Depressive Disorder due to medical condition(Chronic Pain) 10% or 30%???

ickes1656

PEB Forum Regular Member
Registered Member
In my Exam notes it has an X on:

Occupational and social impairment due to mild or transient symptoms
which decrease work efficiency and ability to perform occupational
tasks only during periods of significant stress, or; symptoms controlled
by continuous medication....

Which I understand to be rated at 10%.

What I don't understand is that in the exam notes it also has:
[X] Depressed Mood
[X] Anxiety
[X] Suspiciousness
[X] Chronic Sleep Disorder
[X] Mild Memory Loss, such as forgetting names, directions, or recent events
[X] Disturbances of motivation and mood
[X] Difficulty in adapting to stressful circumstances, including work or a worklike setting

And this is what it says for the rating of 30%

Occupational and social impairment with occasional decrease in work
efficiency and intermittent periods of inability to perform occupational
tasks (although generally functioning satisfactorily, with routine
behavior, self-care, and conversation normal), due to such symptoms
as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or
less often), chronic sleep impairment, mild memory loss (such as
forgetting names, directions, recent events)...

Which has every symptom I have except for panic attacks. Any explanation as to why I would get rated 10 and not 30?

Thanks in Advance!!
 

Siligurl

PEB Forum Regular Member
PEB Forum Veteran
Registered Member
In my Exam notes it has an X on:

Occupational and social impairment due to mild or transient symptoms
which decrease work efficiency and ability to perform occupational
tasks only during periods of significant stress, or; symptoms controlled
by continuous medication....

Which I understand to be rated at 10%.

What I don't understand is that in the exam notes it also has:
[X] Depressed Mood
[X] Anxiety
[X] Suspiciousness
[X] Chronic Sleep Disorder
[X] Mild Memory Loss, such as forgetting names, directions, or recent events
[X] Disturbances of motivation and mood
[X] Difficulty in adapting to stressful circumstances, including work or a worklike setting

And this is what it says for the rating of 30%

Occupational and social impairment with occasional decrease in work
efficiency and intermittent periods of inability to perform occupational
tasks (although generally functioning satisfactorily, with routine
behavior, self-care, and conversation normal), due to such symptoms
as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or
less often), chronic sleep impairment, mild memory loss (such as
forgetting names, directions, recent events)...

Which has every symptom I have except for panic attacks. Any explanation as to why I would get rated 10 and not 30?

Thanks in Advance!!
Hi! First of all, I'm sorry that you're in this boat-- I know how difficult it can be. You should not have been diagnosed with Depression d/t a medical condition. It's a common misdiagnosis. For this diagnosis to be present, the depression must be a direct physiological consequence of the medical condition-- so for example, people with hypothyroidism may experience depression as a direct consequence by an underfunctioning thyroid. Similarly, people with hyperthyroid might experience anxiety as a consequence of an overactive thyroid. Those of us with chronic pain are more likely to experience depression, and maybe even severe depression, but that is not *caused* by the physiology of our condition but is instead a reaction/response to the condition. A more accurate diagnosis would be potentially Major Depressive Disorder or Adjustment Disorder with Depressed Mood. THIS might influence the disability ratings were to address it.

As to your more immediate question, I think the issue is the severity of the disorder and its impact on your life. At a 10%, they're saying the condition(s) is present, mild, and managed relatively well. At a 30%, there is increased severity of the condition(s) and worse impact. The key differences between the 2 breakdown into intensity (of symptoms) and severity (of impact).

Hope this helps.
 

ickes1656

PEB Forum Regular Member
Registered Member
Hi! First of all, I'm sorry that you're in this boat-- I know how difficult it can be. You should not have been diagnosed with Depression d/t a medical condition. It's a common misdiagnosis. For this diagnosis to be present, the depression must be a direct physiological consequence of the medical condition-- so for example, people with hypothyroidism may experience depression as a direct consequence by an underfunctioning thyroid. Similarly, people with hyperthyroid might experience anxiety as a consequence of an overactive thyroid. Those of us with chronic pain are more likely to experience depression, and maybe even severe depression, but that is not *caused* by the physiology of our condition but is instead a reaction/response to the condition. A more accurate diagnosis would be potentially Major Depressive Disorder or Adjustment Disorder with Depressed Mood. THIS might influence the disability ratings were to address it.

As to your more immediate question, I think the issue is the severity of the disorder and its impact on your life. At a 10%, they're saying the condition(s) is present, mild, and managed relatively well. At a 30%, there is increased severity of the condition(s) and worse impact. The key differences between the 2 breakdown into intensity (of symptoms) and severity (of impact).

Hope this helps.
Thank you for your reply.

When I had my exam for the mental portion of the C&P the Psychologist told me he was going to diagnose me with Depressive disorder secondary to chronic pain. At the behavior health clinic they diagnosed me with Adjustment Disorder with Depressed Mood.

I have not received a rating yet but judging by their notes they have marked that I should receive 10% but have all the symptoms marked for 30%. I am not sure how they decide on that or how they relate his diagnosis to my behavior health diagnosis when doing the ratings either.

I have been referred to the MEB for Bilateral knees and my Left wrist and my BH Psychologist has talked to me about being referred for Adjustment disorder but has not referred me for it yet. I am wondering if she does that what would change? This whole process is just confusing to me.
 

THolleyH46

PEB Forum Regular Member
PEB Forum Veteran
Adjustment disorder is a condition expected to last less than six months I believe.
 

KARobinson3

PEB Forum Regular Member
PEB Forum Veteran
Registered Member
Usually with chronic pain or other conditions, you can end up with a dx of chronic adjustment disorder which could last 6 months or forever. Acute Adjustment Disorder is the type that lasts 6 months or less.
 

ickes1656

PEB Forum Regular Member
Registered Member
Usually with chronic pain or other conditions, you can end up with a dx of chronic adjustment disorder which could last 6 months or forever. Acute Adjustment Disorder is the type that lasts 6 months or less.
Thanks for the reply.

My behavior health doc is looking at possibly saying I have reached the Medical Retention point for this and it becoming another referred condition for me. My packet is currently at the PEB and I am awaiting the fit or unfit memo and ratings. Which I will be appealing if she ends up referring me for this as well, along with everything else I have to include since the MEB started.

So most likely it would be a temporary thing at first and as they reevaluate me when I am out they would determine if it is chronic and permanent or not?
 

KARobinson3

PEB Forum Regular Member
PEB Forum Veteran
Registered Member
There is a possibility that you will be put on TDRL to see if your mental health improves once you are in a less stressful environment.
 
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