Just got NARSUM back, request IMR?

fazwich

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Hello, I am looking for some guidance as I just received the NARSUM back after completing all my VA C&P exams. If I am understanding correctly based on reading through previous treads here, the IMR is mainly to address issues with missing or incorrect conditions reported, not with the quality of the exams or the NARSUM itself.

I am active duty Air Force, and while the NARSUM includes all of the unfitting conditions and almost all of the other claimed conditions appropriately, I feel the quality of exam was extremely poor for 2 of my referred (do not meet retention) conditions and as such the reports generated are woefully inaccurate. Specifically the conditions are Idiopathic hypersomnia/narcolepsy and residuals following extensive knee surgery, to include pain, arthritis, and instability of the joint with recurrent dislocation.

For this, it sounds like an IMR may not be the right choice, and I will have to wait for the chance to appeal findings with a VARR, but before making a decision, I wanted to get some second (or third, fourth, etc.) opinions.Thank you so much in advance for any help!
 

BoooBoooKiittyy

New Member
Registered Member
Hello, I am looking for some guidance as I just received the NARSUM back after completing all my VA C&P exams. If I am understanding correctly based on reading through previous treads here, the IMR is mainly to address issues with missing or incorrect conditions reported, not with the quality of the exams or the NARSUM itself.

I am active duty Air Force, and while the NARSUM includes all of the unfitting conditions and almost all of the other claimed conditions appropriately, I feel the quality of exam was extremely poor for 2 of my referred (do not meet retention) conditions and as such the reports generated are woefully inaccurate. Specifically the conditions are Idiopathic hypersomnia/narcolepsy and residuals following extensive knee surgery, to include pain, arthritis, and instability of the joint with recurrent dislocation.

For this, it sounds like an IMR may not be the right choice, and I will have to wait for the chance to appeal findings with a VARR, but before making a decision, I wanted to get some second (or third, fourth, etc.) opinions.Thank you so much in advance for any help!


I'm wondering why my NARSUM is being completed first before anything happens. Is this normal?
As for your situation I would say appeal ASAP because I've heard it's harder to do when you're separated.
 

fazwich

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If you are Air Force, you will go through the Pre-IDES, where your doctor will write up a summary (which mine kept calling the NARSUM), and the local paperwork (records, commander's letter, and doctor's summary) will be sent to AFPC for a determination as to whether a full MEB is recommended. This is the normal process for Air Force, and your final, official NARSUM is not complete until following that determination and the VA C&P exams. This complete NARSUM is what will be sent to the PEB and used by the VA to determine ratings, if my understanding is correct.
 

OUSooner

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If you are Air Force, you will go through the Pre-IDES, where your doctor will write up a summary (which mine kept calling the NARSUM), and the local paperwork (records, commander's letter, and doctor's summary) will be sent to AFPC for a determination as to whether a full MEB is recommended. This is the normal process for Air Force, and your final, official NARSUM is not complete until following that determination and the VA C&P exams. This complete NARSUM is what will be sent to the PEB and used by the VA to determine ratings, if my understanding is correct.
This is exactly right. I had a NARSUM prior to the IRILO at AFPC. Once AFPC says full MEB you will have your C&P exams and the NARSUM will be updated to reflect the conditions indicated during the C&P exams.
 

bradrich222

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So what was found in the C&P exam if not documented on the first NARSUM will be on the NARSUM that goes to the PEB?
 

fazwich

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Brad, the VA will examine you for each of the conditions you claim with the MSC you are assigned after AFPC recommends a full MEB. In my case, I had 3 conditions referred for the MEB/DoD rating and 15 more that the VA examined for their own ratings. They will turn in the results of those exams and that is what makes up the final NARSUM, along with the original write up from your doctor, and an addendum from your doctor stating agreement or updating the original condition list as needed (if additional unfitting conditions are found).

The IMR is the first chance to officially disagree in writing with the condition list or reports from the doctors/VA examiners. After the advice I got here as well as the urging of my PEBLO, I decided to submit an IMR request to get my disagreement with a few key statements made by the VA docs recorded, because even if it amounts to nothing at this stage, it establishes a clear pattern to support a VARR or appeal later (according to my PEBLO). The reviewer was assigned Monday and I was told they have 5 calendar days to provide the feedback. I will update as I hear anything.
 

bradrich222

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That's really good news, thank you for updating. I have 2 unfitting conditions, but only 1 made it to the MEB. I am thinking they should add the second one after they see my results from the C&P. Please do keep us updated on your progress.
 

fazwich

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I got the IMR report back today. The reviewer concurred with the NARSUM as expected. In my case it was not an issue of the conditions, but the quality of the exams and the way they were documented so it is no surprise. I will be contacting legal and my PEBLO to get advice about submitting a rebuttal to reinforce my disagreement but hopefully my package will be at the PEB next week.
 

fazwich

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PEB Forum Veteran
Registered Member
Brad, I did get the results. They are incorporated into the NARSUM and that package is what you will be given 5 days to review before deciding whether to request an IMR, write a rebuttal, or sign and send the package to the PEB as-is.

The response to my IMR is attached. Since I don't disagree with what he says, namely, that my disagreement is with the VA and not the MEB, that it can be deferred, I signed and my package was sent to the PEB today.IMR response.PNG IMR response.PNG
 
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