[613] | 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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