I "refused" medical treatment

behlftball

PEB Forum Regular Member
My Narsum states,

"Additionally, the patient was recommended to have injections for treatment of the back pain. However, the patient does not wish to proceed with injections due to the potential risks of further injury that maybe invovled with the injections. The patient has opted for conservative management. There fore, 5.3.20.10 which states "The individual refuses required medical, surgical, or dental treatment or diagnostic procedures and the condition renders them not qualified for retention," also applies in this case.

Will this have implications on my results or disqualify my chances at retirement? I have heard many rumors revolving around this and really need clarification. Thanks.
 
Refusing treatment usually never works in your favor. The way your statement is worded seems to me like it could damage your situation...to what degree, who knows. I was offered an open chest lung biopsy to fully diagnose lung disease, but requested to bypass it for now because the medical gain vs physical risks weren't in line (the biopsy would only prove that I have an incurable disease, at the risk of the procedure worsening my situation or killing me), but the disease has been diagnosed to 99% by Creighton and Mayo Clinic. If the procedure that you declined could actually help your pain, the board may think that you are in less pain than you state. Good luck either way.

On a side note, my wife gets the same injections, only it's in her ribs from hairline fractures, and she says that they are painful but work really well for about 3 hours. YMMV.
 
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Aye, Whats sad these days is steroid injections are actually part and parcel w/ conservative treatment. and yes denial of medical care that is recommended can seriously hamper your case.
 
Refusing treatment usually never works in your favor. The way your statement is worded seems to me like it could damage your situation...to what degree, who knows. I was offered an open chest lung biopsy to fully diagnose lung disease, but requested to bypass it for now because the medical gain vs physical risks weren't in line (the biopsy would only prove that I have an incurable disease, at the risk of the procedure worsening my situation or killing me). If the procedure that you declined could actually help your pain, the board may think that you are in less pain than you state. Good luck either way.

I was told at one point by an ARMY DOCTOR (butcher) that I needed lower back surgery.

I started looking into it, and discovered the surgery didn't have that great of an outcome - too many post-op complications and results weren't that promising.

So, to PROTECT MYSELF from military medicine, AND to PROTECT MYSELF from getting into that "refusing medical treatment crap-trap", I got TWO outside independant medical assessments and opinions from TWO different, highly qualified back surgeons.

Believe it or not, BOTH surgeons independantly said to either not get the surgery yet - or said it was OK to wait until I couldn't stand it any longer.

I turned in BOTH assessments and recommendations from these surgeons to the Army Docs and the IDES people.

The Army never said another word about surgery for me on this lower back issue.

I was found unfit for my lower back and rec'd 40% for it.

My hope is that there will be an advancement in medical practice for this part of my lower back that will "up the odds" of a better and permanent outcome.

Until then, I live with what lower use I have left of my lower back.

Ain't pretty, but I'm no guinea pig, either.

nwlivewire
 
I was told at one point by an ARMY DOCTOR (butcher) that I needed lower back surgery.

I started looking into it, and discovered the surgery didn't have that great of an outcome - too many post-op complications and results weren't that promising.

So, to PROTECT MYSELF from military medicine, AND to PROTECT MYSELF from getting into that "refusing medical treatment crap-trap", I got TWO outside independant medical assessments and opinions from TWO different, highly qualified back surgeons.

Believe it or not, BOTH surgeons independantly said to either not get the surgery yet - or said it was OK to wait until I couldn't stand it any longer.

I turned in BOTH assessments and recommendations from these surgeons to the Army Docs and the IDES people.

The Army never said another word about surgery for me on this lower back issue.

I was found unfit for my lower back and rec'd 40% for it.

My hope is that there will be an advancement in medical practice for this part of my lower back that will "up the odds" of a better and permanent outcome.

Until then, I live with what lower use I have left of my lower back.

Ain't pretty, but I'm no guinea pig, either.

nwlivewire
I know the kind of pain you live with. I too live with this same pain every day. I just can't seem to find anyone who actually has an example or the regulations where this could possibly hurt my case. It seems like people just say it looks bad, but no one has actually stated that it excluded them from getting retirement or other benefits. Any answers are appreciated
 
Not sure if this reg is current, just the first one found on google.

under paragraph B-3, Appendix 3 of Army Regulation 635-40, (7(p66)) the PEB may deny or reduce compensation for Soldiers who fail to comply with prescribed medical treatment. The Army will not compensate the portion of disability that results if a Soldier unreasonably fails or refuses to take prescribed medications; submit to medical or surgical treatment or therapy; or observe prescribed restrictions on diet, activities, or the use of alcohol, drugs, or tobacco.

This reduction or denial of compensation can only occur if the Soldier was clearly and understandably advised of the proper medical course of treatment, and the Soldier's failure or refusal was willful or negligent and not the result of mental disease or a physical inability to comply.
 
Matching AF reg
41-210
4.63.8. Boards under unique situations:
4.63.8.1. SMs who refuse required professional, medical or dental care, and/or other necessary treatment options may be required to meet an MEB. Refer when:
4.63.8.1.1. The SM was clearly advised of the necessary course of treatment, therapy, medication, or duty limiting or physical restriction.
4.63.8.1.2. The SM‘s failure or refusal was willful or negligent and not the result of mental disease or of physical inability to comply.
 
Not sure if this reg is current, just the first one found on google.

under paragraph B-3, Appendix 3 of Army Regulation 635-40, (7(p66)) the PEB may deny or reduce compensation for Soldiers who fail to comply with prescribed medical treatment. The Army will not compensate the portion of disability that results if a Soldier unreasonably fails or refuses to take prescribed medications; submit to medical or surgical treatment or therapy; or observe prescribed restrictions on diet, activities, or the use of alcohol, drugs, or tobacco.

This reduction or denial of compensation can only occur if the Soldier was clearly and understandably advised of the proper medical course of treatment, and the Soldier's failure or refusal was willful or negligent and not the result of mental disease or a physical inability to comply.
I have seen this portion debated before. It's a fine line they walk and seems hard to implement. One persons definition of "unreasonable" could be drastically different than someone else's.

In this guys case I would assume a descent argument against taking steroid injections or nerve blocks would be the fear of worsening a medical condition because of overusing the back as a result, adverse reaction to steroids, etc. Also, opting for other "sound" forms of therapy or treatment could suffice, as well as other doctors opinions.
 
Oh i agree completely that if he states a reasonable objection he may win, however if it gets to it and a formal board made up of doctors, states that his refusal is not based on sound medical principal and that they believe he is just avoid the shots in order to further his condition to get out of service- etc etc etc etc
 
Just to add, I had yet another steroid injection in my inguinal area last week ( thats a total of 6 before the hip replacement and 2 since) and one part of my left feels better, but the injection site and everywhere around it feel horrible, and byt he time the pain from injection goes away the steroid stops working. So in my limited experience, they may help short term, they may help if i was able to use the time i was not in pain to work out that area and strengthen it ( useless since it is one muscle group out of 5-8 that are injured). But they have done nothing for me but give false hope.
 
Matching AF reg
41-210
4.63.8. Boards under unique situations:
4.63.8.1. SMs who refuse required professional, medical or dental care, and/or other necessary treatment options may be required to meet an MEB. Refer when:
4.63.8.1.1. The SM was clearly advised of the necessary course of treatment, therapy, medication, or duty limiting or physical restriction.
4.63.8.1.2. The SM‘s failure or refusal was willful or negligent and not the result of mental disease or of physical inability to comply.


These type of rules and regulations are exactly WHY I sought out two different medical opinions from other surgeons other than the Army butcher-happy, knife-happy "GOD-Doctor".

My not-to-pleased ears to hear I needed MORE surgery, plus, the surgical post-op and outcomes on this surgerey were sketchy at best. That was enough for me to seek out second and third opinions from competant surgeons. They had no vested interest or outcome in my case, and, they also had no Army "surgeon-in-training" who needed more practice.

It's not what I said that became an issue - it's what I did NOT say. I just went and got two other opinions without saying anything that could be construed as "willfull negligence".

It's what OTHER surgeons said that made the difference as to whether or not the Army found me to be in non-compliance.

As SMs, we DO have a PATIENT CARE BILL OF RIGHTS. Though not exactly as much as a civilian, we still have rights.

Last year, the Army came out with an updated version for SMs. It further supported my actions at getting second/third opinions.

But nobody ever tells you these things. Army Medical Officers often act like GOD - as do NCMs. And YOU, the injured SM, are NEVER to question this!

That's BS.

Know your Servicemeber Patient Care Bill of Rights.

V/r,
nwlivewire
 
but your rights mean nothing when tricare/TMA get involved because TMA has no over seer, they are the approving body/authority for everything that goes through the mil to civilian medical community and answer to NO ONE! ( the rant is from personal experience) but is applicable here, because if the PCM feels he is wasting money by seeking civilian second opinion vs a military doc blah blah blah blah. I quit.
 
There are sometimes ways around TMA. TMA has no "concrete" relationship or position over MTF. Within the MTF TMA should have no authority, only when MTF is sending you outside to civilians. If it's a TMA issue, Congressmen, IG, Surgeon General, etc. can help push them around.

However, I feel your pain Twitch..........it's a zoo.
 
There are sometimes ways around TMA. TMA has no "concrete" relationship or position over MTF. Within the MTF TMA should have no authority, only when MTF is sending you outside to civilians. If it's a TMA issue, Congressmen, IG, Surgeon General, etc. can help push them around.

However, I feel your pain Twitch..........it's a zoo.

I feel for Twitch, too. Insurance companies are a pain in the A$$.

Insurance is another facet, another cut on this big gem.

But I say again, SMs should read this Servicemember Patient Care Bill of Rights. It may help SMs to understand the military medical rules and rights and responsibilities that SMs do have when dealing with this part of the military medical institution.

Thankfully, I had Medicare A/B, and I did not ask for permission to get 2nd/3rd opinions. I just quietly went and sought out opinions on what was best for me and my situation. But I would have paid out-of-pocket for a 2nd opinion if I had to as well. It's a matter of doing what's best for me and my body - and to heck with the rest. I'm the one that has to live with the consequences well after I'm discharged. But since I'm not a Doctor, seeking out a 2nd opinion from a qualified specialist is a reasonable and sane thing to do.

I don't believe that any one Doctor's opinion for surgery is the be all and end all of best knowledge and practices. And I would think the same way and get a 2nd opinion whether they are a civilian or Military Doctor. This military medical "Father knows Best" stuff is for the birds. When two additional medical opinions were different from the first opinion, I held my ground, and the Army couldn't find fault with this as there was no error in compliance.

Again I say, know your rights and get the proper evidence to support your claim.

Insurance is another nightmare.

nwlivewire
 
I had an "anonymous" complaint come down on my doctor for treating me and another SM. Out of hundreds of patients, only records for 2 people were concerned. It was easy to figure out who initiated that complaint since the rest were civilian patients.

Doctor stood his ground and refused to stop treatment; precisely what the MTF hoped would not happen.

It's a sad day when "best medical practice" is judged by those with little or no authority on the subject.

And of course Tricare refused to pay without referrals. That was ok, paid cash, and still stuck with appropriate treatment despite their(MTF) insistence that I could possibly have a "brand new medical condition that is unknown at this time." They assumed anti-depressants, narcotics and muscle relaxers were the answer. I thought otherwise.
 
I had an "anonymous" complaint come down on my doctor for treating me and another SM. Out of hundreds of patients, only records for 2 people were concerned. It was easy to figure out who initiated that complaint since the rest were civilian patients.

Doctor stood his ground and refused to stop treatment; precisely what the MTF hoped would not happen.

It's a sad day when "best medical practice" is judged by those with little or no authority on the subject.

And of course Tricare refused to pay without referrals. That was ok, paid cash, and still stuck with appropriate treatment despite their(MTF) insistence that I could possibly have a "brand new medical condition that is unknown at this time." They assumed anti-depressants, narcotics and muscle relaxers were the answer. I thought otherwise.

Know what you mean pittpan2005.

I find it incredible when a SM can have TWO independent, non-military medical or psych professionals render a very similar, but very diagnosis different than the military medical/psych Officer/Doctor will pronounce - and the military will STILL insist their diagnosis is correct, treatment correct, whatever is correct. And that is even after they have only seen old medical "paper charts" from eons ago and for some reason, the military medical "pros" seem too hard-headed or stiff-necked to consider anything else - like new evidence/assessments from the civilian doctors.

And with CB-WTU SMs, who get the majority of their treatment from civilian medical/psych Doctors, this attitude of military medical "elitism" only serves to prolong the IDES process, costs the military money and time, costs the injured SM unnecessary appeals and lawyer fees, and often-times results in erroneous IDES determinations. Getting a just and fair outcome in the IDES process becomes a very "impacted" process.

The IDES system needs some institutional-grade Ex-Lax.

V/r,
nwlivewire
 
I just had a injection for my back making the pain worse. Amd i told my dr that. He tried doing 2 more sets of epidurals on me. I asked him why i wpuld do 2 more if it made it worse. Would that hurt me? Also i cannot afford to go to a civilian dr because of co payments and all. Would it hurt me when tey to get my meb accepted?
 
My Narsum states,

"Additionally, the patient was recommended to have injections for treatment of the back pain. However, the patient does not wish to proceed with injections due to the potential risks of further injury that maybe invovled with the injections. The patient has opted for conservative management. There fore, 5.3.20.10 which states "The individual refuses required medical, surgical, or dental treatment or diagnostic procedures and the condition renders them not qualified for retention," also applies in this case.

Will this have implications on my results or disqualify my chances at retirement? I have heard many rumors revolving around this and really need clarification. Thanks.
I'm in the same situation I know this post is 8 yesrs old but why not try I'm currently going through with the MEB process I refused spinal injections for the same reason did refusing injections hurt your case at all ?
 
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