MEB help

Hello all, I was recently thrown for a code 37, Im AD USAF. PEBLO contacted me and what not, commanders letter was wrote. Problem is the PCM who started the NARSUM has moved and my PEBLO nor I have any real clarification on where exactly the NARSUM is. They think it was transferred to my new PCM, but my old PCM who I seen the day before he was leaving, told me that he would have my NARSUM finished that day. Now the new PCM is on leave. Anyone know the time frame it generally takes for the PCM to write this thing? Also the referred conditions on the NARSUM should be Idiopathic Hypersomnia/ Narcolepsy, OSA (CPAP), use of stimulant medication (Armodafinil) to stay alert during the day, and it taking longer then a year for me to recover from foot surgery (bunion, Taylor bunion, hammer toe, plantar fasciitis, and PES Planus were present in both feet). Anyone know the chances of me being found fit or unfit? I know IH and Narcolepsy, is rated on how many times I have cataplectic episodes a week. Prior supervisor has agreed I generally fall asleep 3-4 times a day. I as well cannot seem to wake up in the morning and make it to work on time. The wife cannot even wake me up half the time. For these two reason I've been instructed to try and get a duty limitation added to my AF469. Something along the lines of an "Delayed Reporting Time"? What are the chances of getting this and how delayed are we talking? Thanks for any help!

For your NARSUM, that should be able to be completed within a week, maybe less. It kind of depends how busy your base is and how many other individuals your PCM is seeing. Your new PCM should be able to review all previous notes put in by any previous PCMs and write a new NARSUM if need be. My NARSUM was written and I didn't agree with some of the items that were on there and I felt some items were missing. I made an appointment with my PCM to review my NARSUM with him and he was able to update it with me. I haven't looked into your conditions so I couldn't tell you a fit or unfit decision. You can also talk to your PCM about updating your AF469 and talk to him about a delayed reporting update, that might be something you will have to have something written from your PCM and have a sit down with your supervision and possibly your Commander. I'm still new to the MEB, waiting on my final C&P exams and percentages from the VA. And people on here don't typically like to speculate whether you will be found fit or unfit, or what percentages you will receive.

Thank you for the reply! My NARSUM has been in the works for around a month now. Supervision told me they wanted a late report time, specifically "If the PCM doesn't grant it then we will." Suppose they're worried that if new supervisors come in then it will be easier to relay a medical problem with it recorded on my AF469. Good luck to you and this process!

You can always write up a memorandum and have it signed by your supervision or even better your commander if he is in the loop of your medical conditions. Almost like a p.t. waiver but more personal for you. My NARSUM was fairly quick, but my MEB was pretty much going to happen after my 5th knee surgery.

My NARSUM took the provider about 2-3 weeks to write. He wanted to make sure everything I have been through was in there (and I have been through a lot). Providers, if you have a good one, will take as long as they need to write a good one. Some docs may take less with less effort put in. It all really depends on the doc. Also, do NOT hesitate to get your first shirt or commander involved, you'll be amazed how quickly things get done once the commander starts making phone calls! I had to get mine involved and he has helped greatly! good luck to you buddy!

I still haven't heard any news. Problem is, my previous PCM took around a month writing it, then he passed it on to my new PCM. I've asked just about everyone in the MTF where it is and no news. I have an appointment with my PCM at the end of August so I am assuming I should know more around the end of August.

Little update, my PCM finally finished the NARSUM, case sent to AFPC, AFPC said Full Board. I concurred, I went to my inproccessing VA appointment, then received two C and P appointments. Just went through the mental appointment yesterday. Anyhow my PEBLO seemed to be concerned that my occupational impact was not in depth enough. All it states is "Member is duty restricted against squatting, jumping, ladder climbing or running 100 yards" should I be asking my PCM to change this? It seems to me that it should state a fair bit more information, definitely concerning my sleeping conditions and the effect it plays on my job performance.

Thepresident1981 said:

Little update, my PCM finally finished the NARSUM, case sent to AFPC, AFPC said Full Board. I concurred, I went to my inproccessing VA appointment, then received two C and P appointments. Just went through the mental appointment yesterday. Anyhow my PEBLO seemed to be concerned that my occupational impact was not in depth enough. All it states is "Member is duty restricted against squatting, jumping, ladder climbing or running 100 yards" should I be asking my PCM to change this? It seems to me that it should state a fair bit more information, definitely concerning my sleeping conditions and the effect it plays on my job performance.

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More information will never hurt you. It actually helps because most of these people that see your records only have the information provided in the narsum or medical notes that they receive. So this helps "paint a picture" of your medical issues and how they affect you.

Received my C and P reports back today. A few problems, my main concern is the way they reported Idiopathic Hypersomnia and its symptoms. They failed to report it, My General VA examiner told my that my Mental VA examiner should've reported it. Thus is not the case, it appears instead of analogously reporting the said diagnosis through the correct DBQ, the mental examiner appears to have misconstrued the report and generalized it into Chronic Adjustment Disorder and more or less its symptoms. Even the General Examiner stated in the DBQ for Sleep Apnea that there should be a separate DBQ for "Narcolepsy" but there is not one. When and how do I go about fixing this?

One of my man issues is the way the military handles cross coordinating jobs..... I am an aircraft maintainer but yet I should be an expert at finances job also when I handle travel vouchers and accruals, I should also be a CSS expert when I am creating my own orders and using AROWS or DTS to process TDYs or my AGR orders, now I am supposed to be an expert in the medical field while I am going through this half made up IDES system, so I feel your pain. What should have happened is prior to your C&P is you should have been given or researched the DBQs for each possible claim you are making (I did this all myself, but a few days before my C&P the VA coordinator offered to send me all my DBQs, I said sure to make sure what I had been using was the correct ones and so I could fill them out ahead of time with my personal info and learn the "script" of what was going to be asked of me). Now for better or for worse what you are going to be told by the PEBLO and others is that you personally should have been more aware of what you were claiming and DBQs weren't getting filled out properly (weather I believe this line based off the fact we are all virgins going through this process is another question).

Now to fix the problem, tell your PEBLO, let him know you think the DBQs aren't accurate and you are missing DBQs on some of your conditions, these are being sent to the VA for ratings and then to the iPEB to make a determination on your future career, lean on your PEBLO and get what you need fixed now. Hopefully you can get another C&P to add to and fix your issue, don't wait as deeper in to the process you are going to miss the chance to correct it and you will have to ultimately wait until you are a full time civilian to make any corrections.

I contacted the PEBLO she told meto call the MSC, I then contacted MSC and he said the head physician said if I would've needed a Neuro C and P then it would've shown I needed one but it didn't matter how much I attempted to persuade him into getting a C and P for Neuro the physician would claim I didn't need one. Despite Idiopathic Hypersomnia being a Neurological Disorder. Is there anyone else I can call to acquire another C and P?

Well first some insight... Hypersomnia is rated as close as narcolepsy 8106 - I looked at the DBQ and it doesn't say anywhere it needs to be done by Neuro, I had a C&P for Migraines - I see a Neurologist as my specialist but a Gen Med Physician did my DBQ. I am not say mine was handled correctly, maybe I should have seen a Neuro... but I do not see on the DBQ that a Neurologist is required.... it asks if a diagnosis has been made by a specialist, that is as close as it gets. I need to defer to someone that is more of an expert in this step of your process, I don't know how you request this to be fixed.


https://www.vba.va.gov/pubs/forms/VBA-21-0960C-6-ARE.pdf <----- DBQ for Narcolepsy

I was Dxed by a neurologist, but the VA didn't refer my condition to be examined by general or Neuro and he told me it should be Neuro, instead it was refered to mental and the examiner never filled the correct DBQ. So I am missing the Narcolepsy DBQ.

Thepresident1981 said:

I was Dxed by a neurologist, but the VA didn't refer my condition to be examined by general or Neuro and he told me it should be Neuro, instead it was refered to mental and the examiner never filled the correct DBQ. So I am missing the Narcolepsy DBQ.

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I’m so sorry! That’s such a hassle! They need to start paying close attention because this is people’s lives being affected.

Does anyone have a VA rating for idiopathic hypersomnia and how they rate it? I just See that it is rated like narcolepsy

I was rated 80% for idiopathic hypersomnia. Every case is different though, the AF didn't accept mine as Narcolepsy, so they labelled it as IH with cataplexy. I was also seen by a Neurologist that seen and noted me having 2 cataplectic or more episodes a day. Ultimately that how they rate the disorder is by the "Epileptic episodes". Hopefully yours is as well documented as mine was, good luck!

Thank you. I did not get seen by a Neurologist, just did the sleep studies and MSLT. Do you know if that makes a difference?

The doctor who ordered my PSG's and MSLT's was a neurologist. Don"t think it matters, but if his notes reflect that you have problems with sleep attacks and loss of consciousness then that should be rated accordingly. Last person I talked to with IH only had like a 20% because they didn't have problems with sleep attacks and what not. I also had a sleep diary that showed how late I woke up from the sleep drunkness haha and as well as how many times I was observed hallucinating and or collapsing. I may have had overkill, but when I was first diagnosed I read that alot of people have troubles being rated correctly, so i was adamant on correctly documenting it.

Gotcha! I don’t blame you. That helps a lot. Good for you!

I would suggest printing the above mentioned DBQ and perhaps taking it to your doctor to fill out. If all goes to worse you can always appeal if you feel theve not rated you correctly