VA Disability Benefits for Depression

Good afternoon and welcome to Facebook live with Chisholm Chisholm and Kilpatrick my name is Emma Peterson and I’m joined today by Courtney Ross and Michelle DeTore and We’re going to be talking with you a little bit about depression service connection for depression symptoms of depression and pretty much everything you need to know and sort of a basic understanding of how this disability works in the VA disability system as Always if you have questions or comments please feel free to leave them in the comment section and we will try to get them as best as possible a Lot of the information we’re talking about today is available on our website at in our blog section So, please be sure to look on that section of the website if you’ve got further questions All right So with that we’re just gonna dive right in. So Courtney, what are some common symptoms of depression? Sure, so obviously the symptoms for each individual could vary but generally speaking some of the more common symptoms are persistent feelings of sadness of worthlessness Feelings of guilt a lack of motivation or interest in activities that you may have previously enjoyed maybe difficulty sleeping or difficulty concentrating a lack of appetite Resulting in a change in a person’s weight there can also be other physical manifestations so for example digestive or stomach problems due the Feeling depressed. So those are just Examples of some of the common symptoms again, it will vary for each individual. So it’s a broad range It’s the typical things you think of but maybe also some physical things too. Yeah. Pain GI issues things like that exactly. Yeah Alright, so Michelle, how do we show direct service connection for depression? Sure. So direct service- connection has three elements So the first element is that you need to have a current disability. The second element is that there needs to have been a In-service event or injury and the third element is that you need a medical Nexus so basically a medical opinion linking your current diagnosis to the in In-service event or injury. So what are some In-service causes of depression. I know people might think of more like injuries causing you know physical injury what what would cause depression? So it could be anything from Your military service so there could have been an event in your military service, you know, such as you know Things can happen while you’re in service, but you could also have things that are not service related So, you know, you could maybe have a death in the family That was very traumatic and it happened while you were in service And at that point in time you started experiencing depression there could be incidents Like I said earlier or events in service that caused the depression, but I think that a lot of times people Associate that fact that depression has to be directly related to your military service But in reality it just had to occur– begin during your military service. It doesn’t have to be military related depression It can be anything in your life. As long as you were on active duty at that time. Yep. Okay. alright, and what about Really covers sort of direct service connection: something happens, we have an nexus you have a diagnosis. What about secondary service connection Courtney? Yeah So secondary service connection is a different type of way to get Service-connected. And the way it usually works is a veteran has a condition that has already been service-connected by VA So they’re already receiving benefits for it. And the depression has resulted from that already service-connected condition So just to give you an example to provide a little bit of context one of the more common secondary service connection is where a veteran might have an orthopedic condition maybe a back condition and it’s really severe and it has Impacted the veterans daily life and what they’re able to do and the result is that it started to cause them to feel depressed And develop that depression diagnosis. Okay now There are other conditions that can result from depression, right? so for example a lot of the Psychotropic medications might cause weight gain and lead to maybe orthopedic conditions or aggravate orthopedic conditions So it really can work both ways in that Something might happen to you in service to cause an injury and you become depressed And then also the depression itself might lead to other conditions so it can go both ways. Exactly Yeah, or the depression might develop from a condition that has already been established as service-connected. Okay, great What if for veterans who suffer from depression prior to service? Yeah, so you could still get service-connected for the depression even if it existed prior to service if your military service Aggravated that condition and you would need to establish that to VA that even though it existed prior to it your military experience worsened into the condition. Now we talked a little bit Michelle talked a little bit about needing a medical Nexus. So oftentimes VA will schedule you for a C&P examination So, how does that work for depression, Michelle? Sure So a lot of times in the processing of your va claims VA will go out and schedule you for an examination It could be, you know through our private facility or through a VA Medical Center And what you’ll do is you’ll go to a VA examination and you’ll talk to, typically a psychiatrist or a psychologist And they’ll go through the symptoms of your disability and you know, whether it’s an increased rating examination or a service connection examination They’ll discuss why that condition is related to service or like Courtney said related to a service-connected disability or they’ll go through exactly, you know the Severity of the condition and they do that for both types of examinations And then at the end the examiner will compile their findings and submit that to the Department of Veterans Affairs It is something that veterans are able to get a copy of one thing I will say just to be mindful of is it does sometimes take a few weeks for the examiner to finish their findings and get That submitted so sometimes it’s not readily available. However other times it is pretty readily available I would say within the week, but if you do have representatives that are working on your case Whether it’s a veteran’s service organization or a private attorney or practitioner Through access to VA’s electronic systems specifically VBMS you’re able to quickly get that Examination and download it from there so that you can review it Okay, so I think the takeaway there is that they’re not going to give it to you at the end of the exam– –a copy you’re gonna have to request it if you want to see it and it might take a little bit of time to get it and you should certainly reach out to a VSO like our colleagues at DAV your accredited rep. or whoever you’re working with on your claim or if you’re working with your claim by yourself. That’s absolutely fine Go down to the RO ask them for a copy Yeah, make someone help you get this because you absolutely have a right to see it You can also go to the VA Medical Center and there’s a release that you fill out It’s a 5345 and once you submit that to them they should be able to give it to you. Okay, that’s great And then get that form online, right? Yep. Okay, wonderful. So, it’s VA from probably 21 It 21 – 5345 and you just go to the forms page Great Now what can a veteran do if they receive an unfavorable of the exam Courtney? Yeah, so a veteran could submit evidence or argument to counter that unfavorable examination so a few examples of specific things you could do is consider getting your own private medical opinion to assess your Depression and see if that private doctor can provide a nexus to your time in service or again to a condition that’s already service-connected you could also submit lay testimony that outlines the onset of your Psychiatric symptoms in service, or I mean how your symptoms have progressed since you left service. And you could also consider submitting an argument in another lay statement if you don’t feel like that exam Accurately captures your experience with that examiner So If you think it’s inadequate in terms of what you reported to the examiner is not being correctly documented on that examination So it sounds like there’s sort of three general types of evidence. You can submit: medical evidence about your depression lay evidence about what you Experienced and when you experienced it and then some lay argument or just argument against maybe some negative evidence in your case. Yeah Now, how can a veteran submit evidence with an appeal under VA’s new system, under the AMA? Yes We have a lot of content about this. So, please please please go to our website and check it out But how can veterans do that in this new system? so it’s very different under the new system in terms of the rules force when you can submit evidence and it all depends on which Review option you select when you get a decision, so when a veteran gets an initial decision They have three different options now to select they can choose a higher level review of the decision They can choose to file a supplemental claim or they can choose to file an NOD Directly to the board which gives them again three docket options. If you choose higher level review You cannot submit any additional evidence It’s only argument if you choose to file a supplemental claim you can submit additional evidence But it needs to be what’s called new relevant evidence And if you go to if you choose to file an NOD to the board again there are rules for if You can submit evidence will depend on which docket you select for the board So if you choose the direct docket, it’s similar to higher-level review in that you can not so any additional evidence It’s only argument If you choose the evidence docket, you will have 90 days from the date that you file the NOD to submit additional evidence Or if you select the third docket, which is the hearing docket You’re allowed to submit evidence at the time of the hearing or within 90 days after the hearing Okay, so if you caught all that, that’s all great. But again, I really strongly encourage you I think we all three would to go to our website check out What we have on the AMA and the different lanes and dockets You can pick yes talk with whoever you work on your case with about which lane or docket to select Yeah because You want to be sure that you’re picking a lane or docket that you can add evidence if that’s something you need to do. Yes And that also is important not only for service connection cases, but also increased rating cases so what kinds of evidence do veterans need to show an increased rating for if they’ve already been service-connected for depression. Sure Like the evidence we were just talking about you can use medical evidence lay evidence basically, you need to show that your condition increased in severity or that the original rating was incorrect and you can do it by just submitting medical evidence lay evidence or Any type of argument may be against the evidence that is a record showing that that evidence supported a higher rating than what you currently have. And VA has diagnostic codes for every condition pretty much under the sun almost all of them not all of them, but almost And there are a couple DC’s or diagnostic codes that relate to depression But I think the thing to know is that all the mental health conditions have the same criteria So they’ve got you know a couple DC’s 9433; 9434 and so on but the rating criteria is the same whether you have depression PTSD anxiety It’s the same type of factor, so how does VA rate depression Sure, so generally speaking the rating criteria for mental disorders Which as Emma just said said would be what depression what VA uses to rate depression. it’s looking at the occupational and social impairment that’s caused by your depression and the symptom your specific symptoms and how they they result in that occupational and social impairment and For each criteria. So a veteran let me back up and say that a veteran can be rated at 0% 10% 30% 50 70 or 100 so that’s the way the rating criteria is set up and for each one of those ratings there is a list of Symptoms and impairments that VA will consider to decide which rating they think the veteran fits in It’s not an exhaustive list So veterans might have symptoms that fit in with the 50% and others that seem to be more applicable to the 70% Rating and they might have symptoms Resulting from the depression that aren’t listed at all in that rating criteria and VA still needs to be considering those other symptoms as well in terms of how they affect the social and occupational Occupational impairment. Do you need to hit every criteria? Most the criteria to get the rating none of the criteria. How does that work? So there is a definite misconception that you have to have all the symptoms listed in each rating criteria for each percentage However, that’s incorrect. You have to just show they’re– They’re examples So they’re saying that you know These are some examples of what would be a 70% or 50% and you don’t need to have all of them Ideally, you should be falling within some of them. But as long as you’re showing that you know, the Occupational and social impairment that you’re experiencing falls under what they consider to be at that level I think that that’s usually enough to get you the increased ratings. And it’s a little different than maybe like an Orthopedic rating and which relies on you a very mechanical range of motion, hearing loss It has set levels like Courtney said like Michelle said the the diagnostic criteria for mental health conditions are examples So it really goes from you know, no social and occupational impairment up to total Social occupational impairment because every person is unique in how their mental health condition manifests So you certainly can get creative with your arguments and lay statements. Now a lot of times people are diagnosed with more than one mental health condition at a time So Michelle, are they gonna get two ratings for that? How is that gonna work? So as we’ve discussed earlier, um, all mental health conditions are under the same criteria So unfortunately, there’s usually no way to parse out the symptoms So they’re almost always just rated and combined together However, sometimes VA can parse out the symptoms Maybe your anxiety is one thing but your PTSD is another thing and they can they can separate them and medical opinions are there It’s very uncommon that they’re able to do it. But typically they’ll take the two diagnostic codes. They’ll give you one condition They’ll say you have PTSD with anxiety depression and it’s rated at 70% Because they can’t separate the symptoms that you have from your PTSD your anxiety and your depression. You’re not gonna get a 30 for PTSD and a 30 for depression You’re just gonna get one rating of all those symptoms as if it was one condition? Yep. But they’ll list out the different diagnoses that you might have Yep. Okay, and I think that’s important to note because sometimes we come across clients that want to file claims for you know They have anxiety and they want to file for PTSD or vice versa so certainly talk with your representative about whether or not that’s a good idea if VA is under rating you because they’re not Considering some symptoms because they say it’s due to a non service-connected Psychiatric Disability it might be worth it. But if they’re considering everything you have It might not be worth it because you’re not gonna get an additional reading by filing for service connection. And sometimes it does, you know Sometimes they’re not considering it because it’s part of another condition But sometimes you have the opposite effect where VA is considering it and saying that it’s part of that condition but if you go and file for PTSD when youre service connection for anxiety They might say well now you’re saying these symptoms are due to a non service-connected condition and we’re gonna reduce or lower your rating Yeah, so it’s just something to be mindful of when you are filing for multiple diagnoses. Okay. So what if a veteran is unfortunately hospitalized due to their depression. Do they get any special compensation for that? Yeah So if you if veterans hospitalized for 21 days or more they can get what’s called a temporary total ratings or a temporary 100% rating for the time that they are hospitalized until the time that they are discharged. If you– if a veteran’s Hospitalized and this is again assuming it’s for the depression and then the service-connected condition If they’re hospitalized for the depression for at least six months They’ll get the temporary total rating for that six months of hospitalization. And then for the six months following discharge Okay, and of course like any condition out there a veteran can get TDIU due to depression if it prevents you from working Okay, so you can either end up with a temporary rating if you’re hospitalized or if you can’t work certainly consider looking into that tdiu Rating. Are there common mistakes that VA makes when adjudicating depression claims? Yeah, I mean one of the things we were talking about previously was, you know, in-service incurrence of depression So sometimes VA will make the mistake that saying that well know your depression is due to this other event that happened while in service But it’s not related to your military service and they’re missing the fact that it still happened during military service They’ll also sometimes say that well you had depression in service but it resolved and now your depression is really due to your post service life stressors Without considering the fact that it was still you know going on maybe you just weren’t treating for it. So those are very common errors that we see and then they also try to parse out and say that oh, it’s due to your Personality disorder these symptoms. It’s not due to this anxiety that’s due to service Okay, and anything veteran to remember Courtney when claiming depression? Yeah, I think just kind of thinking back about the the things that we talked about in terms of establishing direct service connections So keeping in mind that you need the diagnosis so you need the current disability And you need to be able to point to something in service whether it is a military event or something that happened to you in service Outside of your military experience and then that medical Nexus is gonna be really important you need something tying together your current disability To your time and service or again to a condition you may already be service-connected for that has resulted in your depression Okay, Michelle anything that I think veterans need to be mindful of when claiming depression? So just because you started up claiming depression and you later get a diagnosis of PTSD Doesn’t mean that you now are required to file a new claim VA is supposed to broadly construe your claim for depression to include all Psychiatric conditions because you’re not a medical doctor you don’t necessarily know what your medical diagnosis is But you are competent to talk about the symptoms you’re experiencing and VA is supposed to be aware of that and treat cases as such Okay, great. That’s pretty much all we have hopefully short and sweet information on depression Once again, Emma Peterson with Courtney Ross and Michelle Detore from Chisholm Chisholm and Kilpatrick and we’ll see you next time

20 thoughts on “VA Disability Benefits for Depression

  1. you guys are literally fantastic, thank you for providing such valuable information to individuals like me going through a full MEB. You all have me ready to tackle every compensation exam!

  2. Wow, I have learned a lot from you all because I have a lot of symptoms and was not aware what I could claim from a related back injury while on active duty. Thanks a million

  3. my husband was diagnosed or came up with the rating for PTSD with depression and anxiety so they categorize that all together instead of using the PTSD and then secondary having depression or secondary anxiety. Is that because they consider that double-dipping so they can't list them separately they have to combine them into one?

  4. CCK is representing me now. The VA doctors placed the cast on my lower right leg too tightly in March 1999 resulting in damage to numerous right leg nerves. The VA doctors hid the damage and despite the C&P exam in Sep 2000 with the VA podiatrist stating "polyneuropathy due to tight cast", the 2 rating specialists only granted code 8622 neuritis of the superficial perineal nerve. I was never referred to neurology despite the VA primary care nurse, VA physical therapist, and VA podiatrists all mentioning nerve damage. Due to severe nerve pain and a host of secondary conditions I was forced to stop work in Aug 2006. Only in 2017 did I discover by accident that the VA has been grossly under compensating me for the last 18 years. In 2017 I had a C&P exam done by a VA nurse and in 2018 another C&P exam done by a VA physician assistant. Since 2017 to date I filed numerous claims for SMC, TDIU, nerve damage, and more and denied despite overwhelming medical proof. The VA simply ignored the DBQ's claiming loss of use of right foot, ignored the nerve study, and allowed their own unqualified examiners to overrule the countries top neurologists. I submitted 4 DBQ's from private neurologists all stating severe nerve damage and pain, that the pain affects my ability to work, and 2 neurologists stated that a prosthesis would equally serve me. In addition I have a detailed nerve study from Tufts Medical Center May 2000 proving severe nerve damage to numerous right leg nerves. I have been treated for depression for years and still being treated for depression and have been attending a pain clinic for years. I suffer from complex regional pain syndrome, neuritis, neuralgia, paralysis, atrophy, trophic changes, chronic depression, chronic sleep loss, and more. I cannot escape the horrific nerve pain and consulted for amputation. The VA did increase my nerve rating from 10 to 20% and granted 70% for depression. Yet despite the overwhelming medical proof the VA still denied SMC, TDIU, and 100% for severe multiple nerve damage. Now it's taking 7 months just for CCK to obtain my VA medical file from the VA. CCK and I are awaiting a date to speak with a judge via closed circuit TV. We are also appealing TDIU which takes 10-26 months. I also expect CCK to file CUE (Clear and Unmistakable Error) from the date of injury Feb 1999 due to VA coverup. I am due CUE from 1999, TDIU from Aug 2006, SMC, plus pain, chronic sleep loss.

  5. OMG! I filed for depression and stress in 2006 within a year after leaving active duty and I was denied depression and stress because I missed my PTSD exam and never filed an appeal. Then, I was told by my VRO I could not continue school because she thought I had PTSD. I got an exam for the PTSD 2 years later and was rated 30, 50, then 70 percent with MDD. But when I filed a claim to reopen the claim of depression the VA denied it. How can the VA treat the depression as a separate disorder whenever it suits the VA?

  6. I have 5 disorder's but they refuse of payment…I have no rating at all. They are service connected as of July 2019… When it started is June 24,1983…….36 years 3months and10days…..AGO.

  7. What if the VA had you scheduled for a future Evaluation, and they don’t contact you in writing to setup an appointment to see a C&P doctor for that supposedly Future Evaluation Appointment? Will the VA make a decision without that appointment?

  8. I am fighting for my TDIU since my back surgery in February this year and ended up with failed back surgery syndrome. I've lost my jobs and interest in doing anything. I've thought about ending myself at times because I feel worthless!. I have friends who help and have been referred to a mental health professional at the VA. I need assistance in getting answers why they keep pushing timeline far away. Can you help me?

  9. My name is Timothy A.Dobbs and I was a client of yours. I was trying to file a claim for depression. My file was closed because I couldn't be contacted. I dropped off the radar because I was admitted to the psych ward at secured heart medical Center after a suicide attempt. I was later incarcerated for 4 and a half months. My new number is 509 904 2332.

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