Opinion ID: 566839
Heading Depth: 2
Heading Rank: 1

Heading: Evidence prior to June 30, 1979

Text: 5 While Lankford complains of mental ailments since 1964, he began receiving treatment fairly regularly through the Veteran's Administration (VA) in 1974. 1 On March 28, 1974, Dr. Charles M. Robinson, clinical psychologist at the VA Hospital in Atlanta, Georgia (VAHG), performed an intake interview with Lankford and reported one of his chief symptoms was difficulty controlling his temper. Dr. Robinson noted that Lankford acknowledged problems dealing with others during his military service, especially with those of higher rank; that his wife recently had him arrested for aggravated assault; and that he had been arrested previously for assault during a family brawl. Dr. Robinson noted that Lankford was not forthcoming with information during the interview and that he revealed much socially maladaptive behavior. J. App. at 158. Dr. Robinson diagnosed an Anxiety Reaction in an individual with a passive-aggressive personality structure. Id. 6 Ms. Prentice Reynolds, the psychiatric social worker assigned to Lankford's case at the VAHG, reported in her February 6, 1975 progress notes that Lankford had been fired from his job at a dialysis clinic. She observed: He has lost several jobs in the past few years and it appears to be due to [patient's] inability to get along with others. Id. at 162. 7 On March 20, 1975, after psychological testing, Lankford was diagnosed as having passive-aggressive personality disorder, depressive reaction, chronic alcoholism and suspected incipient organic brain syndrome. Id. at 154. This report, prepared by Dr. Shirley S. LaRoche, staff psychologist at the VA Hospital in Murfreesboro, Tennessee (VAHT), also indicated that Lankford's psychological profile showed an individual with a passive-aggressive personality, schizoid features manifested by a degree of paranoid ideation, sexual conflict and maladjustment, withdrawal and regression, [and] a degree of mood fluctuation is prevalent from depression to periods of euphoria. Id. Dr. LaRoche also noted that Lankford experienced blackout spells and that he admitted to thirteen years of alcohol abuse. She also noted suicidal ideation. Id. 8 On March 29, 1975, Lankford was readmitted to VAHT after having been discharged two days earlier. He was discharged twenty-one days later with a diagnosis of passive-aggressive personality disorder and alcoholism. In September 1975 he was again admitted to the hospital after having taken an overdose of valium. He apparently had quarrelled with his wife and was having extreme anxiety because of separation from her. He also complained of insomnia, anorexia, crying spells and marital problems. The ALJ found that with treatment, Lankford adjusted to the idea of a divorce from his wife. Id. at 17. 9 On June 15, 1976, Lankford again sought admission to VAHT claiming that he had overdosed on his medication. The nurse noted a suspicion that this might have been a manipulative gesture to get into the hospital. Later, Lankford admitted that he found admission to the hospital helpful as a way to get his life back together. The doctor noted that Lankford seemed to be experiencing stress from his extended family. 10 On June 16, 1976, Lankford was admitted to VAHT for alcohol abuse and passive-aggressive personality disorder. He was treated there for 14 days. 11 The next incident occurred on May 27, 1977, when Lankford was admitted to the VA Hospital in Gainesville, Florida (VAHF) for forty-seven days after he lost control and  'slapp[ed] his wife' during an anxiety attack. Id. at 172. Dr. Director, his treating physician, at first thought that Lankford's symptoms, including anxiety, behavior problems and a persistent tremor in his hand were due to alcohol abuse. However, after more extensive examination of Lankford and his history, the doctor determined that the hand tremor was genetic, finding such a tremor in both Lankford's father and brother, who do not abuse alcohol. During this period Lankford reportedly stated that alcohol was the only drug, prescribed or otherwise, which gave him relief for his anxiety and his hand tremor. Indiral was prescribed for the tremor with good results. Anti-depressants and tranquilizers were also prescribed and seemed to help. 12 Lankford spent another week at the VAHF in September 1977 for depression and insomnia. He was released on September 22, 1977, and the physicians noted that he was considered stable regarding his affect and mood. Id. at 174. Two days later, after returning home, he was involved in a physical altercation with his neighbor and ended up in jail. The police transferred him to the VAHF on September 24, where he was admitted to avoid harm to himself and others in light of the fact that [a]t the time of admission, the patient was judged to have homicidal ideation. Id. 13 On May 16, 1978, Lankford was again hospitalized in a VA Hospital in Tennessee after having been injured the night before in a car accident. The psychology department staff experts did an analysis and it was their impression that the veteran had a past history of episodes of violence, impulsive behavior, physical complaints for which no medical basis was found, domestic strife, excessive drinking, etc. Id. at 177. Further, the staff noted that they thought that Lankford would not benefit from psychiatric treatment at the hospital. Id. In addition, an incident occurred at the hospital which is worth noting. On May 23, Lankford asked that a social worker call his wife to see if she could visit him. The social worker, unable to reach Lankford's wife, left a message. Upon hearing that the social worker had not succeeded in contacting his wife directly, he flew into a rage, was verbally abusive to the social worker, threatened suicide and left the ward in the rain saying he was going to kill himself. Four hours later he returned for his belongings and was given an irregular discharge. Id. 14 On May 26, 1978, Lankford was readmitted to VAHT for a twenty-one-day stay with a similar diagnosis of passive-aggressive personality disorder with symptomatic depression, and alcohol addiction. On June 22, 1978, he was admitted for thirty-six-day stay and was treated for chronic anxiety, hookworm infestation and persistent right knee pain. 15 On August 22, 1978, Lankford underwent a psychological evaluation by Dr. Norman L. Stephenson, staff psychologist at the VAHT. According to his reports, Lankford was unresponsive in general to the Rorschach and TAT stimulit [sic] with intermittent periods marked by hostile voice tone and facial expression, towards the examiner. Id. at 180. Dr. Stephenson opined that: 16 [U]nder stressful conditions, passive aggressive features may emerge through hostility projected onto others in his environment, or directed inward through alcohol abuse or suicide attempts. This style of relating may keep him socially withdrawn and unwilling to relate to others. Possible areas of difficulty may include: alcohol abuse, failure to establish significant relationships with others, and excessive anxiety which may be debilitating. 17 Id. at 181.