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- Hi and welcome to Hill and Ponton
Veterans Disability blog.
I'm Natalia Jofre, the company COO,
- And I'm Attorney Melanie Williams.
- And today we're gonna be talking about,
Adjustment Disorder, and adjustment disorder with anxiety.
So, Melanie, I had never heard of adjustment disorder,
why don't we start with the basics?
Can you tell us what adjustment disorder is?
- Yes, so adjustment disorder is the inability
to adjust to a stressful life event,
or something traumatic.
so you have a hard time,
coping with something that you went through,
and you have a stronger reaction than is expected.
So usually, the symptoms,
after you go through this stressful
or traumatic incident could be,
feeling sad or hopeless, feeling stressed.
A lot of times they're even physical symptoms,
like if you have headaches, or fatigue or indigestion,
So basically just some kind of,
difficulty coping with something that happened.
It typically last,
an acute adjustment disorder would be something that lasts,
no longer than six months.
But it can also be chronic,
when it continues to bother you and disrupt your life.
- Okay. And so hence begs the question,
what about adjustment disorder with anxiety?
- Yeah - How do those play together?
- Yeah, so adjustment disorder disorder with anxiety
is gonna be specifically,
having symptoms of anxiety
with the adjustment disorder.
So feeling overwhelmed, feeling anxious, feeling worried.
There are actually six different types
of adjustment disorders,
So - Wow
- Yeah. So not only with anxiety,
but there's also with depressed mood,
You could have a combination of anxiety and depressed mood.
You can have disturbance of conduct,
as well as mixed disturbance of emotions and conduct,
or it could just be unspecified adjustment disorder.
So it's just gonna depend on the type of symptoms,
and behavior that you're exhibiting.
- Gotcha. Do you find anxiety
to be a common condition amongst veterans?
- Yes, absolutely. The statistic is 10% of veterans report
elevated levels of anxiety
and 7% of veterans have been diagnosed with,
an adjustment disorder specifically.
The reality of it is,
it's probably much much higher than that,
because a lot of times veterans,
don't report these things,
or they may not be willing to admit it,
but it's especially with among the clients that we have.
it's it's very, very common.
- Okay,I know with PTSD,
there's triggers. Right.
So how about with adjustment disorder?
Are there, have you noticed any any certain triggers,
for adjustment disorder as well?
- Yeah, absolutely.
So it's, it probably will look a lot like what
a PTSD stressor will look like.
So it could be the death of a family member.
It could also be a major life change or an illness.
A lot of times we see veterans diagnosed
with adjustment disorder in service,
when they are having difficulty performing,
or just showing different disciplinary,
they're required different types of disciplinary action
because of how they're acting and stuff like that.
And so, just being in the military,
because it's so different from the life
that they're used to
It's a whole new environment,
that alone sometimes can trigger adjustment disorder,
as well as any stressor or traumatic event
that they gone through,
being in combat or whatever the case may be,
just like with PTSD.
So it can be, a specific one incident,
or it could just kind of be a major life change or event.
- Got it.
How is adjustment disorder with anxiety,
different from just anxiety,
when I say just,
I know that anxiety is a significant condition.
But so how do you differentiate the two?
- Yeah. So, adjustment disorder,
is gonna be experiencing psychological
or behavioral symptoms,
due to an identifiable stressor.
Yeah, and it's usually within three months
of that identifiable stressor,
that's what the diagnostic criteria is gonna look for.
Anxiety could be general anxiety,
there are lots of different ways,
that it could look like,
while adjustment disorder specifically
is gonna to relate to,
a specific instance or event
that you're going to have trouble adjusting to.
- Can you give me an example.
So I guess I wanna understand
like if you were a victim of military sexual trauma,
or if you were shot at,
or something like that,
like, is that what you're talking about
in terms of a specific event?
- Yes. - Okay. Okay. Okay.
- Yeah. And and it doesn't have to be something,
as traumatic as that.
People outside of the military
can also experience adjustment disorder.
But usually, it's gonna point to,
something specific like that,
or like the death of a family member,
or if you were diagnosed with cancer,
or something along those lines.
- Just in a nutshell,
can you give us an idea
of what some of the more specific symptoms are?
- Yeah. So again, if we're talking about
adjustment disorder with anxiety,
there's gonna be a feeling,
obviously, of anxiety, being worried,
just feeling of overwhelmed.
Adjustment disorder in general is gonna have symptoms,
kind of like any other mental illness,
where you will experience hopelessness, depression,
anything along those lines,
but you can also have physical symptoms because of it.
So, when the stress is so severe
that it causes headaches,
that it causes daily fatigue,
and even, indigestion,
things like that.
- Wow. Okay. So next question is the usual question,
can you actually receive benefits,
as a result of adjustment disorder?
- Yes, absolutely.
So it's going to be the same as any other mental condition.
If you can prove that either it started in service,
and you have that same condition now,
or if you have it due to something that happened in service,
and you're able to establish that Nexus
or that link between the two,
You can get service connected for adjustment disorder,
just like any other mental condition.
- Okay, and how about,
as a secondary service connected disability,
so if the veteran is already receiving,
permanent service connected benefits,
and now they're being affected
by adjustment disorder or issues,
is it possible to do something like that?
- Yes, Yes, for sure.
So if you are service connected for an illness,
and that causes you to have adjustment disorder,
which, like we mentioned is very possible,
let's say your service connected for a cancer or diabetes,
and you have a hard time adjusting to that,
and then develop this mental condition,
because of that, you can get service connected,
for your adjustment disorder.
And even the other way around,
if you're service connected for adjustment disorder,
and then you have physical symptoms because of that
and you develop those really severe headaches
or the indigestion leads to,
abdominal condition or something along those lines,
you can get secondary service
connected for those issues as well.
- Okay, great.
What sort of evidence is helpful,
to prove these claims in order to get benefits?
- Yeah. So it's gonna look like
any other mental condition
that you're trying to get service connected for.
So you'll want a doctor's opinion,
you'll want a clear diagnosis from a doctor,
as well as treatment records.
So, continuity of symptoms,
showing that you have been getting treatment for this,
being able to point to,
what incident it is that caused this
having a doctor provide that nexus,
between service and the condition.
And even buddy statements.
we've talked about that a lot before
- The sacred buddy statement.Yeah.
- Yes, exactly, having other people in your life,
talk about the symptoms,
before this incident happened,
you were fine,
and then afterwards, you started exhibiting
all of these symptoms,
whether it's, service itself
or something that happened in service.
- I was talking to Rachel about,
all of these things that are now affected with COVID,
and we talked about CMP exams
and how they're being handled differently now,
in our new normal,
as are we as we're currently working
from home CMP exams here,
how would they be handled?
Or do they?
(clears throat)
Pardon me?
Do they issue a CMP exams for adjustment disorder?
And are they any different from any others?
- They're gonna look the same
as other CMP exams for mental conditions.
So, for PTSD,
there's a specific list of questions that they go through,
but for other conditions,
it's basically a general kind of questionnaire
a general questions that they ask about
your symptoms, they will diagnose you with a condition,
so they will try to find out what the proper diagnosis is,
they'll find out your symptoms,
the frequency, the severity,
and then make an opinion from there.
So it'll, - Okay
- They'll ask you about the same questions
all the time. - Okay
So once they do all of that,
how do they rate it?
How do they rate adjustment disorder?
And are there any caps?
because I think with tinnitus, there's a 10%. Right.
- Okay, Exactly.
- So anything like that with adjustment disorder?
- Yeah. So mental disorders in general,
are rated at either 0%, 10%, 30%,
50%, 70%, or 100%.
So you can get a 100% rating,
for adjustment disorder
or any other mental condition.
They will be the same thing they'll be looking at,
the symptoms and how those symptoms affect
your everyday life,
affect your ability to function occupationally and socially.
So they will look at things like,
are you able to establish and maintain relationships?
Are your symptoms controlled with medication?
Do you have a hard time
adjusting to stressful circumstances,
or are you able to take care of your daily activities,
like your personal hygiene and things like that.
So depending on the severity,
they'll assign a rating of any of those
that I mentioned.
- Okay, great. Any common issues
with these types of claims
that you can maybe for warn people about,
or any other recommendations you can make?
- Yeah, I think the biggest thing is,
establishing the diagnosis,
because mental health conditions,
the symptoms look so similar,
and whether you have a stressor,
whether it started in service,
you'll just wanna make sure that
the doctor has a clear idea of,
what you're going through,
what you're experiencing
to be able to properly diagnose you.
But remember that,
you can only get service connected for,
or you'll only get a rating,
for one service connected mental condition.
So oftentimes, it doesn't necessarily matter,
what the diagnosis is,
or what the condition is,
as long as you're able to connect it to service,
you'll still only get that one rating
for one mental condition.
- Okay. All right. Great.
All right, Melanie, thank you so much.
We hope you'll enjoy,
enjoy us again,
we hope you'll join us again.
We do hope you're enjoying yourself,
by the way when we do these as well.
But we do hope you'll join us again,
if you have any questions or concerns in the meantime,
please feel free to visit our website,
or call our office.
Thank you.
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