Medical assesment made by my doc

Hello,

Im in the navy and on my way to the PEB all im waiting for is for my chain of command to finish the NMA (non medical assesment) My questions are the write up my doc is sending to the board to me looks horible. I have type 2 diabetes and insulin dependant thus making me non deployable i also have hyper tension. My doc has done nothing but threaten to "rail road me out of the navy" since becoming insulin dependant. I wrote a rebutal to go up with my package and in there I stated how he has broken patient privacy by discussing my disease with non medical staff as well as not allowing me to receive meds prescribed by another doctor. He imformed me that those are accusations and has intentions to send me to NJP and even court martial. He recently grasping for straws asked me if I was an alcohalic and I said no and he said that would explain why my disease isnt any better I told him no I wasnt an alcohalic he then refered me to an addiction treatment center and threatend if I didnt go I could face an admin sept. I glady went because I was in fear of a admin sept well when I arrived to the center they evaluated me for 2 weeks during this two weeks I consumed no alcohal and was given a breathalizer test daily to make sure I and everyone else wasnt drinking. well needless to say the treatment center sent me home with a mis diagnosis that I was not alcohal dependant and my gluclose levels were still dangerously hi. This seemed to make him made because he told me before I left that "he hoped they would diagnose me as a full blown alcohalic so it would ease his mind" since he hasnt been able to help me get my disease under control. with his threats of NJP and all I feel like I should pull my rebutal but im so scared that if I just let his assesment go that the board will discharge me with nothing as far as a % of disability. because he basically staes Im non compliant to treatment and I smoke. I have almost 16 yrs of nothing but honorable service to my country and my chain of command is supporting me and are writting a really good non medical assesment but I just dont know if that will help. I also was wondering if a person receives more than 20% disability does that mean your not entitled to any severance pay?
I apoljize for all my bad penman ship and mis spelled words but you all seem so friendly here and I dont think you will hold that against me.
I thank you in advance for anyone that is willing to discuss all this with me.
 
Click to expand...
Bizott,

Welcome to PEBFORUM! We are glad to have you.

First, it sounds like you want a "fit finding." Is that the case? If so, your NARSUM, while important, may be overcome with other evidence of your good duty performance. If your NMA is strong, you will be in a better position.

As far as the doctor sending you to NJP or Court-Martial, he can't. It is a command perogative, and I can tell you as a former military prosecutor, this will not be something the Staff Judge Advocate will support. I can't conceive of a charge that would stick (and in fact have an easier time thinking of one's that would better fit the doctor's conduct).

All this aside, your rebuttal may not have helped your case. Generally, you want to focus on the facts that will support your position. WIth that in mind, I would focus on gathering evidence supporting your position.

Finally, if you are found unfit, you may have a stronger chance now (since the passage of the 2008 NDAA) with remaining on active duty even after an unfit finding.

Please let us know any questions. I wish you the best of luck through this process.
 
Jason,
Thank you for such a quick reply. Yes I would love to be found fit and be able to retire in 5 yrs however I have exausted all avenues in trying to be able to stay and have been told NO because I'm insulin dependant and that makes me non deployable. So I have given up on that battle however Im just so afraid that with my docs write up that the board will side with him and I will receive nothing.

So do you think that sending a rebutal isnt a good idea? My chain of command is still writing the NMA and with his threats Im seriously considering pulling it.

Thank you very much again and Im really glad I was able to find your site under google.

Also I forgot to say Im a Navette and the Navy counts half of my inactive reserve time so in all actuality if they board looks at it like this I only have 11 yrs.

I know only the board will make the decesion as far my % they rate me but with your knowledge do you think they may come back with 0 though I had none of these medical conditions untill 3 yrs ago?

Thank you again!
 
As far as non-compliance impacting your rating, this is the relevant portion os SECNAVINST 1850.4E:

3805 Assignment Of Aggravation Factors When Prescribed Treatment Is Refused
Or Omitted​
Although a service member would not be Fit to continue naval service, a member’s
degree of disability may have been aggravated or increased by, among other things, an unreasonable failure or refusal to submit to medical or surgical treatment or therapy, to take prescribed medications, or to observe prescribed restrictions on diet, alcohol, drugs, or tobacco. The compensable disability rating may be reduced to compensate for such aggravation or increase when the existence and degree of aggravation are ascertainable by application of accepted medical principles, and where it is clearly demonstrated that:
a. the member was advised clearly (with appropriate documentation) and
understandably of the medically proper course of treatment, therapy, medication or
restriction; and
b. the member's failure or refusal was willful or negligent, and not the result of​
mental disease or of physical inability to comply."

You will have to see how the IPEB rates you (especially their rationale for the rating). However, I would be willing to bet you were not counseled on non-compliance in a way that allows reduction of rating. Even if so, I think there are arguments to be made (not saying they are sure fire winners) that your use of tobacco is due to addiction. On this point, I would consider enrolling in smoking cessation classes, to show you are trying. Finally, I would argue that it is impossible to assign a degree to which your diabetes is affected by tobacco (this one is probably a winning argument; to overcome, they would likely need to cite to scholarly articles or treatises assigning a degree of aggravation due to smoking. I am not sure about this, but I doubt they exist, and if they do, I doubt the PEB cites to them).

Like I said, any disagreement I would file would focus on the points you dispute. It is ultimately your case, and you have to decide what to disupte. But, if it is not focused on the facts neccesary for an appropriate rating, you will not help your case much.

One question, I am not familiar with "Navette." Is that a term for an inactive reservist? As far as them rating you even though you did not have the condition 3 years ago, that issue would tend to go to the pre-existing nature of the condition. I don't see this as apparent from the facts you describe, but has anyone called this a pre-existing condition?

Glad to help!



 
Bizott,
Welcome and sorry to hear you have found the "turd in doctor punch bowl." I can understand frustration on the part of a doctor about circumstances of a patient (maybe he thinks you're condition is a reflection of his abilities or something?), but he doesn't sound very professional at all. I've worked with a few folks who sound like this guy-best approach with them (and in my opinion, with this guy) is just how Jason indicated. Be the stable, professional Sailor that you are, and express that in your conduct with the board. I would say staying on topic, discussing only those facts that are relevant to your condition and remaining neutral will outweigh whatever the good doctor has to say. Those gentlemen on the board are all career military,...they can see through the b.s to get to the root as well as any of us. Good luck and stick around,...these guys are terrific!
 
Unlike the Army and the Air Force, the Navy/Marines gives absolutely no rationale for their ratings in their IPEB decisions. However, when you go to a formal board, they give very detailed ratings rationale in their formal board decisions. In fact, you usually have to wait three weeks for the decision so that they can prepare the response. It is the worsts of times and the best of times when it come to ratings rationales from the Navy PEB's.

Miike
 
You must log in or register to reply here.
Top