Increase for Mental Health rating

[rocco587]

Hello, 

I am currently 30% disabled for adjustment disorder with anxiety, I filed a supplemental claim for an increase with documents of past hospitals that I've been to (outside the VA) with my VSO 8 months ago and had the increase denied.  Since then I decided to get help from the VA and I am seeing a psychologist and psychiatrist to have my issues addressed, and have a pretty thorough paper trail with the VA for the past 6 months, they are taking the route of treating me for PTSD.

From what I understand all mental health issues are lumped together, but for some reason instead of filing another supplemental claim with the new VA records my VSO wants to file for PTSD separately to see if I can get an increase.  

Does anybody know why my VSO would want to take this route, instead of filing another supplemental claim for the increase?  It is confusing to me that we are doing this. 

Thanks in advance. 

[ShrekTheTank]

I think for rating it is just easier.  You can go any route you want, but the VA is the only one that can say yes you have PTSD or you do not.  A private doctor can't tell the VA if you have it or not.

They can give syptoms and what they think is the issue, but your C&P at the VA will make that determination.

The issue a lot Vets have is the VA loves to lowball PTSD right off the bat.   Since you have a good papertrail, your VSO might think this is a good idea and he could be right.  If you have it laid out and are not holding anything back, then you will be good.  You might need to fight it for a while, but you will get there!

[broncovet]

You posted:

Quote

all mental health issues are lumped together, but for some reason instead of filing another supplemental claim with the new VA records my VSO wants to file for PTSD separately to see if I can get an increase.  

Sort of.  All "service connected" mental health issues are lumped together. 

You can have mental issues which are SC, you can also have mental issues which are NOT SC.  

PTSD, however, is almost always SC, when VA diagnoses it, if you have a stressor.  

The Caluza element of mental disorders (PTSD) is called a stressor, instead of an "event in service".  

With your "adjustment disorder and anxiety", this is somewhat limited, but PTSD has many more symptoms that could result in additional (higher) ratings.  

I have heard of Veterans who got a discharge for "adjustment disorder" and were denied.  VA likes to see it called MDD, or PTSD, and "not so much" for it to be called "adjustment disorder".  

I understand the military was pushing people out with a "adjustment disorder" so they did not have to pay PTSD/MDD benefits.  

Im actually suprised you got SC for "adjustment disorder".  

My advice is to comply with VSO's request, and apply for PTSD/increase.  

PTSD can be caused by events "unrelated" to military service, such as trauma from an automobile accident, getting shot in civilian life, or even being raped etc.  

Once service connected, you will be rated on symptoms.  

If you are SC for adjustment disorder, but you have symptoms of depression and are not SC for depression, those symptoms are nsc and not compensable.  

Sometimes there is not a clear line between which symptoms are what mental disorder, and, I think the VA is supposed to take the "favor the Veteran" approach.  Still, if its not SC, you wont be getting SC compensation for it.  

Edited January 3, 2023 by broncovet

[john999]

PTSD has so many possible symptoms to include depression, substance abuse, and all the other things such as sleep disorders and the rest.  I bet the VA would lump them all together under PTSD.  If your VSO advises you to ask for an increase I would do it.  VSO's tend to be very conservative.  You must have a good case.  I would not worry about being reduced.  Adjustment disorder is a hoax IMO.  If you have stressors or combat awards then PTSD claim is the right way to go.  I think adjustment disorder is or was a way for VA to avoid a PTSD diagnosis.  PTSD very often gets 100% rating and this costs the VA and runs up the budget.  

[rocco587]

On 1/3/2023 at 1:00 PM, shrekthetank1 said:

I think for rating it is just easier.  You can go any route you want, but the VA is the only one that can say yes you have PTSD or you do not.  A private doctor can't tell the VA if you have it or not.

They can give syptoms and what they think is the issue, but your C&P at the VA will make that determination.

The issue a lot Vets have is the VA loves to lowball PTSD right off the bat.   Since you have a good papertrail, your VSO might think this is a good idea and he could be right.  If you have it laid out and are not holding anything back, then you will be good.  You might need to fight it for a while, but you will get there!

 

On 1/3/2023 at 3:10 PM, broncovet said:

You posted:

Sort of.  All "service connected" mental health issues are lumped together. 

You can have mental issues which are SC, you can also have mental issues which are NOT SC.  

PTSD, however, is almost always SC, when VA diagnoses it, if you have a stressor.  

The Caluza element of mental disorders (PTSD) is called a stressor, instead of an "event in service".  

With your "adjustment disorder and anxiety", this is somewhat limited, but PTSD has many more symptoms that could result in additional (higher) ratings.  

I have heard of Veterans who got a discharge for "adjustment disorder" and were denied.  VA likes to see it called MDD, or PTSD, and "not so much" for it to be called "adjustment disorder".  

I understand the military was pushing people out with a "adjustment disorder" so they did not have to pay PTSD/MDD benefits.  

Im actually suprised you got SC for "adjustment disorder".  

My advice is to comply with VSO's request, and apply for PTSD/increase.  

PTSD can be caused by events "unrelated" to military service, such as trauma from an automobile accident, getting shot in civilian life, or even being raped etc.  

Once service connected, you will be rated on symptoms.  

If you are SC for adjustment disorder, but you have symptoms of depression and are not SC for depression, those symptoms are nsc and not compensable.  

Sometimes there is not a clear line between which symptoms are what mental disorder, and, I think the VA is supposed to take the "favor the Veteran" approach.  Still, if its not SC, you wont be getting SC compensation for it.  

 

On 1/4/2023 at 2:18 PM, john999 said:

PTSD has so many possible symptoms to include depression, substance abuse, and all the other things such as sleep disorders and the rest.  I bet the VA would lump them all together under PTSD.  If your VSO advises you to ask for an increase I would do it.  VSO's tend to be very conservative.  You must have a good case.  I would not worry about being reduced.  Adjustment disorder is a hoax IMO.  If you have stressors or combat awards then PTSD claim is the right way to go.  I think adjustment disorder is or was a way for VA to avoid a PTSD diagnosis.  PTSD very often gets 100% rating and this costs the VA and runs up the budget.  

Thanks for the responses, this helps me understand this better.  I will do what the VSO is asking and see what happens!

[El Train]

Why is your VSO wanting to put in for PTSD?  Do you have that diagnosis or getting treatment from the VA or outside the VA?  PTSD is pretty specific.  You had some sort of documented event in the military that caused PTSD and you are getting treatment for it.  If you are getting treatment for it (meds, cognitive behavioral therapy, etc.), then it's basicly a new claim, if granted will be combined with your adjustment disorder.  It will require treatment along with meds from the VA.  The C&P will grant the diagnosis based on treatment records.  You will need a stressor incident (witnessing death, near death experience, combat action medal, etc.). They will investigate this stressor unless you have a combat action award, then it is presumed.  If you have no treatment for PTSD but another mental condition, I'd just put in for an increase on your current 30% adjustment disorder.  I have a friend that has 100% due to anxiety alone. 

PTSD can be granted years or decades after service, other mental conditions are way more difficult from what I understand.  PTSD can have delayed onset.

BTW, you would be surprised at how many VSO's just aren't very good at what they do.  Mine had 25 years experience.  I handled most of my own claims.  When the dust settled and I got 100% P&T, SMC-S, that dude was asking me for advice.  They're good at getting records, submitting evidence, and answering basic questions.  He told me I had slim and no chance on some claims I wanted to apply for that I got approved at maximum rating.

Edited January 6, 2023 by El Train

[Phury & Rhage]

I'm just chiming in, but there are some obvious benefits to having a mental health diagnosis that ISN'T PTSD.  In order for PTSD to be service-connected, you have to have a stressor.  In a lot of cases, there are problems with verifying stressors.  There are some big exceptions to that.  If you were in any combat/exposed to enemy combatants, VA concedes that exposure as a stressor.  Then the hurdle becomes getting the examiner to link your current diagnosis to the conceded stressor.  If there are records of other stressors that could underlie a PTSD diagnosis (childhood/anything else when you weren't in the service) then it can be difficult to get the examiner to say that it was your service stressor that is responsible.  It can be easier to service-connect other mental health diagnoses because they can be linked to service without being the result of a specific stressor.  A common service-connection is for depression/other MH condition due to the effects of your other SC conditions.  Secondary connection is also easier for Veterans to obtain because it only requires a link to a current SC condition rather than trying to dig through service records for support.  This is also where your private opinion can carry a lot of weight.  VA examiners don't have a lock on determining whether your MH condition is related to your other SC conditions.  Private examiners are on a level playing field there.  If nothing else, having a private examiner link your MH condition to your SC conditions sets up a good appellate record.  

Good luck to you,

Phury