Veteran Hypochondriacs Should Not Be Denied VA Disability

While there is a great deal of stigma around being a hypochondriac, it in fact stems from a legitimate mental health disorder known as hypochondriasis. The most updated version of the Diagnostic and Statistical Manual for Mental Health Disorders, Fifth Edition (DSM-5), divides hypochondriasis into two separate conditions:

(1) somatic symptom disorder, and

(2) illness anxiety disorder.

The difference between these two diagnoses is that veterans with somatic symptom disorder have physical symptoms that are persistent and cause disruption to their daily lives. They may also have excessive anxiety about these symptoms. There is often no medical explanation for these symptoms or underlying causes other than a mental health disorder, which is why it is termed somatic.

It might take a while for a veteran to realize they struggle with this at a VA disability level. Too often, the veteran has several other presenting problems that don’t immediately point to the veteran being a hypochondriac.

Those with illness anxiety disorder rarely exhibit any physical symptoms but have disproportionate anxiety about developing a serious illness. This may manifest as frequent doctor’s visits to check their health or avoiding doctors altogether.

In this post, we will primarily discuss larger hypochondriasis, as this is a mental health disorder recognized by the VA. If you’d like to learn more about getting a somatic symptom disorder VA rating, you can check out our post specifically on somatoform disorders.

What is Hypochondriasis?

As discussed above, hypochondriasis is a mental health disorder in which a veteran has debilitating anxiety about developing a serious illness. They may exhibit some minor physical symptoms that spark anxiety or they may not. Either way, there is severe concern about their overall physical health. To receive a diagnosis of hypochondriasis, you must experience this anxiety for a prolonged period of time, usually a minimum of 6 months.

While the DSM-5 has now retired the use of this term and split it into two separate disorders, the VA still recognizes hypochondriasis and you can receive a VA rating for hypochondriasis, somatic symptom disorder, or anxiety based on the VASRD.

The hypochondriac region of the abdomen is a separate thing and is unrelated to the mental illness hypochondriasis.

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What Are the Causes of Hypochondriasis?

There are many potential causes of hypochondriasis. As with many mental health disorders, it is difficult to define a specific cause of the condition. Some possibilities include:

• Extreme trauma like domestic violence or war
• Childhood trauma (neglect, abuse)
• Extreme stress
• Family history of anxiety disorders
• Presence of other mental health disorders such as depression
• Childhood illness or other serious illness in the family

This is not a definitive list. It is clear from these potential causes, however, that veterans may experience one or more of these during their term of service which might cause hypochondriasis. Experiencing any of these before enlistment can amplify these effects during your service, too.

What Are the Symptoms of Hypochondriasis?

The primary symptom of hypochondriasis is anxiety related to developing a severe illness. This can manifest in a number of ways, such as:

• Constantly researching various illnesses or symptoms
• Avoiding people or public places for fear of contracting an illness
• Exaggerating the severity of symptoms
• Oversharing health symptoms or status with those around you
• Repeatedly checking vital body functions like blood pressure or temperature
• Obsession with normal body functions such as heart rate
• Seeking constant reassurance from loved ones that you are healthy
• Concern over healthy bodily functions such as gas

Hypochondriasis is not just a regular level of anxiety of getting sick—which most people experience at some point—but an extended and extreme type of anxiety. Other symptoms can show up if you have somatic symptom disorder, such as secondary back pain and other physical ailments. Often those with SSD use these physical manifestations as proof that something is in fact deeply wrong, even when diagnostic tests can’t find an explanation for the symptoms they experience.

For diagnosis of hypochondriasis, you will most likely need a behavioral health specialist referral, such as to a psychologist or psychiatrist. The DSM-5 has a list of criteria that patients must meet in order to be classified as having a specific disorder, including SSD.

For veterans, it is very important to get this diagnosis from a VA-approved healthcare professional. You will need to show the diagnosis in your compensation and pension (C&P) exam. While not everyone needs to undergo C&P exams in order to get their benefits, it is very common with mental illnesses, because the VA likes to evaluate them on a case-by-case basis. Your C&P exam for somatic symptom disorder or hypochondriasis will help to determine your VA disability rating and thus how much you get in monthly benefits.

Here are some tips on your C&P exam from one of our VA disability lawyers.

Does the VA Recognize Mental Health Disorders?

Yes, the VA does recognize mental health disorders. However, it can be a challenge to get higher ratings for mental health-related illnesses. A lot of headway has been made in recognizing the severity of mental illness and how it can affect someone’s day-to-day life. But because the diagnosis can be more subjective due to the lack of physical symptoms, it is often more difficult to get approved for disability benefits. It is also often more challenging to prove a service connection since mental illness can be triggered by many different things. Further, each individual veteran can have a different mental health reaction to the same event.

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The VA doesn’t usually give 100% TDIU for just a single disability. They typically add up disabilities and veterans meet the criteria like this:

1. You have at least 1 service-connected disability rated at 60% or more disabling, or 2 or more service-connected disabilities—with at least 1 rated at 40% or more disabling and a combined rating of 70% or more—and
2. You can’t hold down a steady job that supports you financially (known as substantially gainful employment) because of your service-connected disability. Odd jobs (marginal employment), don’t count.

Taken from https://www.va.gov/disability/eligibility/special-claims/unemployability/

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The VA uses a general rating formula for mental disorders that is similar to the physical illness rating system. It is based primarily on how debilitating the illness is and your capacity to hold down a regular job. Typically, mental health disorders are rated at 30%, 50%, 70%, or 100%. A rating of 70% indicates a fairly severe illness that affects your ability to work and interact in a healthy way with friends and family. Thirty percent indicates a milder mental health concern, where you have difficulty with certain daily tasks, and may not be completely reliable for work, but are still able to keep a part-time job.

In some cases, the VA may issue a 0% rating. This acknowledges the existence of a specific mental health disorder, but an assessment that the organization doesn’t believe affects the veteran’s life in a meaningful way. If you receive a 0% rating, you should definitely appeal. Make sure to detail the effects of your illness on your daily life. Woods & Woods can help with this appeal process to ensure that you are presenting all the relevant information.

One bonus to a 0% rating is that the VA acknowledges a service connection. From there we can work on your appeal from the perspective of how severe your symptoms are. You can also get SMC money with a 0% rating, which is a start.

Here, one of our VA disability lawyers talks about what we do when we appeal your case to the Veteran’s Administration.

On the opposite end of the spectrum, it is possible to receive a 100% rating for severe mental illnesses. These are usually very apparent and reserved for people who are socially unresponsive, catatonic or have persistent delusions and hallucinations that medication cannot control. Veterans with this rating are often discharged right into a mental healthcare facility.

The hypochondriasis VA rating, VA disability rating for major depression and anxiety, VA rating for chronic PTSD, and other mental health disorders are extremely important and can vary greatly. This is why it can be useful to employ the services of experts in dealing with the VA to help you present your case. These are challenging topics to discuss and you don’t have to negotiate with the VA alone.

The General VA Rating Formula For Mental Disorders

How to Get a Hypochondriasis VA Rating

To get a hypochondriasis VA rating, you must show your diagnosis and prove that the illness is connected to your time in service. This is often a challenging task, even for physical injuries. It can be even more challenging with mental health disorders. Now that the DSM-5 is no longer using the term hypochondriasis, but it is still used by the VA, you may have to work with your doctor to ensure that your paperwork uses the correct terminology. Thankfully, somatic symptom disorder and illness anxiety disorder are also recognized by the VA. If you are diagnosed with either of these conditions, you may still get VA disability benefits.

Of course, because of the stigma surrounding the use of the word hypochondriac, many people who have this illness will not accept this diagnosis. There is a perception that it is an invented illness, when, in fact, it is a recognized mental health disorder. Many with hypochondriasis may also find it difficult to accept that they have a mental health disorder and not a physical illness. For others, having a diagnosis can be very comforting.

Regardless, if there is a diagnosis of hypochondriasis, the veteran then needs to establish a cause that is related to the term of service. Any degree of trauma can cause this mental health disorder, so it’s simply about making a strong enough case to the VA med board. Woods & Woods is very adept at arguing cases such as this, that involve complex evidence. We can help veterans and their loved ones get the maximum benefits possible.

Here one of our VA disability lawyers goes over the questions Woods and Woods, The Veteran’s Firm, is often asked about veterans’ disability claims and appeals.

What to Do If Your Rating is Too Low

If you undergo the C&P exam but feel that the rating you receive is too low, you should absolutely appeal. As we’ve discussed frequently above, mental health disorders are perceived as more subjective and thus are often not rated appropriately. The most important thing you can do to plead your case is to demonstrate how your illness affects your daily life and ability to earn an income.

It is also possible, in certain circumstances, to get more money for a low disability rating through a scheduler agreement or holistic addition. The scheduler agreement pertains to how the disability manifests, so while the rating may generally be accurate, you may still argue that you need additional income because of a variety of reasons.

The holistic addition relates to the full picture of your overall health. So while you may have a disability rating for anxiety of 30%, if you also have other mental health or physical ailments, you can qualify for an addition to your rating that will get you additional benefits.

Here one of our VA disability lawyers talks about how SMC (Special Monthly Compensation) works to help you get more money for extra expenses related to your disabling condition every month.

The main takeaway is this: If you feel your service-induced mental illness has led you to experience debilitating effects, you shouldn’t just accept the first evaluation of your situation. Woods & Woods can help you work through the complicated appeals process to get you the benefits that you deserve.

Mental health is extremely complicated. We, as a society, are still working through the stigma that surrounds it. We know many veterans experience some degree of mental illness upon leaving the service. Thankfully, the VA has made an effort to recognize this and compensate veterans accordingly. There is still work to be done, and having an advocate on your side can be immensely helpful in pleading your case.

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We’ve Helped Thousands of Veterans, Many with Mental Health Disabilities

Reach out today for a no-obligation evaluation of your situation. Our lawyers will be happy to discuss your case with you and give their honest opinion on whether we can be of help. Our goal is to make sure that veterans are getting the VA disability benefits they need to live. Don’t hesitate to ask for help.

At Woods and Woods, the Veteran’s Firm, we’ve helped thousands of veterans with their VA disability applications and appeals. We’ve been adding staff and lawyers during the Covid pandemic to serve disabled veterans better in difficult times.

Call us today to discuss your VA disability appeal or your first application. The call is free and we won’t charge you a single fee until we win your case. We even pay for the postage for all of the documentation you send to our office. You can look for a VA disability attorney near you or call us and join the thousands of veterans living off of VA disability thanks to Woods and Woods.

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