independent medical

[embalmerswife]

Anyone asked for an independent medical advocate and get one? I now the regs were supposed to be published by July 1, but the Army didn't meet the deadline. We have a soldier here that needs one, but our base is telling them they have no idea what he's talking about. Does your MTF appoint one? Does your MTF pay? Does your MTF schedule? Is the IMA a doctor? an advisor? Anyone seen the actual reg. on paper yet?
Thanks!

[Jason]

There are no regulations published on this yet (which is really getting under my skin). I have advised in some cases to write and ask for one, citing the law. So far, I have seen one MTF (Brooke Army Medical Center) grant one. Remember, the law requires that you request the independent medical advisor (IMA).

If they do not grant one, I think that if there is a question as to diagnosis or rating criteria, it will be easier to get a re-hearing later (perhaps with the current condition rated, not the earlier).

On another point, something I have been thinking about is what sort of privilege attaches to this advisor. In other words, what happens if the advisor says something that hurts your case? There are, as I see it, two approaches. Assume that the PEB can have access to and use the report of the IMA against you. This means you should weigh carefully asking for review and in what particular areas. But, I tend to think that the IMA report should be "privileged." Meaning that it is for your use in preparation of your case and should not be divulged to the PEB without your permission. This may or may not be how they treat this. But I think everyone should be aware of this and object if it is used against your wishes. Giving even more thought to this, if you have an attorney and they request the IMA on your behalf, I think that you can further argue that this is attorney-client work product and is protected from disclosure by Federal Law. These issues have not been explored yet on appeal, so it is uncertain how these issues will resolve. My advice is to consider all of this carefully when making a decision on how to proceed.

I will post more as soon as I hear more.

[builtgypsy]

I've asked, and asked, and asked again, and it seems like it is either misinterpreted (my PEBLO couldn't get it wrapped around his head that it wasn't my personal doctor I was talking about), or completely ignored.

[cvma544]

This is the verbage I used to request the independent medical review in letter form to the PEBLO. She of course just looked at me like I was insane, (I am but that another issue), anyway she asked me what she was supposed to do with it. I told her to include a copy in my file as I would be attaching a copy for my NARSUM comments. I suggested she forward a copy to the DCCS (director of clinical services).

I respectfully request an independent physician to review the findings and advise me on the Medical Evaluation Board Report generated by IRACH-Ft Knox.
Under NDAA 2008 Sec. 1612 the effective date of this right granted effective was 1 July 2008.
Please advise as to how and when we can accommodate this request when the Part 1 &2 physical, Orthopedic consult, and NARSUM are complete.
However I wish to call to your attention that I am also being treated by the VA for neurological problems, carpal tunnel, and migraine headaches as a result of a neck injury in Iraq. This makes me wonder if I should see a neurologist unless the Army has the intentions of using the VA’s diagnoses of carpal tunnel and migraines and also plans to adopt the EMG test results also from the VA.

They have not replied yet, I submitted this on July 28, 2008

Stu

[embalmerswife]

Thanks for the responses! The soldier here is in WTU and has to take steroid shots for his back because of multiple herniated disks. He's had them rewrite his NARSUM over and over again because they change something everytime to make it incorrect. This time, in what he feels like is retaliation, they reduced all his numbers on his profile and told him not to communicate with the PEBLO except through COC. (By the way did I tell you they were calling his multiple herniated disks, pulled back muscles.) His ortho doctors are all at another base, but they have the GP here writing his NARSUM, not his ortho doc. It is quite common at our MTF that NARSUMs are wrong. I knew about the IMA, but now I can tell him more specifically what to request reg-wise and its implications. Ya'll are awesome!