Need NARSUM Help

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flemdawg

Well-Known Member
Registered Member
I received my narsum the other day and although all of the diagnoses are correct only one condition was found to be unfitting and that was PTSD. There are a few diagnosis and items that i'm sure are unfitting according to 40-501 and others i'm just not sure about.
Lets get to the unsure about. I had a complete nose amputation (by the IED that hit my face) diagnosed with traumatic amputation of nose, diagnosed with complete and permanent anosmia (loss of smell).
both said meets medical retention standards but from what i read permanent anosmia isn't medically acceptable. I'm also not sure about gastritus that i am diagnosed with.
Also diagnosed with lumbar strain and L5 radiculopathy

To the things that i'm sure that should not be acceptable.
Migraines. diagnosed with migraines, neurologist exhausted all treatment and in clinical notes states that SM requires MEB for Migraines. Commanders letter states "SM leaves work 3-4 days a week due to dibilitating migraines, I also go to the clinic frequently for migraines and they send me home.
Diagnosed with torn rotatorcuff having surgery on shoulder may 8th. I was diagnosed with a lot more stuff but i'm sure that they meet medical standards.
Any help or advice would be greatly appreciated. I have to make a decision on my NARSUM on tuesday.
 
The only input I would give from my experience is the gastritis. I'm not sure how much you match with mine but I had a scope done in 2011 and had ulcers from throat to my intestines. Vomiting multiple times a day having blood come up in vomit and bowel movements. It was all documented well but from my unfitting conditions only mental health was unfitting. I did all my C&P exams aug/sept 2012 and when I had proposed Ratings back. I received 60% for all the Gastro problems. Not sure if that helps you out but it was my experience with the system.
 
Request an independent medical review (IMR) and get a second opinion. Requesting an IMR will add a bit to your overall timeline, but it is crucial to ensure that your package is as accurate as possible now, before it gets to the PEB- it's much easier to get it right now than to fight it later...many people here on the forum can attest to this after having to deal with the FPEB or (later) PDBR.:eek: You can also submit a rebuttal to the NARSUM. Also remember that just because one or more of your conditions are not notated in your NARSUM as potentially unfitting (because only the PEB can determine if a condition is truly unfitting- the NARSUM is just a review/recommendation), the PEB is required to review all of your conditions and they could determine that any (or all) of your other conditions aside from PTSD (referred condition) are also unfitting.
 
It is to your advantage to have as many conditions found to fail retention standards as possible.

Some conditions are by their very presence going to fail retention standards. Others have qualifiers (e.g., length of time diagnosis has been in place, inadequate response to specific treatments, etc.). Finally, there are catch-all circumstances where significant interference with performance/deployability, etc. can be enough. (There are variations between the military services).

I would compare the NARSUM to the facts of your case and your service regulations. If there are inconsistencies, you can/should address them after the impartial review. (The review is unlikely to change anything- if it does, great. But the main point is to get your views on the record).
 
thanks, the MEB doc called me about a month ago to review over the phone and she said that she doesn't care if she has all of the documentation (because PEBLO never gave them my documentation) that it's my problem not hers and she said she's not going to waste her time digging through paperwork. she said she's getting pushed to get it done quick so thats whats she's going to do. still can't find anything on amputation of nose
 
flemdawg said:
thanks, the MEB doc called me about a month ago to review over the phone and she said that she doesn't care if she has all of the documentation (because PEBLO never gave them my documentation) that it's my problem not hers and she said she's not going to waste her time digging through paperwork. she said she's getting pushed to get it done quick so thats whats she's going to do. still can't find anything on amputation of nose
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I would not let a crappy attitude from a doctor who seems to busy to do her job stop you from fighting for what you deserve.

I am thinking that the nose amputation by itself may not be listed. My quick/gut instinct is that it would seem likely to interfere with use of chemical protection/NBC gear, may cause issues with sinuses, infections, and perhaps respiratory problems. I think you have to look at the facts of your case closely. Think about how the amputation impacts your functioning and duty performance. That is the disability that may be unfitting. The nose amputation on its own may not be unfitting. Of course it is going to have a big impact on your life- but perhaps it would not on duty performance. I am reminded of a few cases I had as a JAG where the member had lost their testicles in an IED blast. They were shocked (and more than a little upset) that the Army said that loss of testicles does not impact their ability to perform their duties. For that disability, anatomical loss of testicle, they were fit. However, the mental anguish that resulted caused depression- that condition was unfitting. So, the loss itself was not rated- however, the consequences were. Not sure if this is going to be your case or if this helps.
 
flemdawg said:
thanks, the MEB doc called me about a month ago to review over the phone and she said that she doesn't care if she has all of the documentation (because PEBLO never gave them my documentation) that it's my problem not hers and she said she's not going to waste her time digging through paperwork. she said she's getting pushed to get it done quick so thats whats she's going to do. still can't find anything on amputation of nose
Click to expand...

Wow! It continues NOT to amaze me that certain healthcare professionals won't remain "professional" in the performance of their own chosen occupations.

When their time comes to be faced with our medical challenges, I pray that they receive similar treatment.

Best Wishes!
 
flemdawg said:
I received my narsum the other day and although all of the diagnoses are correct only one condition was found to be unfitting and that was PTSD. There are a few diagnosis and items that i'm sure are unfitting according to 40-501 and others i'm just not sure about.
Lets get to the unsure about. I had a complete nose amputation (by the IED that hit my face) diagnosed with traumatic amputation of nose, diagnosed with complete and permanent anosmia (loss of smell).
both said meets medical retention standards but from what i read permanent anosmia isn't medically acceptable. I'm also not sure about gastritus that i am diagnosed with.
Also diagnosed with lumbar strain and L5 radiculopathy

To the things that i'm sure that should not be acceptable.
Migraines. diagnosed with migraines, neurologist exhausted all treatment and in clinical notes states that SM requires MEB for Migraines. Commanders letter states "SM leaves work 3-4 days a week due to dibilitating migraines, I also go to the clinic frequently for migraines and they send me home.
Diagnosed with torn rotatorcuff having surgery on shoulder may 8th. I was diagnosed with a lot more stuff but i'm sure that they meet medical standards.

Whatever you do, If the NARSUM isnt right, you need to appeal it. in fact, if anything isnt right you need to have the MEB attorney at least look at it. having said that, you need to work for getting every word of your C&P report 100% accuratte.Read AR 40-501 Chapter 7-4, it tells about how the meb should be conducted. Also read Ar 635-40
Chapter 4-11.
Any help or advice would be greatly appreciated. I have to make a decision on my NARSUM on tuesday.
Click to expand...
 
flemdawg said:
I received my narsum the other day and although all of the diagnoses are correct only one condition was found to be unfitting and that was PTSD. There are a few diagnosis and items that i'm sure are unfitting according to 40-501 and others i'm just not sure about.
Lets get to the unsure about. I had a complete nose amputation (by the IED that hit my face) diagnosed with traumatic amputation of nose, diagnosed with complete and permanent anosmia (loss of smell).
both said meets medical retention standards but from what i read permanent anosmia isn't medically acceptable. I'm also not sure about gastritus that i am diagnosed with.
Also diagnosed with lumbar strain and L5 radiculopathy

To the things that i'm sure that should not be acceptable.
Migraines. diagnosed with migraines, neurologist exhausted all treatment and in clinical notes states that SM requires MEB for Migraines. Commanders letter states "SM leaves work 3-4 days a week due to dibilitating migraines, I also go to the clinic frequently for migraines and they send me home.
Diagnosed with torn rotatorcuff having surgery on shoulder may 8th. I was diagnosed with a lot more stuff but i'm sure that they meet medical standards.
Any help or advice would be greatly appreciated. I have to make a decision on my NARSUM on tuesday.
Click to expand...

From my experiences, during your interactions with DoVA and MEB/PEB representatives, it's a good practice to be very proactive and involved in the DoD IDES MEB/PEB process.

If you are not satisfied with the results of the NARSUM, you should "immediately" seek the assistance of Legal Services in order to initiate your options: an IMR and/or MEB Appeal. Again, you should "immediately" seek the advise of Legal Services.

Due to the limited response time, Legal Services will probably suggest submitting an Independent Medical Review (IMR) which shall extend the NARSUM election decision point. If the IMR results are not supportive of your intentions, then you can submit a MEB Soldier's Appeal with any additional supportive documentation.

Thus, your "health" fortune to speak-up is now, and it's critical in order to have an opportunity for any future maximum DoD and DoVA compensation!

Best Wishes!
 
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