Jason Perry
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I am furious with the Air Force MEBs at the moment. I have come across this issue again and again. A client of mine was told to "come in today to sign her MEB." There are problems with the MEB, so I advised my client to request an Impartial Review. Her PEBLO told her that if she wants to do that, she has to submit a rebuttal by Monday (three calendar days from now). This is complete BS.
Per AFI 41-210:
4.66. Impartial Review. If the SM requests an impartial review, an impartial physician or other appropriate healthcare professional (not involved in the SM‘s MEB process) must be assigned to offer a review of the medical evidence presented by the NARSUM and associated consults.
4.66.1. The impartial health professional should advise the SM within five duty days on whether the MEB findings adequately reflect the complete spectrum of injuries and/or illnesses. For cases in which the Impartial Review does not validate the MEB findings, the Impartial Reviewer will contact the MEB Board President (SGH or SGP who signed block 26 on AF Form 618) concurrently with notification to the SM.
4.66.1.1. In such cases, the MEB Board President must consider whether changes to the MEB package are warranted, and whether to reconvene the MEB once changes have been documented.
4.67. Rebuttal Letters. Armed with the decision of the MEB and, if requested, the information from the Impartial Review, the member may choose to submit a Rebuttal Letter to the MEB Convening Medical Authority (CMA).
4.67.1. Per DoDI 1332.38, E2.1.33, the CMA must be a senior medical officer, appointed by the MTF Commander, with detailed knowledge of directives pertaining to standards of medical fitness and disposition of patients, disability separation processing and familiar with the Veterans Affairs Schedule for Rating Disabilities (VASRD). It is recommended that the MTF Commander consider the SGH, SGP and Senior Profile Officer as the appointed MTF Convening Medical Authority primary and alternates, if the MTF Commander is not a physician. See Personnel and Readiness Policy Memorandum on Implementing Disability-Related Provisions of the National Defense Authorization Act of 2008, 14 Oct 08.
4.67.1.1. The acting CMA for any particular case may not be one of the three physicians who served on the MEB, and may not be the Impartial Reviewer for that particular case.
4.67.2. If the SM requested an Impartial Review, the SM shall be afforded seven calendar days from the date of Impartial Reviewer notification of review results to prepare a Rebuttal Letter and submit it to the MEB Convening Medical Authority, who shall be afforded seven calendar days to consider the Rebuttal Letter and return the fully documented decision to the SM.
4.67.3. If the SM did not request an Impartial Review, but chooses to submit a Rebuttal Letter, the SM will be afforded seven calendar days from the date of decision established in section 4.65.1. (2) to prepare a Rebuttal Letter and submit it to the MEB Convening Medical Authority, who shall be afforded seven calendar days to consider the Rebuttal Letter and return the fully documented decision to the SM.
4.67.4. If the member submits a Rebuttal Letter, the MEB results shall not be forwarded to the PEB until the Rebuttal process is finalized and MEB results indicate the SM may be unfit for duty. The fully documented Rebuttal Letter, and response, will be included with the MEB package sent to the PEB. Exceptions to timelines may be granted by an authority appointed by the SAF.
4.67.5. At the conclusion of the Impartial Review and/or Rebuttal process, the PEBLO will counsel the SM and ask him/her to sign and date the AF Form 618, blocks 29(a) and 29(b) signifying that he or she has been informed of the findings and has received the response to the Rebuttal Letter, and recommendations of the MEB. After the PEBLO meets with the member, the PEBLO assembles the package and forwards it to IPEB per the instructions of the Disability Counseling Guide for Physical Evaluation Board Liaison Officers, published by HQ AFPC/DPSD.
4.67.6. If the SM submitted a Rebuttal Letter, the PEBLO will assure the member that both the Rebuttal Letter and the Convening Medical Authority‘s response to the Rebuttal Letter will be included in the package which will be forwarded to HQ AFPC/DPSD to the Informal Physical Evaluation Board (IPEB)."
Rest assured, I am challenging this in my client's case. (I am not overly concerned about this in my client's case. Almost always, when I push back, the MEB/PEBLO folds on this issue...and when they don't it is effective ammunition at the PEB). However, I am greatly concerned by the fact that I see a pervasive issue where Airmen are told they need to justify their request for an impartial review, have to submit a rebuttal prior to the review, or have to jump through hoops to get what is guaranteed them by statute and regulation. I suspect that many Airmen forgo their rights because of a BS and illegal requirement for them to justify their request for an impartial review.
Keep it up, Air Force MEBs. Failure to follow the regulations and provide members with their rights will only come back to bite you with a system wide challenge (read as lawsuit) for denial of a substantive right of members. Or a nice heads up to Senate/House Armed Services Committees.
Per AFI 41-210:
4.66. Impartial Review. If the SM requests an impartial review, an impartial physician or other appropriate healthcare professional (not involved in the SM‘s MEB process) must be assigned to offer a review of the medical evidence presented by the NARSUM and associated consults.
4.66.1. The impartial health professional should advise the SM within five duty days on whether the MEB findings adequately reflect the complete spectrum of injuries and/or illnesses. For cases in which the Impartial Review does not validate the MEB findings, the Impartial Reviewer will contact the MEB Board President (SGH or SGP who signed block 26 on AF Form 618) concurrently with notification to the SM.
4.66.1.1. In such cases, the MEB Board President must consider whether changes to the MEB package are warranted, and whether to reconvene the MEB once changes have been documented.
4.67. Rebuttal Letters. Armed with the decision of the MEB and, if requested, the information from the Impartial Review, the member may choose to submit a Rebuttal Letter to the MEB Convening Medical Authority (CMA).
4.67.1. Per DoDI 1332.38, E2.1.33, the CMA must be a senior medical officer, appointed by the MTF Commander, with detailed knowledge of directives pertaining to standards of medical fitness and disposition of patients, disability separation processing and familiar with the Veterans Affairs Schedule for Rating Disabilities (VASRD). It is recommended that the MTF Commander consider the SGH, SGP and Senior Profile Officer as the appointed MTF Convening Medical Authority primary and alternates, if the MTF Commander is not a physician. See Personnel and Readiness Policy Memorandum on Implementing Disability-Related Provisions of the National Defense Authorization Act of 2008, 14 Oct 08.
4.67.1.1. The acting CMA for any particular case may not be one of the three physicians who served on the MEB, and may not be the Impartial Reviewer for that particular case.
4.67.2. If the SM requested an Impartial Review, the SM shall be afforded seven calendar days from the date of Impartial Reviewer notification of review results to prepare a Rebuttal Letter and submit it to the MEB Convening Medical Authority, who shall be afforded seven calendar days to consider the Rebuttal Letter and return the fully documented decision to the SM.
4.67.3. If the SM did not request an Impartial Review, but chooses to submit a Rebuttal Letter, the SM will be afforded seven calendar days from the date of decision established in section 4.65.1. (2) to prepare a Rebuttal Letter and submit it to the MEB Convening Medical Authority, who shall be afforded seven calendar days to consider the Rebuttal Letter and return the fully documented decision to the SM.
4.67.4. If the member submits a Rebuttal Letter, the MEB results shall not be forwarded to the PEB until the Rebuttal process is finalized and MEB results indicate the SM may be unfit for duty. The fully documented Rebuttal Letter, and response, will be included with the MEB package sent to the PEB. Exceptions to timelines may be granted by an authority appointed by the SAF.
4.67.5. At the conclusion of the Impartial Review and/or Rebuttal process, the PEBLO will counsel the SM and ask him/her to sign and date the AF Form 618, blocks 29(a) and 29(b) signifying that he or she has been informed of the findings and has received the response to the Rebuttal Letter, and recommendations of the MEB. After the PEBLO meets with the member, the PEBLO assembles the package and forwards it to IPEB per the instructions of the Disability Counseling Guide for Physical Evaluation Board Liaison Officers, published by HQ AFPC/DPSD.
4.67.6. If the SM submitted a Rebuttal Letter, the PEBLO will assure the member that both the Rebuttal Letter and the Convening Medical Authority‘s response to the Rebuttal Letter will be included in the package which will be forwarded to HQ AFPC/DPSD to the Informal Physical Evaluation Board (IPEB)."
Rest assured, I am challenging this in my client's case. (I am not overly concerned about this in my client's case. Almost always, when I push back, the MEB/PEBLO folds on this issue...and when they don't it is effective ammunition at the PEB). However, I am greatly concerned by the fact that I see a pervasive issue where Airmen are told they need to justify their request for an impartial review, have to submit a rebuttal prior to the review, or have to jump through hoops to get what is guaranteed them by statute and regulation. I suspect that many Airmen forgo their rights because of a BS and illegal requirement for them to justify their request for an impartial review.
Keep it up, Air Force MEBs. Failure to follow the regulations and provide members with their rights will only come back to bite you with a system wide challenge (read as lawsuit) for denial of a substantive right of members. Or a nice heads up to Senate/House Armed Services Committees.