ptsd C &p Exams Results

[larry1961]

file a claim secondary to epilepsy. had a c&p on jan.11,07, got copy of exam.

AXIS: I major depression disorder, single episode, severe with psychotic features, in partial remmission. ptsd chronic delayed(non combat related training injury)

AXIS: III complex partial epilepsy, djd, right ankle injury due to seizures, history of kidney disease.

AXIS: IV death of family members, including death of mother, unemployment, epilepsy.

AXIS: V GAF=50

doctor's opinion: veteran's serious depression is most likely cause by his service connected epilepsy psychmotor type (complex partial epilepsy).

[Vike17]

Larry1961,

Without being able to read the whole exam and the rational the examiner used to make this opinion, it seems like the exam would be enough to award service-connection for MDD as secondary to the epilepsy.

One thing to keep in mind there is a provision within the rating schedule regarding mental disorders and seizures under §4.124a, it states;

"Mental Disorders in Epilepsies: A nonpsychotic organic brain syndrome will be rated separately under the appropriate diagnostic code (e.g., 9304 or 9326). In the absence of a diagnosis of non-psychotic organic psychiatric disturbance (psychotic, psychoneurotic or personality disorder) if diagnosed and shown to be secondary to or directly associated with epilepsy will be rated separately. The psychotic or psychoneurotic disorder will be rated under the appropriate diagnostic code. The personality disorder will be rated as a dementia (e.g., diagnostic code 9304 or 9326)"

I hope this helps!

Vike 17

Edited March 31, 2007 by Vike17 (see edit history)

[Hoppy]

Larry,

Why was this C&P scheduled? What was the claim for. I see several issues that are confusing. He calls the major depressive disorder a single episode. You might need a diagnosis of chronic depression for service connection and this doctor knows this and wrote the exam in a way to weaken a claim. Partial remission? What does this mean. In one way it leaves the door open for the establishment of a chronic condition because the so called single event has not totally resolved. It might require continued treatment and evaluation to establish the chronic depression.

If you are not in treatment, I would suggest that you go to a VAMC and ask for continued treatment and evaluation to establish chronic depression due to SC epilepsy to strengethen the claim. You can always file the claim tomorrow and get into treatment and submit evidence later. You can usually get better and stronger evaluations from a treating physician who spends a significant amout of time working with you than from a C&P examiner who bases an opinion on one exam.

Also, has the non combat PTSD stressor been established. If the stressor is not accepted then they might say you have both chronic PTSD of unknown origin and a single episode of depression due to SC epilepsy. That might be hard to SC.

I think the claim would be much stronger if they called the depression due to SC epilepsy chronic. Also, if the PTSD stressor is not established they will probably need to schedule another C&P to determine if any part of the GAF associated with the service connected psych condition can be established. That is of course they determine the SC depression due to epilepsy is chronic.

These are my concerns and questions about this C&P. I could be misinterpreting this. However. I have seen other C&P doctors who are experts at writing reports that the veteran thinks sounds good but all they do in the long run is "BLOW SMOKE".

Edited March 31, 2007 by Hoppy (see edit history)

[LarryJ]

Well, I can see that I need to change my screen name.

Tbird, how do I go about doing that?

[larry1961]

Larry1961,

Without being able to read the whole exam and the rational the examiner used to make this opinion, it seems like the exam would be enough to award service-connection for MDD as secondary to the epilepsy.

One thing to keep in mind there is a provision within the rating schedule regarding mental disorders and seizures under §4.124a, it states;

"Mental Disorders in Epilepsies: A nonpsychotic organic brain syndrome will be rated separately under the appropriate diagnostic code (e.g., 9304 or 9326). In the absence of a diagnosis of non-psychotic organic psychiatric disturbance (psychotic, psychoneurotic or personality disorder) if diagnosed and shown to be secondary to or directly associated with epilepsy will be rated separately. The psychotic or psychoneurotic disorder will be rated under the appropriate diagnostic code. The personality disorder will be rated as a dementia (e.g., diagnostic code 9304 or 9326)"

I hope this helps!

Vike 17

[larry1961]

thanks for the reply vike 17. here more from the report.

mr. ross has two primary mental disorder including major depression and ptsd, these two have overlapping symtoms of detachment, isolation, decreased concentration. however they appear to be separate primary disorders in this veteran.it is not possible sto fully delineate all symptons as some symtons are interrelated to both disorders.

mr. ross has developed of major depression most likely from partial complex epilesy pt . with this kind of epilesy often have high incidence of psychistric problems including major depression developing from neuroal changes in the brain and from consequence of its treatments with meds. and side effects.

[Hoppy]

This sounds better. The intertwined symptoms can get rated if only one condition is SC'd. If you get denied with this there are ways to strengthen this report.

The depression single event could continue to be a weak point. In this report the doctor does not mention time frames of the development of the depression, such as long term chronic. Neither does he mention a prognosis such as "recovery is not likely". I have seen doctors write reports indicating conditions that were in remission as spontanously resolving.

The reports that I have seen that I feel are strong say things like "long term and untreatable".