her statement in italic and then I will post other stuff about my hospitilizations and then the PTSD C&P again

At this time the examiner is asked to note that the veteran is already service connected for major depressive disorder, and, if post traumatic stress disorder is found, indicate which one is predominant. In the opinion of this examiner, the major depressive disorder accounts for approximately 60% of the veteran’s symptomatology, and the post traumatic stress disorder by estimate accounts for approximately 40% of the veteran’s symptomatology. It is not possible to provide differential global assessment scores for each Axis I diagnosis in that it appears that these diagnoses are interactive

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now for the rest

October 7th 2006 I was admitted to the psychiatric ward for being suicidal. I stayed 9 days and was released on October 15th, 2006.

Admission Diagnosis:

Axis I

Major Depressive Disorder, Generalized Anxiety Disorder, Panic Disorder with agoraphobia, nicotine dependent.

Axis II

Differed

Axis III

Coronary Artery Disease, Hypertension, Chronic neck pain, chronic recurrent Nephrolithiasis BBPV.

Axis IV

Chronic Mental illness, chronic pain, financial strain, unemployment.

Axis V

Gaf 25, given suicidal preoccupation and recent active suicidal ideation.

I was released on a sunday and on monday (next day) I started HIOT (High Intensity Outpatient Therapy) 8 AM till 2PM (mon-fri) 5 days a week for 6 weeks.

On my ninth day of HIOT (October 26th) I had a meltdown during the morning session and became suicidal again. I was taken straight to the psychiatric ward. I was admitted for a second time in the psychiatric ward for being suicidal.

Admission Diagnosis:

Axis I

1. Major Depressive Disorder

2. Generalized Anxiety Disorder v Panic Disorder with agoraphobia.

3. Nicotine dependent.

Axis II

Deferred

Axis III

Coronary Artery Disease, Hypertension, Hyperlipdemia,Chronic neck pain, recurrent Nephrolithiasis BBPV.

Axis IV

Severe; depression, chronic pain and medical conditions, financial strain, unemployment, recent cardiac catherization.

Axis V

Gaf 30.

On December 21st 2006 I had a C&P Physical for PTSD. My exam was conducted by XXXXX XXXX MD. DR XXXXX made the following diagnosis

Axis I

1. Major Depressive Disorder secondary to pain syndromes.

2. Post traumatic Stress Disorder, chronic, delayed onset, with panic symptoms.

3. Nicotine dependent.

Axis II

Differed

Axis III

1. Nephrolithiasis.

2. Coronary Artery Disease.

3. Gastroesophageal reflux disorder.

4. Hyperlipidemia.

5. Hypertension.

6. Tinnitus.

7. Hiatal Hernia.

8. Knee Condition.

Axis IV

Psychosocial and environmental problems; conflict with former wife; unemployment; multiple health problems; inadequate finances; exposure to traumatic situations while serving in the navy, duty Military Police.

Axis V

Global assessment of functioning rated at 45, with serious impairment in social and occupational functioning.

OTHER OPINION: “ XXXXX M. XXXXXXX is a 48 year old retired Navy Military Police (Master at Arms), who is currently 60% service connected with 30% for major depressive disorder. The veteran has claimed service connection for post traumatic stress disorder, and, reviewing his symptomatology and trauma statements, it appears that the veteran’s claim of post traumatic stress disorder is supported. At this time the examiner is asked to note that the veteran is already service connected for major depressive disorder, and, if post traumatic stress disorder is found, indicate which one is predominant. In the opinion of this examiner, the major depressive disorder accounts for approximately 60% of the veteran’s symptomatology, and the post traumatic stress disorder by estimate accounts for approximately 40% of the veteran’s symptomatology. It is not possible to provide differential global assessment scores for each Axis I diagnosis in that it appears that these diagnoses are interactive and also aggravated by the veteran’s medical condition. 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.”

On January 2nd 2007 while talking with my PCP XX XXXX I told him that my depression was getting the worse of me and I was thinking of things I shouldn’t be. I told him I needed to be admitted by I had to take care of some things first . He suggested I come to his office on Jan 4th, so my wife took me to the VAMC and subsequently to XXXXXX office. After talking it was decided that XXXXXX would take me down to mental health to talk to someone in intake. On January 4th 2007 I was admitted for a third time to the psychiatric ward for being suicidal and additionally homicidal. I was released on the 17th of January 2007.

Admission Assessment: XXXXXXX, XXX is a 48 year old MALE with MDD and GAD as well as multiple medical problems including HTN, CAD, and recurrent Nephrolithiasis who presents to MHC with his wife with concerns of suicidal and homicidal ideation

Axis I:

1. Major depressive disorder

2. Generalized anxiety disorder v panic disorder with agoraphobia.

3. Nicotine dependence.

Axis II:

1. Cluster B Traits.

Axis III:

1. Coronary Artery disease.

2. Hypertension

3. Hyperlipidemia

4. Chronic neck pain

5. Recurrent Nephrolithiasis

6. Benign paroxysmal vertigo.

Axis IV:

Severe; depression, chronic pain and medical conditions, recent cardiac catherization.

Axis V:

GAF 29

Edited March 1, 2007 by BETRAYED

[Objee]

Betrayed,

The way I read her statement, she says the two are blended together with depressive disorder causing about 60% of your psyche problems and PTSD causing about 40% of your symptoms. When you combine that with your inpatient admissions

with complaint of both SI and HI and your Inpatient Assessment GAF at 25 - 30%, I can't see how they won't raise your rating.

Ralph

The below statement is taken from my PTSD C&P I think I can use this to get my depression SC30% raised. I think it is pertinent to my case I am just brain fried and asking you guys are you seeing a relationship between ptsd and depression in the doctors statement?

First I am going to post just part of her statement in italic and then I will post other stuff about my hospitilizations and then the PTSD C&P again

At this time the examiner is asked to note that the veteran is already service connected for major depressive disorder, and, if post traumatic stress disorder is found, indicate which one is predominant. In the opinion of this examiner, the major depressive disorder accounts for approximately 60% of the veteran’s symptomatology, and the post traumatic stress disorder by estimate accounts for approximately 40% of the veteran’s symptomatology. It is not possible to provide differential global assessment scores for each Axis I diagnosis in that it appears that these diagnoses are interactive

-------------------------------------------------------------------------------------------------------------------------------------------------

now for the rest

October 7th 2006 I was admitted to the psychiatric ward for being suicidal. I stayed 9 days and was released on October 15th, 2006.

Admission Diagnosis:

Axis I

Major Depressive Disorder, Generalized Anxiety Disorder, Panic Disorder with agoraphobia, nicotine dependent.

Axis II

Differed

Axis III

Coronary Artery Disease, Hypertension, Chronic neck pain, chronic recurrent Nephrolithiasis BBPV.

Axis IV

Chronic Mental illness, chronic pain, financial strain, unemployment.

Axis V

Gaf 25, given suicidal preoccupation and recent active suicidal ideation.

I was released on a sunday and on monday (next day) I started HIOT (High Intensity Outpatient Therapy) 8 AM till 2PM (mon-fri) 5 days a week for 6 weeks.

On my ninth day of HIOT (October 26th) I had a meltdown during the morning session and became suicidal again. I was taken straight to the psychiatric ward. I was admitted for a second time in the psychiatric ward for being suicidal.

Admission Diagnosis:

Axis I

1. Major Depressive Disorder

2. Generalized Anxiety Disorder v Panic Disorder with agoraphobia.

3. Nicotine dependent.

Axis II

Deferred

Axis III

Coronary Artery Disease, Hypertension, Hyperlipdemia,Chronic neck pain, recurrent Nephrolithiasis BBPV.

Axis IV

Severe; depression, chronic pain and medical conditions, financial strain, unemployment, recent cardiac catherization.

Axis V

Gaf 30.

On December 21st 2006 I had a C&P Physical for PTSD. My exam was conducted by XXXXX XXXX MD. DR XXXXX made the following diagnosis

Axis I

1. Major Depressive Disorder secondary to pain syndromes.

2. Post traumatic Stress Disorder, chronic, delayed onset, with panic symptoms.

3. Nicotine dependent.

Axis II

Differed

Axis III

1. Nephrolithiasis.

2. Coronary Artery Disease.

3. Gastroesophageal reflux disorder.

4. Hyperlipidemia.

5. Hypertension.

6. Tinnitus.

7. Hiatal Hernia.

8. Knee Condition.

Axis IV

Psychosocial and environmental problems; conflict with former wife; unemployment; multiple health problems; inadequate finances; exposure to traumatic situations while serving in the navy, duty Military Police.

Axis V

Global assessment of functioning rated at 45, with serious impairment in social and occupational functioning.

OTHER OPINION: “ James M. Cummings is a 48 year old retired Navy Military Police (Master at Arms), who is currently 60% service connected with 30% for major depressive disorder. The veteran has claimed service connection for post traumatic stress disorder, and, reviewing his symptomatology and trauma statements, it appears that the veteran’s claim of post traumatic stress disorder is supported. At this time the examiner is asked to note that the veteran is already service connected for major depressive disorder, and, if post traumatic stress disorder is found, indicate which one is predominant. In the opinion of this examiner, the major depressive disorder accounts for approximately 60% of the veteran’s symptomatology, and the post traumatic stress disorder by estimate accounts for approximately 40% of the veteran’s symptomatology. It is not possible to provide differential global assessment scores for each Axis I diagnosis in that it appears that these diagnoses are interactive and also aggravated by the veteran’s medical condition. 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.”

On January 2nd 2007 while talking with my PCP XX XXXX I told him that my depression was getting the worse of me and I was thinking of things I shouldn’t be. I told him I needed to be admitted by I had to take care of some things first . He suggested I come to his office on Jan 4th, so my wife took me to the VAMC and subsequently to XXXXXX office. After talking it was decided that XXXXXX would take me down to mental health to talk to someone in intake. On January 4th 2007 I was admitted for a third time to the psychiatric ward for being suicidal and additionally homicidal. I was released on the 17th of January 2007.

Admission Assessment: XXXXXXX, XXX is a 48 year old MALE with MDD and GAD as well as multiple medical problems including HTN, CAD, and recurrent Nephrolithiasis who presents to MHC with his wife with concerns of suicidal and homicidal ideation

Axis I:

1. Major depressive disorder

2. Generalized anxiety disorder v panic disorder with agoraphobia.

3. Nicotine dependence.

Axis II:

1. Cluster B Traits.

Axis III:

1. Coronary Artery disease.

2. Hypertension

3. Hyperlipidemia

4. Chronic neck pain

5. Recurrent Nephrolithiasis

6. Benign paroxysmal vertigo.

Axis IV:

Severe; depression, chronic pain and medical conditions, recent cardiac catherization.

Axis V:

GAF 29

[betrayed]

BETRAYED:

By the numbers, what are your current ratings, pls ?

1) 30 depression/ 30 for kidney stone disease

2) 10 gerd

3) 10 tinnitus

4) 10 each knee bilateral pfps

Mental illnesses are lumped together to avoid "pyramiding". (rating-wise), PTSD or depression, if both are considered SCed.

I don't know which is more disabling

Doctor said 60% for depression and 40% for PTSD

Edited March 1, 2007 by BETRAYED

[Vike17]

Betrayed,

You will not receive a seperate rating for depression an PTSD, They will be rated togther with the dominant one reflecting the evalution.

By claiming PTSD on top of your current service-connected depression, it will actually do nothing for the evaluation itself. Both are rated according to the symptoms you have. In you case it is possible that PTSD from an ealier event while in the service may have made your depression worse where a higher evaltion may be in order, but to actually file a claim for PTSD is a waste of time. Just request am increase in evaution of your Depression.

Vike 17

[betrayed]

Betrayed,

You will not receive a seperate rating for depression an PTSD, They will be rated togther with the dominant one reflecting the evalution.

By claiming PTSD on top of your current service-connected depression, it will actually do nothing for the evaluation itself. Both are rated according to the symptoms you have. In you case it is possible that PTSD from an ealier event while in the service may have made your depression worse where a higher evaltion may be in order, but to actually file a claim for PTSD is a waste of time. Just request am increase in evaution of your Depression.

Vike 17

Vike

I completley understand one mental rating, good point about ptsd maybe backing my depression claim up to a earlier date. But my question is how can I use the doctors statement "It is not possible to provide differential global assessment scores for each Axis I diagnosis in that it appears that these diagnoses are interactive" to bolster my write up in my appeal......................

[Vike17]

Betrayed,

You're trying to put all of your eggs in one basket with that one statement. The rating is ultimately derived from the symptoms you have from your depression, not the GAF assigned to it. And since depression is a main symptom of PTSD, the symptoms are pretty much "interchangeable" so to speak. Does this make sense?

Vike 17

[betrayed]

Betrayed,

You're trying to put all of your eggs in one basket with that one statement. The rating is ultimately derived from the symptoms you have from your depression, not the GAF assigned to it. And since depression is a main symptom of PTSD, the symptoms are pretty much "interchangeable" so to speak. Does this make sense?

Vike 17

actually I am trying to put the icing on the cake with that statement

yes I understand what your saying. I posted all the other diagnoses from my inpatient stays. Unfortunatley none of the doctors progress notes seem to be as powerfull as what I percive the ending statement in the PTSD C&P

now being that, the doc said 60% for depression and 40% for PTSD and it appears that these diagnoses are interactive

I am trying to use the interactive statement to pertain this statement 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 thats a mighty powerfull statement

sure would have been better if she said 50/50.

I am going to the library to get the DSM-IV to see what I can learn about interactive diagnoses.

maybe I am just peeing in the wind as usual LOL

Edited March 1, 2007 by BETRAYED