| 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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