Letter to request IMR?

Track

Registered Member
Background, I went DNIF back in march for what eventually turned out be to be shingles/keratitis and was pinged for a MEB in November. Turns out a herpes virus running amok for several weeks does some weird crap to the eye and the surrounding nerves. With everything said and done, I was left with trigeminal neuralgia, hazing on the cornea, permanent mydriasis from a damaged nerve, and everything that goes a long with it including diplopia.

So, there's quite a bit of screw ups on my part with this, the first being the fact that I don't have diplopia anywhere on my medical records. I never noticed the double vision until I got my new RX glasses and actually started wearing them. By that time, my appointments with the ophthalmologist seeing me were every 3 months and consisted of a quick 5 minutes of making sure the virus hasn't flared back up.

Going into the process, I screwed up with the VA claim because I didn't write out everything I thought was wrong with my eyes. I had asked the VA rep if I needed to or was it going to be covered in the C&P exam. He said to just put "both eyes" down and that everything should be gone over in detail in the exam. The claim already covered the keratitus and infection within the eye itself. The day of exam I spent maybe 10 minutes with the nurse and maybe 5 minutes with the doc. He did a quick light test and then when I specifically asked about the double vision, remarked it was from the pupil not being able to constrict enough to focus and that I would continue to have it.

Today, I went over the NARSUM with the PEBLO and the diplopia was nowhere on it, with the VA doc checking no for that specific question. Talking it over with the PEBLO, she said it was up to me if I wanted to request an IMR and that it was no guarantee it would be added. After reviewing the VA C&P records at home I also feel like he didn't accurately describe the eye and the damage done. The entire exam and document just felt very rushed and lazy.

I guess my questions are, is there a sample letter out there for a request for IMR and how badly did I shoot myself in the foot for not attempting to make sure the double vision was documented?
 

gsfowler

Staff Member
PEB Forum Veteran
Yes, request the IMR and make sure the correct medical records get sent to the IMR physician via your PEBLO and medical records technician. Often the IMR physician will only be looking at the AHLTA notes so he or she may not know the condition exists.

Also look over the VASRD to see if the diplopia will actually raise your rating from the keratitis and infection within the eye itself.

This thread has the ratings for the eye: http://www.pebforum.com/site/threads/vasrd-schedule-of-ratings—eye.410/
 

Warrior644

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PEB Forum Veteran
Registered Member
Background, I went DNIF back in march for what eventually turned out be to be shingles/keratitis and was pinged for a MEB in November. Turns out a herpes virus running amok for several weeks does some weird crap to the eye and the surrounding nerves. With everything said and done, I was left with trigeminal neuralgia, hazing on the cornea, permanent mydriasis from a damaged nerve, and everything that goes a long with it including diplopia.

So, there's quite a bit of screw ups on my part with this, the first being the fact that I don't have diplopia anywhere on my medical records. I never noticed the double vision until I got my new RX glasses and actually started wearing them. By that time, my appointments with the ophthalmologist seeing me were every 3 months and consisted of a quick 5 minutes of making sure the virus hasn't flared back up.

Going into the process, I screwed up with the VA claim because I didn't write out everything I thought was wrong with my eyes. I had asked the VA rep if I needed to or was it going to be covered in the C&P exam. He said to just put "both eyes" down and that everything should be gone over in detail in the exam. The claim already covered the keratitus and infection within the eye itself. The day of exam I spent maybe 10 minutes with the nurse and maybe 5 minutes with the doc. He did a quick light test and then when I specifically asked about the double vision, remarked it was from the pupil not being able to constrict enough to focus and that I would continue to have it.

Today, I went over the NARSUM with the PEBLO and the diplopia was nowhere on it, with the VA doc checking no for that specific question. Talking it over with the PEBLO, she said it was up to me if I wanted to request an IMR and that it was no guarantee it would be added. After reviewing the VA C&P records at home I also feel like he didn't accurately describe the eye and the damage done. The entire exam and document just felt very rushed and lazy.

I guess my questions are, is there a sample letter out there for a request for IMR and how badly did I shoot myself in the foot for not attempting to make sure the double vision was documented?
_______________________________***:D*** Happy New Year! ***:D***________________________________

Welcome to the PEB Forum! :)

Hmm, have you also consulted with the MEB Legal Office within your specific military branch of service at this point for assistance? :confused:

As such, they are trained within the DoD IDES process and would know exactly how to effectively request an IMR for review by the MEB! Take are and I hope for much success with your DoD IDES case file! :cool:

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer!"

Best Wishes!
 

Track

Registered Member
Yes, I sent an email yesterday asking for help, as it was after hours. I also noticed he didn't put paralysis of accommodation and kept calling it anisocoria. It bugs me because while that technically is correct, the code for mydriasis covers it better, and helps to show why I have the Diplopia and accommodation issue.
 

Warrior644

Staff Member
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PEB Forum Veteran
Registered Member
Yes, I sent an email yesterday asking for help, as it was after hours. I also noticed he didn't put paralysis of accommodation and kept calling it anisocoria. It bugs me because while that technically is correct, the code for mydriasis covers it better, and helps to show why I have the Diplopia and accommodation issue.
Okay, good deal! :)

Hopefully, the request, performance, and completion of the IMR shall resolve your specific MEB issues prior to your DoD IDES case file being forwarded to the DoD PEB for a fitness determination if at least one medical impairment was deemed "medically unacceptable" by the MEB. Take care! :cool:

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer!"

Best Wishes!
 

chaplaincharlie

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I can't imagine and IMR not resolving your issues. My experience with USAF was that they wanted to make things right and did their best to resolve issues quickly.
 

Track

Registered Member
I can't imagine and IMR not resolving your issues. My experience with USAF was that they wanted to make things right and did their best to resolve issues quickly.
That's what I hope. I gave the PEBLO the letter on Tuesday as well as sign the NARSUM stating that I wish for a impartial review. I went through a blank DBQ and it made me realize he didn't even sign the boxes about keratitis and scleritis, the two conditions kicking me out... I'm also looking into going to a civilian doc and having them fill out the form. However, I'm wondering if I should wait to see what they decide for the impartial review.
 

chaplaincharlie

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May I suggest, you make an apportionment to get another opinion while you wait on the IMR. You can always cancel and it sometimes take a while to get into see a specialist!
 
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