TDRL

[tdrecord]

Originally Posted by Jason

... many times the Soldier no longer has current documentation of their condition. On active duty, the Soldier often had detailed records and good documentation. But after being temporarily retired, Soldiers circumstances often change. Sometimes there is no Troop Medical Clinic or Military Treatment Facility (MTF) nearby and they may not be able to take time off from work to get proper treatment. The result is that their records are sparse and the Board has no evidence to support a higher rating. As a result the Soldier loses their benefits. This is especially prevalent with Asthma and Migraine cases. I cannot stress enough how important it is to have evidence of your condition over a minimum of several months. It is not nearly as helpful to document one or two pieces of evidence right before the formal Board. Recent evidence without any previous documentation can sometimes be viewed by the Board as being manufactured or untrue. In order to prevent this, Soldiers need to get documentation of their condition, especially within the 4-5 months prior to their re-evaluation. Soldiers need to go to their medical appointments, pick up their prescriptions, and comply with their treatment plan....

Jason,

One thing the SM can do is to keep a migraine log/diary and document every episode. Include in the log the medicines prescribed and dosage. Be sure to update this section whenever the dosages or medicines change. Describe the episode, including the severity, the duration, what triggered the episode or what the conditions were immediately preceeding the episode. Also include a notation on how it affected their job. (e.g., did it occur on the job and result in lost productivity for their employer, did it prevent them from going to work, etc.) Then take this diary/log to every doctors appointment and show the log to the doctor. Once the doctor reviews the log, they will usually include the patient reports in their notes. Then the SM can provide the patient records to the board for the documentation needed.

[rreed454]

The statements you made Jason regarding not getting the proper care on TDRL are spot on. If you are on TDRL make sure you are educated. After I was put on TDRL and left service I was not assigned a PEBLO and had no one to answer my questions.
At my second evaluation, the doctor I saw at Camp Pendleton was a reservist and when I walked into his office he asked me what I was here for. I explained to him that I was on TDRL and he didn't even know what that was. He asked me what he was suppose to do! I was dumbfounded and he told me he would take care of it. I was on TDRL for Type 1 Diabetes and this doctor did a "full and thorough" examination of the condition in under 5 minutes. From the time I was in his office to the time I left was around 7 minutes. I left that place with a bad feeling.
The board reviewd my case and guess what, they moved me from 40% to 20%. I then went requested a FPEB, went to Washington and testified. I explained the incompetencies of the medical doctors and all the issues regarding my condition. After months of deliberation, I was given 40% PDRL.
It was a long drawn out and stressful process that could have easily been avoided if the military trained the doctors how to handle TDRL cases and if I would have better educated myself about the process and told the doctor what needed to be done in a more proper and systematic way.

Thought I would share that stuff like that does happen.

[Jason]

tdrecord,

That is a good tip, and I agree that it is an effective way to get migraines documented. Thanks for sharing!

[Jason]

rreed454,

Thanks for sharing that experience. Your experience with the TDRL re-exam really shows a systemic problem with MEBs and TDRL re-exams in general. That problem is that there is not much training for military doctors on the administrative requirements and importance of the MEBs/re-exams and the MEBs are de-centralized. What that means is that you can end up with very inconsistent results depending on what doctor at what MTF prepares the medical evaluation/NARSUM.

Contrast this with the PEB, which tends to give more consistent results because they are centralized. What ends up happening is that in some cases, the PEB will kick back a sub-standard MEB to the MTF for correction. However, a real problem with the PEB as "gatekeeper" is that the doctor doing the eval at the MTF has eyes on the patient and is is a much better place to make a judgment about a Servicemembers physical condition than the IPEB, who only has the records (including the substandard eval) in front of them with which to make a judgment. I don't know that you can centralize the MEBs any more, because the doctors have to be out at the MTFs, but I think it is important to realize the issue and to understand through cases like yours that the MEB is a very important step in the process and getting accurate info in the records is key to a good result.

Thankfully, you were able to get an ultimate good result. Thanks for sharing your story!

[WJBROWN43]

. I was on TDRL for Type 1 Diabetes and this doctor did a "full and thorough" examination of the condition in under 10 minutes. From the time I was in his office to the time I left was around 8 minutes. I left that place with a bad feeling.
The Navy reviewd my case and guess what, they moved me from 40% to 20%. I then went requested a FPEB, went to Washington and testified. is their anyone out there can help me with this.

[Jason]

WJBROWN43,

Welcome! What were the results of the Formal PEB?

What help are you looking for? Do you have any specific questions/concerns?

[ksbcde]

Ok, I just got my letter and they are placing me on TDRL with 60%. I have lung disease due to the sulfur fires in Iraq 2003. This all just came threw today so we still have our 10 days for review. I was looking for help in the pros and cons of TDRL. At this point I am looking for any advice. Thank you.

[Jason]

ksbcde,

First, I think it is important to recognize that it is very difficult to convince the PEBs to change their mind regarding the TDRL vs. PDRL determination.

The biggest con is the fact that the TDRL is a temporary finding. At the re-evaluation, you may be found stabilized and retired, continued on TDRL (for up to 5 yeards total), stabilized and separated, or found fit.

I think the other question to ask is what outcome would you be looking for? If you want a higher rating, I think you should also consider the interaction between your military compensation and VA compensation. This will be fact specific based on your years of service. Did they make a finding regarding whether your injuries were "combat-related"? I know some about the sulfur-fires, depending on the circumstances of what you were doing, there may be an argument that you should be considered "combat-related" both for military disability compensation purposes and for CRSC, which will then further impact your decision.

[ksbcde]

Jason,

Thank you so much for the info. It is believed that they put me on TDRL since my breathing test are not stable and continuing to get worse. They did not put it combat related and I believe we are going to appeal that. I was at Q-West and was a crew chief on the Black hawk helicopter. We flew threw this fire all the time. I currently only have 50% lung function. Any advice in getting the combat related changed?

[Jason]

Like most things in this system, it is all about having good evidence.

Letters from commander or superiors documenting your being there and the circumstances, flight logs, AAR's, etc. That type of stuff would help getting you to the exposure part.

I would also think it would be helpful getting evidence of symptoms soon thereafter (sick call slips, statements from others documenting symptoms, LODs, etc.). Or perhaps an opinion letter from a pulmonologist (or other MD if you can't find a respiratory specialist) stating an opinion that your condition was caused by the exposure.

If you have an LOD that states your condition was caused by flying over fumes, I think you may have enough evidence right there. Of course, the question then becomes if they believe these facts equals "combat-related." If the facts are not in dispute, then it is a legal argument that you are disagreeing about.

Best of luck!