How to Maximize Your Coverage with Mental Illness Diagnoses
Welcome to the Texas Mental Health Directory!
My name is Darrell C. Scott, Editor-in-Chief, and during my 10-years working in Mental Health as a Medical Writer and VP of Clinical Operations, I've clocked in 5-years of coordinating and generating the necessary documents treating Mental Health providers needed to assist Texas Veterans with completing ongoing claims for Disability Benefits and have seen a 100% success rate at getting veterans' benefits approved.
The application process can be convoluted, frustrating, and slow and the Texas VA Office does not have the best customer service. Without the proper guidance and carefully worded documentation will likely increase the chances of your claim being denied, or you may receive less coverage than you deserve.
Below, I will discuss how Texas Veterans can leverage their Mental Illness to increase their coverage to potentially 100%.
WHERE TO START?
1. Establish Treatment with a Qualified Mental Health Provider.
If you have a history of seeing a psychiatrist, this is a good start. However, your visit history must be current and consistent. The VA wants to see that you are not only professionally diagnosed, but also that you are actively seeking treatment and participating in your mental health.
You want a mental health history that dates back at least 2-5 years, with evidence of recent or continued exacerbation in your symptoms within 6-months to 1-year at the time you begin the application process.
When discussing your claim with your provider, be sure to be open, honest, and as detailed as possible about your experience in the military and the events that contributed to your current condition.
Recommendations for treatment:
A.) Visit with a Psychiatrist or Psychiatric Nurse Practioner for an updated Psychiatric Evaluation & establish monthly medication management visits |
B). Establish Trauma Therapy with a qualified Clinical Psychologist/Therapist |
2. Obtain Military Records/ Copy of DD-214
You will need a copy of your complete Military Records, which should also include a copy of your Certificate of Release or Discharge from Active Duty (DD214).
It's best to get a jump start on this while in treatment because at the time this article is being written the VA Records Department is only fulfilling Medical Record Requests for what they deem an "Emergency"
Unfortunately, Disability Claims for mental illness do not qualify as an emergency. It can take up to 6-months or longer to secure your records from the VA office.
Your Psychiatric Nurse Practioner or Psychiatrist will need to review your Military Records and utilize them when completing your DBQ and Nexus Letter. You cannot complete the claim without them.
3. Complete the Appropriate Application Forms
When applying, you will need to have downloaded the appropriate DBQ form for your Diagnosis. I have provided the 2 most commonly used forms below.
What is a DBQ?
DISABILITY BENEFITS QUESTIONNAIRE.
These are elaborate questionnaires that require a clinical summary of your mental health diagnosis, symptoms, treatment history, medication history, etc... All of these variables must be related to the primary diagnosis for which the patient is applying for the benefits. The diagnoses provided must be attributed to the trauma the patient has experienced as a result of their service in the military and supported in the patient's military records, medical records, and mental health records.
This form must be completed by a licensed Psychiatrist or Psychiatric Nurse Practitioner
COMMONLY APPROVED DIAGNOSES:
Post Traumatic Stress Disorder (PTSD) |
Major Depressive Disorder (MDD) |
Schizoaffective Disorder |
Traumatic Brain Injury (TBI) |
Please note that these are not the only qualifying Mental Illness Diagnoses, however, these are the major players and are often accompanied by subsequent diagnoses such as Primary Insomnia, Generalized Anxiety Disorder, or Bi-Polar Disorder.
4. NEXUS LETTER
What is a Nexus Letter?
A Nexus Letter is a detailed diagnosis letter that serves to tell your story and connects the traumatic events of your past to your current diagnosis.
The claims made in this letter must be supported by clinical evidence and literature.
Where can I get a Nexus Letter?
1. Your Treating Psychiatrist Office
Every provider is different and you will need to confirm with your doctor's office regarding their specific Nexus Letter/Veteran services.
2. D.S.E.Publishing Medical Writing Services
Outsourced Letter: This letter is usually drafted by DSEP on behalf of your treating provider who may or may not have the time to write one for you in their hectic schedule.
DSEP essentially acts as a ghostwriter and drafts the letter on behalf of your treating provider
DSEP has 5-years of experience drafting Nexus Letters and Diagnosis Letters for Houston Veterans and has worked alongside the prominent Tranquility BHC in assisting their patients with their VA Disability Claim needs
This letter will need to be submitted to your treating Psychiatrist for a final signature. Please visit DSEPublishing.com to learn more!
3. Tranquility Behavioral Health Clinic
This office offers excellent Veteran Disability Claim services and has been a go-to office for these types of documents.
The benefit of going to Tranquility BHC for your Nexus Letter needs is that they also work with DSEPublishing to generate your Nexus Letter and they have been successful in assisting Houston veterans to get the benefits they need for 10 years.
Please be advised that you will need to have been an established patient with verifiable treatment history for your condition before you can qualify for these services
5. File Claim/Submission to the VA Office
To file a claim, you will need to visit the Texas Veterans Commissions website to open your claim.
All the above-mentioned documents are guaranteed to be requested during the claim submission process. However, the VA office has claim advisors that will assist you throughout the process and will outline any additional documents they will need to get your claim approved.
Hopefully, after reading this article, you will be able to open your claim with these documents ready to go, as securing them can take months or even up to a year and will inevitably prolong the approval process.
