| 1 | DVBCWME8 ;BPOIFO/RLC - MENTAL DISORDERS (EXCEPT PTSD & EATING DISORDERS) ; 12/27/06 3:02pm | 
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| 2 | ;;2.7;AMIE;**118**;Apr 10, 1995;Build 3 | 
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| 3 | ;Per VHA Directive 10-92-142, this routine should not be modified | 
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| 4 | ; | 
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| 5 | TXT ; | 
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| 6 | ;;E. Diagnosis: | 
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| 7 | ;; | 
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| 8 | ;;    Provide: | 
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| 9 | ;; | 
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| 10 | ;;    1. The Diagnosis must conform to DSM-IV and be supported by the findings | 
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| 11 | ;;       on the examination report. | 
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| 12 | ;;    2. If the diagnosis is changed, explain fully whether the new diagnosis | 
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| 13 | ;;       represents a progression of the prior diagnosis or development of a new | 
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| 14 | ;;       and separate condition. | 
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| 15 | ;;    3. If there are multiple mental disorders, delineate to the extent possible | 
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| 16 | ;;       the symptoms associated with each and a discussion of relationship. | 
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| 17 | ;;    4. Evaluation is based on the effects of the signs and symptoms on | 
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| 18 | ;;       occupational and social functioning. | 
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| 19 | ;; | 
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| 20 | ;;    NOTE:  VA is prohibited by statute, 38 U.S.C. 1110, from paying compensation | 
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| 21 | ;;    for a disability that is a result of the veteran's own ALCOHOL OR DRUG | 
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| 22 | ;;    ABUSE.  However, when a veteran's alcohol or drug abuse disability is | 
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| 23 | ;;    secondary to or is caused or aggravated by a primary service-connected | 
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| 24 | ;;    disorder, the veteran may be entitled to compensation.  See Allen v. | 
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| 25 | ;;    Principi, 237 F.3d 1368, 1381 (Fed. Cir. 2001).  Therefore, it is important | 
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| 26 | ;;    to determine the relationship, if any, between a service-connected disorder | 
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| 27 | ;;    and a disability resulting from the veteran's alcohol or drug abuse. | 
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| 28 | ;;    Unless alcohol or drug abuse is secondary to or is caused or aggravated | 
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| 29 | ;;    by another mental disorder, you should separate, to the extent possible, | 
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| 30 | ;;    the effects of the alcohol or drug abuse from the effects of the other | 
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| 31 | ;;    mental disorder(s).  If it is not possible to separate the effects in | 
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| 32 | ;;    such cases, please explain why. | 
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| 33 | ;; | 
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| 34 | ;;F. Global Assessment of Functioning (GAF): | 
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| 35 | ;; | 
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| 36 | ;;    NOTE:  The complete multi-axial format as specified by DSM-IV may be | 
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| 37 | ;;    required by BVA REMAND or specifically requested by the rating specialist. | 
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| 38 | ;;    If so, include the GAF score and note whether it refers to current | 
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| 39 | ;;    functioning.  A BVA REMAND may also request, in addition to an overall | 
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| 40 | ;;    GAF score, that a separate GAF score be provided for each mental disorder | 
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| 41 | ;;    present when there are multiple Axis I or Axis II diagnoses and not all | 
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| 42 | ;;    are service-connected.  If separate GAF scores can be given, an explanation | 
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| 43 | ;;    and discussion of the rationale is needed. If it is not possible, an | 
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| 44 | ;;    explanation as to why not is needed. (See the above note pertaining to | 
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| 45 | ;;    alcohol or drug abuse.) | 
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| 46 | ;; | 
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| 47 | ;;G. Effects of the Mental Disorder on Occupational and Social Functioning: | 
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| 48 | ;; | 
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| 49 | ;;Evaluation of Mental Disorders is based on their effects on occupational | 
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| 50 | ;;and social functioning.  Select the appropriate assessment of the veteran | 
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| 51 | ;;from the choices below: | 
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| 52 | ;; | 
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| 53 | ;;   - Total occupational and social impairment due to Mental Disorder signs | 
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| 54 | ;;     and symptoms. | 
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| 55 | ;; | 
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| 56 | ;;     Provide examples and pertinent symptoms, including those already reported | 
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| 57 | ;; | 
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| 58 | ;;                             OR | 
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| 59 | ;; | 
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| 60 | ;;   - Mental Disorder signs and symptoms result in deficiencies in most of | 
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| 61 | ;;     the following areas:  work, school, family relations, judgment, | 
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| 62 | ;;     thinking, and mood. | 
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| 63 | ;; | 
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| 64 | ;;     Provide examples and pertinent symptoms, including those already reported | 
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| 65 | ;;     for each affected area. | 
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| 66 | ;; | 
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| 67 | ;;                             OR | 
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| 68 | ;; | 
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| 69 | ;;   - There is reduced reliability and productivity due to Mental Disorder | 
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| 70 | ;;     signs and symptoms. | 
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| 71 | ;; | 
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| 72 | ;;     Provide examples and pertinent symptoms, including those already reported. | 
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| 73 | ;; | 
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| 74 | ;;                             OR | 
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| 75 | ;; | 
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| 76 | ;;   - There is occasional decrease in work efficiency or there are intermittent | 
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| 77 | ;;     periods of inability to perform occupational tasks due to Mental Disorder | 
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| 78 | ;;     signs and symptoms, but generally satisfactory functioning (routine | 
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| 79 | ;;     behavior, self-care, and conversation normal). | 
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| 80 | ;; | 
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| 81 | ;;     Provide examples and pertinent symptoms, including those already reported. | 
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| 82 | ;; | 
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| 83 | ;;                             OR | 
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| 84 | ;; | 
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| 85 | ;;   - There is Mental Disorder signs and symptoms that are transient or mild, | 
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| 86 | ;;     which decrease work efficiency and ability to perform occupational | 
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| 87 | ;;     tasks only during periods of significant stress. | 
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| 88 | ;; | 
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| 89 | ;;     Provide examples and pertinent symptoms, including those already reported. | 
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| 90 | ;; | 
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| 91 | ;;                             OR | 
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| 92 | ;; | 
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| 93 | ;;   - Mental Disorder symptoms require continuous medication. | 
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| 94 | ;; | 
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| 95 | ;;                             OR | 
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| 96 | ;; | 
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| 97 | ;;   - Select all that apply: | 
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| 98 | ;;   - Mental Disorder symptoms are not severe enough to require continuous | 
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| 99 | ;;     medication. | 
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| 100 | ;;   - Mental Disorder symptoms are not severe enough to interfere with | 
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| 101 | ;;     occupational and social functioning. | 
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| 102 | ;; | 
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| 103 | ;;Include:  your name; your credentials (i.e., board certified psychiatrist, | 
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| 104 | ;;licensed psychologist, psychiatry resident or psychology intern, | 
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| 105 | ;;LCSW, or NP); circumstances under which you performed the examination, | 
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| 106 | ;;if applicable, (i.e., under the close supervision of an attending | 
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| 107 | ;;psychiatrist or psychologist); name of supervising psychiatrist or | 
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| 108 | ;;psychologist, if applicable. | 
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| 109 | ;; | 
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| 110 | ;; | 
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| 111 | ;;Signature:                                          Date: | 
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| 112 | ;; | 
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| 113 | ;; | 
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| 114 | ;; | 
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| 115 | ;;Signature of Supervising | 
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| 116 | ;;  Psychiatrist or Psychologist:                     Date: | 
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| 117 | ;;END | 
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