9210 - Other specified and unspecified schizophrenia spectrum and other psychotic disorders
DBQ: Link to Index of DBQ/Exams by Disability for DC 9210
Definition
The appearance of psychotic symptoms where there may be inadequate information to make a specific diagnosis. There may also be contradictory information or the psychotic symptoms may not meet the criteria for a specific psychotic disorder.
Etiology
Generally, causes are unknown. A preexisting personality may predispose to the development of the psychotic disorder.
Signs & Symptoms
The symptoms may include: delusions, hallucinations, and disorganized speech, or the person may remain in a fixed posture or be unable to move or talk (catatonic behavior). The person may exhibit symptoms based on the following examples:
Postpartum psychosis that may not meet criteria for other psychotic disorders.
Psychotic symptoms that have not disappeared after lasting less than a month (therefore not meeting the criteria for brief psychotic disorder); persistent hearing of voices (auditory hallucinations) without any other symptoms; persistent non-bizarre delusions with occasional mood occurrences that are present during the delusional disorder; and the presence of a psychiatric disorder whose cause has not been determined.
Tests
A comprehensive clinical assessment is conducted by obtaining a through history, and ruling out other specific conditions associated with the psychotic disorder.
Treatment
Drug therapy, supervision, and community support services are parts of the treatment.
Residuals
Persons with the condition may require short-term drug therapy and supervision.
Special Considerations
This disease shall be granted service connection although not otherwise established as incurred in or aggravated by service if manifested to a compensable degree within the applicable time limits under 38 CFR 3.307 following service in a period of war or following peacetime service on or after January 1, 1947, provided the rebuttable presumption provisions of 38 CFR 3.307 are also satisfied [38 CFR 3.309 [Disease subject to presumptive service connection], 38 CFR 3.309(a).[chronic disease].
If a Veteran is a former prisoner of war, this disease shall be service connected if manifest to a degree of disability of 10% or more at any time after discharge or release from active military, naval, or air service even though there is no record of such disease during service, provided the rebuttable presumption provisions of 38 CFR 3.307 are also satisfied [38 CFR 3.309(c) Disease subject to presumptive service connection].
May be entitled to special monthly compensation where the Veteran has a single service-connected disability rated as 100% with additional service-connected disability or disabilities independently ratable at 60% or more, which are separate and distinct from the 100% service-connected disability and involves different anatomical segments or bodily systems. See 38 CFR 3.350(i)(1) – Special Monthly Compensation (SMC).
Competency must be addressed in cases where a mental condition is initially evaluated as totally disabling or when the total evaluation is continued in a rating decision. This includes when individual unemployability is awarded or continued on the basis of a single mental health disability, and when assigning or continuing a temporary total evaluation for a mental disorder under 38 CFR 4.29 [38 CFR 3.353 [Determinations of incompetency and competency]].
Reference 38 CFR 3.384 for the applicability of the term psychosis.
Review 38 CFR 3.354 with regard to determinations of insanity
Notes
An incapacitating episode is a period during which bed rest and treatment by a physician are required.
Ratings under diagnostic codes 9201 to 9440 will be evaluated using the General Rating Formula for Mental Disorders. Ratings under diagnostic codes 9520 and 9521 will be evaluated using the General Rating Formula for Eating Disorders.
Review the special provision outlined in 38 CFR 4.125 through 38 CFR 4.129 for decisions related to mental disorders.
The nomenclature employed in this portion of the rating schedule is based upon the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM–5) (see 38 CFR 4.125 for availability information). Rating agencies must be thoroughly familiar with this manual to properly implement the directives in 38 CFR 4.125 through 38 CFR 4.129 and to apply the general rating formula for mental disorders in 38 CFR 4.130.