Last one...I promise. I know MH conditions can be 'sensitive', so I'll ask you not to 'judge me' too harshly based on my conditions, but here goes...to me, it reads almost Verbatim as 30%, but if not, please let me know and why. This is not my primary condition, and though I was working for an addendum for my PEB, a situation resulted that prohibited that from taking place, but depending upon my results, it may come up in a FPEB later.
My concern is with the whole "overlap in symptoms" and what is or is not considered secondary to my chronic pain issue, and does that have an input on what I would be rated without it. Bottom line, I've been in Chronic pain for 7 years, so yeah, my career has been derailed, and yeah, I'm limited in what I can do around the house and with my family, and yeah, the pain EVERY DAY does have a psychological impact on how I feel about myself, my life, my future--both professional and personal, etc. I am limited in what I can and cannot do in the future. Even something as simple as teaching is pretty much out the door based upon my inability to be on my feet for more than 30 minutes without incredible pain. So my future job prospects are limited to sedentary work only. And yeah, that DOES have an impact on my psychological wellbeing, being the 'bread winner' of the family. Not trying to 'whine' here, I'm just stating that I'm more frustrated than anything, and that's based upon a long story on how I got to where I am today, which I'll spare you all.
Anyway, any input would be appreciated. Thanks!
1. Diagnosis
a. Does the Veteran now have or has he/she ever been diagnosed with a mental disorder(s)?
[X] Yes[ ] No
If the Veteran currently has one or more mental disorders that conform to DSM-5 criteria, provide all diagnoses:
Mental Disorder Diagnosis #1: Unspecified Anxiety Disorder
ICD code: F41.9
Comments, if any:
Most likely began during Navy service.
Mental Disorder Diagnosis #2: Adjustment Disorder with mixed anxiety and depressed mood
ICD code: F43.23
Comments, if any:
Attributable to chronic pain related to hernia/inguinal and low back conditions and the impact they have had on his physical functioning, occupational functioning, and career options.
b. Medical diagnoses relevant to the understanding or management of the MH Disorder:
Chronic pain related to hernia (inguinal) and low back conditions
Comments, if any:
These conditions are relevant to the understanding of the Adjustment Disorder with mixed anxiety and depressed mood only.
2. Differentiation of symptoms
a. Does the Veteran have more than one mental disorder diagnosed?
[X] Yes[ ] No
b. Is it possible to differentiate what symptom(s) is/are attributable to each diagnosis?
[X] Yes[ ] No[ ] Not applicable (N/A)
If yes, list which symptoms are attributable to each diagnosis and discuss whether there is any clinical association between these diagnoses:
Depressed mood is attributable to Adjustment Disorder only. Sleep impairment and anxiety are attributable to both disorders; due to overlap in symptoms between the disorders, it is not possible to differentiate what portion of each shared symptom is attributable to each diagnosis without resorting to mere speculation. Although there is no direct clinical association between his 2 disorders, the Unspecified Anxiety Disorder that developed prior to the Adjustment Disorder around 1998 has most likely caused him to become more susceptible to developing other psychiatric disorders.
3. Occupational and social impairment
a. Which of the following best summarizes the Veteran's level of occupational and social impairment with regards to all mental diagnoses? (Check only one)
[X] Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with normal routine behavior, self-care and conversation
b. For the indicated level of occupational and social impairment, is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by each mental disorder?
[ ] Yes[X] No[ ] No other mental disorder has been diagnosed
If no, provide reason that it is not possible to differentiate what portion of the indicated level of occupational and social impairment is attributable to each diagnosis:
Some overlap in symptoms.
My concern is with the whole "overlap in symptoms" and what is or is not considered secondary to my chronic pain issue, and does that have an input on what I would be rated without it. Bottom line, I've been in Chronic pain for 7 years, so yeah, my career has been derailed, and yeah, I'm limited in what I can do around the house and with my family, and yeah, the pain EVERY DAY does have a psychological impact on how I feel about myself, my life, my future--both professional and personal, etc. I am limited in what I can and cannot do in the future. Even something as simple as teaching is pretty much out the door based upon my inability to be on my feet for more than 30 minutes without incredible pain. So my future job prospects are limited to sedentary work only. And yeah, that DOES have an impact on my psychological wellbeing, being the 'bread winner' of the family. Not trying to 'whine' here, I'm just stating that I'm more frustrated than anything, and that's based upon a long story on how I got to where I am today, which I'll spare you all.
Anyway, any input would be appreciated. Thanks!
1. Diagnosis
a. Does the Veteran now have or has he/she ever been diagnosed with a mental disorder(s)?
[X] Yes[ ] No
If the Veteran currently has one or more mental disorders that conform to DSM-5 criteria, provide all diagnoses:
Mental Disorder Diagnosis #1: Unspecified Anxiety Disorder
ICD code: F41.9
Comments, if any:
Most likely began during Navy service.
Mental Disorder Diagnosis #2: Adjustment Disorder with mixed anxiety and depressed mood
ICD code: F43.23
Comments, if any:
Attributable to chronic pain related to hernia/inguinal and low back conditions and the impact they have had on his physical functioning, occupational functioning, and career options.
b. Medical diagnoses relevant to the understanding or management of the MH Disorder:
Chronic pain related to hernia (inguinal) and low back conditions
Comments, if any:
These conditions are relevant to the understanding of the Adjustment Disorder with mixed anxiety and depressed mood only.
2. Differentiation of symptoms
a. Does the Veteran have more than one mental disorder diagnosed?
[X] Yes[ ] No
b. Is it possible to differentiate what symptom(s) is/are attributable to each diagnosis?
[X] Yes[ ] No[ ] Not applicable (N/A)
If yes, list which symptoms are attributable to each diagnosis and discuss whether there is any clinical association between these diagnoses:
Depressed mood is attributable to Adjustment Disorder only. Sleep impairment and anxiety are attributable to both disorders; due to overlap in symptoms between the disorders, it is not possible to differentiate what portion of each shared symptom is attributable to each diagnosis without resorting to mere speculation. Although there is no direct clinical association between his 2 disorders, the Unspecified Anxiety Disorder that developed prior to the Adjustment Disorder around 1998 has most likely caused him to become more susceptible to developing other psychiatric disorders.
3. Occupational and social impairment
a. Which of the following best summarizes the Veteran's level of occupational and social impairment with regards to all mental diagnoses? (Check only one)
[X] Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with normal routine behavior, self-care and conversation
b. For the indicated level of occupational and social impairment, is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by each mental disorder?
[ ] Yes[X] No[ ] No other mental disorder has been diagnosed
If no, provide reason that it is not possible to differentiate what portion of the indicated level of occupational and social impairment is attributable to each diagnosis:
Some overlap in symptoms.
