How do VA examiners really grade mental health conditions?

TallTree

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I was just diagnosed with Bipolar II and have a lithium prescription that works great. I understand that I'll probably be going to an MEB soon, and have been researching as much as I can to be ready. Something I'm confused about is how the VA examiners really rate a subjective condition like bipolar. I have a copy of the mental disorders DBQ, and see there's a bunch of check boxes for things like:

- Flattened affect
- Mild memory loss, such as forgetting names, directions or recent events
- Inability to establish and maintain effective relationships

and obviously much more. So do they simply just ask if I have these sympoms? Because I do get a lot of them during my manic/depressive phases, but not necessarily all the time, and with my luck not during the exam. So do I tell them just that? Do I need to tell my psychologist or psychiatrist so they can write it in their notes? Do I need to actually go to couples therapy to document that this condition is damaging to my marriage?

Any insight is appreciated. If it makes a difference, I'm 11 years active duty AF.
 
When I did my mental health C&P, they asked a bunch of questions. Do you experience "x,y,z symptom" and just had a conversation about it. Mine was for anxiety/depression, so it was basically me telling them how my anxiety/depression impacts my life in and outside of work. There's a checklist on the C&P exam form and then they have a write up at the end.

The DBQ is 5 pages long but goes over occupational/social impairment, history, any relevance to your occupation and education, any prescribed medications, any legal/behavior history, substance abuse, the checklist of symptoms, and behavioral observations (notes from the examiner basically). At the end, they write any other remarks they have which on mine was essentially a summary of everything they marked down in the separate sections. Hope that helps some, I don't have any experience with bipolar myself but the DBQ is for mental disorders (other than PTSD/eating disorders).

As for how it has impacted your marriage, I have seen others talk about getting buddy letters which could also be from your wife. She can write a letter discussing how your diagnosis has impacted your marriage.
 
I’m sure this is implied, but are those buddy letters specifically written for the exam or are they for the MEB Board as a whole?
 
You will be interviewed and your records reviewed. The review will identify symptoms, if any. The symptoms, if any, will then be parlayed into a diagnosis.

The reason the the form has things like "flatten affect".... is MH diseases require ertain things to be diagnosed. Each MH condition has its own criteria. The examiner must check enough blocks to support his/her diagnosis.
 
Ah I see, so basically I need to have my symptoms documented with my psychologist at mental health so they're in my records, then perhaps discuss them with the examiner during the interview. Seems pretty straight forward.
 
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