AD NAVY FINDINGS - SEEKING KNOWLEDGABLE ADVICE

⚪️PEB FINDINGS⚪️

AD USN
(MH related)

Timeline:
MEB start- 18OCT2021
QTC Exams- 1-8DEC2021
Sent to PEB- 20DEC2021
PROPOSED VA Ratings - 01APR2022
UNFIT notice- 19MAY2022
Received/Reviewed findings- 27MAY2022
VA% - 100% (not P&T)
DOD% - 0%

I’m absolutely stunned. I was referred to MEB for chronic migraines, 3 different MH diagnoses, and OSA. The only unfit condition from DOD was migraines and they rated it at 0% despite having a shit ton of supporting evidence of severity. VA also rated my migraines at 0%. I’m meeting with my attorney on Tuesday, but here’s my thought process at the moment. EDUCATED and EXPERIENCED insight is appreciated:

My wife and I are moving back to our home state as soon as possible. She’s 3 months pregnant and we want to get settled back home ASAP to get her a doctor, set up home, etc.. The idea of dragging this out to a formal board doesn’t sound great for our timeline, so my initial reaction would be to take my severance pay ($50k) and run since I wouldn’t have to pay it back. I understand Tricare would be out the door, but I’ll get reevaluated by VA after 6 months for MH and as long as that goes well, I’d be P&T. I’d pick up CHAMPVA from there.

Has anyone received 100% VA and 0% DOD? It’s a very unusual situation. Hoping to get educated insight.
 
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Drwat said:
⚪️PEB FINDINGS⚪️

AD USN
(MH related)

Timeline:
MEB start- 18OCT2021
QTC Exams- 1-8DEC2021
Sent to PEB- 20DEC2021
PROPOSED VA Ratings - 01APR2022
UNFIT notice- 19MAY2022
Received/Reviewed findings- 27MAY2022
VA% - 100% (not P&T)
DOD% - 0%

I’m absolutely stunned. I was referred to MEB for chronic migraines, 3 different MH diagnoses, and OSA. The only unfit condition from DOD was migraines and they rated it at 0% despite having a shit ton of supporting evidence of severity. VA also rated my migraines at 0%. I’m meeting with my attorney on Tuesday, but here’s my thought process at the moment. EDUCATED and EXPERIENCED insight is appreciated:

My wife and I are moving back to our home state as soon as possible. She’s 3 months pregnant and we want to get settled back home ASAP to get her a doctor, set up home, etc.. The idea of dragging this out to a formal board doesn’t sound great for our timeline, so my initial reaction would be to take my severance pay ($50k) and run since I wouldn’t have to pay it back. I understand Tricare would be out the door, but I’ll get reevaluated by VA after 6 months for MH and as long as that goes well, I’d be P&T. I’d pick up CHAMPVA from there.

Has anyone received 100% VA and 0% DOD? It’s a very unusual situation. Hoping to get educated insight.
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First Issue- The DOD rating for migraines comes directly from the VA rating decision in the IDES process- the Navy PEB was required to adopt it. That rating decision likely came directly from your Migraines C&P exam report. The mechanism to appeal that rating is called a VA One-time Reconsideration Request ("VARR"). A VARR is a written appeal supported by medical and nonmedical evidence showing either why the original decision is flawed or that there is new evidence showing that the severity of the condition has increased. This is why I always review my clients' C&P exam reports as soon as they are completed, identify any flaws in the exams and file an appeal of deficient exams accompanied by evidence showing the flaws in the exam report via a VA Form 4138 uploaded by the MSC to the VA D-RAS in Providence, RI. This often causes the VA D-RAS staff in Providence to disregard flawed exams. If it does not, then you have at least set the stage for a successful VARR and will keep developing evidence to support it while the decision is pending.

Second issue- to add conditions that were not found to be unfitting, you will have to present your case at a formal hearing ("FPEB"). In Navy cases, the first step is to always review what is known as "the voting packet" in the TRIM File. The TRIM file is the Navy Yard case file. The "voting packet" contains the informal notes of the IPEB members and will tell you how they reached their decision so that you and your attorney can reverse engineer an approach to overcoming their rationale. Note- the Navy is the only service that provides these informal notes and they are often a treasure trove of info. And, for those unfamiliar with the process, the voting packet is the first document that FPEB members read when assessing a case file.
 
johnbgately said:
First Issue- The DOD rating for migraines comes directly from the VA rating decision in the IDES process- the Navy PEB was required to adopt it. That rating decision likely came directly from your Migraines C&P exam report. The mechanism to appeal that rating is called a VA One-time Reconsideration Request ("VARR"). A VARR is a written appeal supported by medical and nonmedical evidence showing either why the original decision is flawed or that there is new evidence showing that the severity of the condition has increased. This is why I always review my clients' C&P exam reports as soon as they are completed, identify any flaws in the exams and file an appeal of deficient exams accompanied by evidence showing the flaws in the exam report via a VA Form 4138 uploaded by the MSC to the VA D-RAS in Providence, RI. This often causes the VA D-RAS staff in Providence to disregard flawed exams. If it does not, then you have at least set the stage for a successful VARR and will keep developing evidence to support it while the decision is pending.

Second issue- to add conditions that were not found to be unfitting, you will have to present your case at a formal hearing ("FPEB"). In Navy cases, the first step is to always review what is known as "the voting packet" in the TRIM File. The TRIM file is the Navy Yard case file. The "voting packet" contains the informal notes of the IPEB members and will tell you how they reached their decision so that you and your attorney can reverse engineer an approach to overcoming their rationale. Note- the Navy is the only service that provides these informal notes and they are often a treasure trove of info. And, for those unfamiliar with the process, the voting packet is the first document that FPEB members read when assessing a case file. So, you owe it to yourself to become familiar with its contents.
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Thanks for the insight! Do you have a estimated time it takes For the VARR to be done?
 
I was discharged from the Navy in 2004 with 0% and 30% from the VA. I ended up with 100% from the VA in 2015. I had to apply to the PDBR in 2018 to have them go over and re-evaluate my discharge condition. It took them until 2021 to get a conclusion. I ended up at 30% from the Navy, which granted me retirement and ultimately CRSC. Bottom line is these things take time and you have to fight for what you deserve
 
johnbgately said:
Second issue- to add conditions that were not found to be unfitting, you will have to present your case at a formal hearing ("FPEB"). In Navy cases, the first step is to always review what is known as "the voting packet" in the TRIM File. The TRIM file is the Navy Yard case file. The "voting packet" contains the informal notes of the IPEB members and will tell you how they reached their decision so that you and your attorney can reverse engineer an approach to overcoming their rationale. Note- the Navy is the only service that provides these informal notes and they are often a treasure trove of info. And, for those unfamiliar with the process, the voting packet is the first document that FPEB members read when assessing a case file.
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John,

Is there anyway to informally request (written appeal) to add a condition as unfitting without going through the entire FPEB process? Like when the 199 comes back from the IPEB phase? I am USMC AD. Thanks.
 
WaitingOnPEBLO said:
John,

Is there anyway to informally request (written appeal) to add a condition as unfitting without going through the entire FPEB process? Like when the 199 comes back from the IPEB phase? I am USMC AD. Thanks.
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Army personnel can request an IPEB Reconsideration when submitting a request for an FPEB. Unfortunately, the Navy eliminated this option- which they call the FPEB formal reconsideration- several years ago. However, with a strong enough case, it is possible for your counsel to request a President-directed IPEB Recosndieraiton. The President of the PEB can, at his sole discretion, choose to grant or reject this request. However, with a strong brief and supporting evidence submitted by your counsel, most Navy FPEB hearings are being adjudicated as stipulated findings- an on the record decision- either shortly before or during the hearing.
 
Dolgar2 said:
I was discharged from the Navy in 2004 with 0% and 30% from the VA. I ended up with 100% from the VA in 2015. I had to apply to the PDBR in 2018 to have them go over and re-evaluate my discharge condition. It took them until 2021 to get a conclusion. I ended up at 30% from the Navy, which granted me retirement and ultimately CRSC. Bottom line is these things take time and you have to fight for what you deserve
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Could you contact me via message?
 
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