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Opinions on C@P exam

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Ken Dillon


Good morning, about 2 weeks ago I had C@P exam at major depression at the local Va clinic with VA doctor. Two questions in his note he writes 

sub-clinical trauma-related symptoms, he also writes in his report that 
DSM-5 diagnosis: Other Specified Depressive Disorder (persistent dysphoric
    mood and amotivation secondary to chronic pain with functional limitations)-

    more likely than not proximately due to or the result of service-connected
    intervertebral disc syndrome (previously rated as degenerative disc disease,
    herniated lumbar disc).  I think that this helps my case, what are your opinions?


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It says it right there, “ more likely than not…”.  Without seeing any of your other evidence, though, there is no way to know. His opinion could be completely opposite the clinical picture presented in the  available medical evidence- only you know that.

Assuming that the two track together, yet I, this is a favorable sounding opinion. 

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*An addendum- this opinion depends on what you claimed- if you claimed PTSD, it might not be as favorable-to you- because it could result in you being rated something "not" PTSD, if that is important to you. PTSD and many other MH conditions overlap considerably. You can only be rated for 1 MH, though, and often depression, dysthymia, etc are subsumed under PTSD, and can sometimes help towards that end because a previously Dx'd depression today could end up being tomorrow's PTSD rating. The depression/disassociate disorder/personality disorder/whatever was actually a precursor to a later PTSD rating. I know that with some PTSD/MST seeking veterans, they want their rated contention to be specific to PTSD/MST.  I suspect as a validative finding that 'it happened' and, thats great! It's a sign of coping, of healing, and accepting-and can be a strong mechanism for personal peace that the event/events that led up to it are recognized. Working specifically with PTSD claims, I applaud that.

That said, MH is MH when it comes down to rating, and what is important isn't so much the Dx for most people or what its called for most people but the amount of effect it has for your ability to function occupationally and socially. Some doctors or examiners, for whatever reason, seem loathe to dx PTSD in people unless they had a building fall on them, or were injured in some grievous hollywood manner- that takes away from the gravity of the event for you, the applicant, and is my personal pet peeve with as many of these as I read. That is a whole other topic, though.

VA rates all mental health conditions using the same diagnostic criteria.  Mental health conditions are rated at 0%, 10%, 30%, 50%, 70%, and 100% using VA’s General Rating Formula for Mental Disorders (38 CFR § 4.130).  These ratings are based on the level of social and occupational impairment a condition presents. So, whether it's called depression, PTSD, socio-affective disorder, whatever, if your symptoms meet X,Y,Z in the ratings schedule then most of the time that is what you are rated. The hard part with PTSD specifically is the stressor and Dx- many vets have difficulty documenting a stressor/stressors- especially older vets- because as much as it can be said that the military operates on a river of paperwork, that paperwork can be really fickle or missing when it comes to documenting some things like non-routine health issues or operational events.

Sometimes in the absence of a defined stressor that YOU know happened to you you may get dx'd by a doctor with depression or something else because you can't find anything in your service records that points to the event/events that you are claiming as the root of your stressor. Depression can spring from myraid causes- constant pain, medical issues, social stigma, but PTSD is specifically defined by an event or events that are the root of the disorder. If you can't find or document that or point to behavior marker changes that indicate that 'something' happened, PTSD in a vaccum is harder to get diagnosed. I see a lot of claims that started as ratings for depression that eventually end up as PTSD because somewhere along the way after the initial rating a veteran finds something that allows them to define a root stressor, so they refile again, or appeal, for vindication- again, thats great, and is really powerful at helping with the emotional and/or spiritual coping process. 

Edited by brokensoldier244th
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2 hours ago, Ken Dillon said:

more likely than not proximately due to or the result of service-connected intervertebral disc syndrome (previously rated as degenerative disc disease,

Ok it sounds like you are already rated for  intervertebral disc syndrome.

The way I read it the doctor stated your depression or mental health what ever they want to call it.

Stated that it is do to intervertebral disc syndrome.

To me it sound like you should be rated soon.

Now what% is based all that other stuff.

The way I see it

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