Post TDRL review: ordered to see another ortho and neuro..Do I have to go thru VA?


PEB Forum Veteran
Apr 11, 2008
Hey everyone, its been a while.

Quick Question: Do I have to go through the VA for my referrals or can I go through TRICARE and pay my co-pays and take that info back to the doctor in TX?

Long and detailed Summary (venting): Back in October 2010 I was sent to TX for 1st tdrl re-eval of my back. The neuro down there said that the military hasn't done all it can do for me.....from his 20 min appt with me he knocked my back from 60 (incap episodes) to 20, and then added 20 for my hip and 10 for right leg radiculopathy...for a new total of 40%. Anyway-the orders on the bottom of the tdrl review are for me to see another ortho (this will make 6) TX tdrl doc seems to think I would do well to have a back stimulator implanted...and he thinks I need a new hip...all that I'm still good for 40%...nice. Oh and he wants me to see another neuro (that will make 4th) because of my radiculopathy...Anyway....the doctor I had been seeing was thru Tricare/Peterson AFB active duty-he's now in Iraq. He wrote up a NARSUM and the TX doc discounted it.

Before I went to TX I had gone to the VA to establish a pcm...who ended up being a N.P. who was completely incompetant as far as I'm concerned..she stayed behind the desk typing. So, I got back from TX and I have avoided the VA until 6 weeks ago when I went in and asked for a different pcm.... hoping I would get a doc ( don't get offended if you are a N.P) ....well, I got assigned another N.P. Today was my appt. I was in no hurry to get there and ended up 15 min late. They said they couldn't see me & they'd have to reschedule me for April 5th. Now, I take full accountablility that I was late...I'm surprised I even went. Last time I went to the VA I broke out in HIVES-so I really wasn't excited about this! I asked if they could just give the orders from the TX Neuro (tdrl doc) to the N.P. so she could get me the two referrals I needed (have to be done by Nov 2011). Answer was no. She had to see me for an initial appt of an hr...which they didn't schedule me for anyway (they screwed up and put me in a 30 min slot). I DONT WANT TO GO TO THE VA...I DON'T WANT TO GO TO ANY DOCTORS ANYMORE. I'm so done with it all! And the attitudes. My appt on the 5th will be at 0800...ok, fine...but I don't sleep well, and usually I don't fall asleep until about 5am every morning..and I sleep until about 10am. I explained and asked if they had afternoon appts. The lady said, well whats the will probably be up anyway!!!! It was such a mess...thats not all that happened..but anyway, OMG...I can't stand the VA system in Colorado Springs. If I were here for a cold...sure, no problem....but they don't get this tdrl thing at all!

It should be the same, right....I should be able to go through Tricare, go to a new active duty doc at Peterson AFB, get the referrals (its worth my co-pays.) ..and then just get the reports to the TX tdrl doc.

As long as I have proof that I've gone to docs and I have reports...I should be ok, correct?

Jason Perry

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May 15, 2007
Post TDRL review: ordered to see another ortho and neuro..Do I have to go thru VA


Great to see you posting! Sorry to hear about the pain and angst (figurative and literal) with your evaluation and treatment...

I am not sure about your question. If you mean can you take the info from either the VA or a provider from TriCare referral, the answer is that you can use/submit any evidence you want to the PEB. The real confusion about your question comes from what level of submission of the evidence you mean.

A HUGE concern I have about TDRL re-evaluations is that I believe that many times they ignore the requirement to allow you to review the TDRL re-evaluation and to be accorded your right to an impartial medical review and to rebut/appeal the findings of the TDRL re-eval. I think you should be able to do so, but I think that in many cases they just conduct the re-eval and forward without the opportunity to exercise your rights. If they do give you the opportunity, I think you should try to submit the information at the MEB/TDRL level because this means that the evidence you submit will be seen by the IPEB. (Essentially, this gives you the greatest chance to get a good outcome from the IPEB). If they do not, then you are in the position of submitting the "new" evidence to the FPEB after an adverse finding from the IPEB.

Hope this makes sense and let us know any follow up questions.