Met my MSC today

H

HiOffcr

PEB Forum Regular Member
PEB Forum Veteran
Registered Member
The reality finally set in, that my 11 year career may be coming to an end soon.

My referred condition is DDD Lumbar. During our meeting with my MSC, I identified 17 additional conditions:
Urinary frequency/urgency/incontinence
Sciatica
Numbness in L foot
Erectile dysfunction
Bilatteral hip pain
Bilateral Shoulder injury
Bilateral Ankle Injury
Irritable Bowel Syndrome
Scars to L arm and neck (riser burn)
Numbness, finger L hand
Chronic Fatigue
TBI
L eye degenerative disease
Dry Eyes
Bilateral Retropattelar Pain Syndrome
Insomnia
PTSD

That being said, I have a few questions:
1. Will the numbness in the foot, erectile dysfunction, urinary issues and sciatica be rolled into the DDD Lumbar, since they are a result thereof? Or, will they be looked at seperately and be determined as fit/unfit?
2. I forgot to tell the MSC about my radiculopathy, but it is annotated numerous timess in my record. Can I still have this considered.
3. I have been diagnosed with PTSD by a LCSW and a Psychiatrist. I am currently taking Klonopin (for sleep), Restoril, Prozasin, Prozac (60mg). I have frequent anxiety and anger attacks but it has not affected my administrative work performance. However, it is documented in my MH record, as well as in my Commanders Statement, that one of my triggers is the sight of blood. Being a Medic, that pretty much limits what I can do. That being said, is it possible that that the PTSD could be found unfitting, even though it was not a referred condition?
 
Depending on how it is worded etc. in your NARSUM they may move it to unfitting/cat one, but it is unlikely they will do it on their on. IF you can prove either by documentation/testimony and the VA rates it appropriately then you can fight for it to be moved at formal board. it is a win/loose type deal though, if the va rates it at 50% by default then chances are you will be placed on TDRL instead of PDRL which is a huge difference in freedom after service, state/fed. benefits etc. but if its listed as mild and rated under MDD etc. and not unfitting then you may get away with PDRL. I am no expert on the issue and hopefully someone will chime in, but wanted to get you the gist of havign to fight at formal board to have conditions moved up.
 
HiOffcr said:
The reality finally set in, that my 11 year career may be coming to an end soon.

My referred condition is DDD Lumbar. During our meeting with my MSC, I identified 17 additional conditions:
Urinary frequency/urgency/incontinence
Sciatica
Numbness in L foot
Erectile dysfunction
Bilatteral hip pain
Bilateral Shoulder injury
Bilateral Ankle Injury
Irritable Bowel Syndrome
Scars to L arm and neck (riser burn)
Numbness, finger L hand
Chronic Fatigue
TBI
L eye degenerative disease
Dry Eyes
Bilateral Retropattelar Pain Syndrome
Insomnia
PTSD

That being said, I have a few questions:
1. Will the numbness in the foot, erectile dysfunction, urinary issues and sciatica be rolled into the DDD Lumbar, since they are a result thereof? Or, will they be looked at seperately and be determined as fit/unfit?
2. I forgot to tell the MSC about my radiculopathy, but it is annotated numerous timess in my record. Can I still have this considered.
3. I have been diagnosed with PTSD by a LCSW and a Psychiatrist. I am currently taking Klonopin (for sleep), Restoril, Prozasin, Prozac (60mg). I have frequent anxiety and anger attacks but it has not affected my administrative work performance. However, it is documented in my MH record, as well as in my Commanders Statement, that one of my triggers is the sight of blood. Being a Medic, that pretty much limits what I can do. That being said, is it possible that that the PTSD could be found unfitting, even though it was not a referred condition?
Click to expand...

Welcome to the PEB Forum! :)

From my experiences within the DoD IDES MEB/PEB process, I offer responses to your inquiry as follows:

Q1. Will the numbness in the foot, erectile dysfunction, urinary issues and sciatica be rolled into the DDD Lumbar, since they are a result thereof? Or, will they be looked at seperately and be determined as fit/unfit?
A1. In my opinion, there exist a potential "roll-up" as secondary medical effects. If there exist medical conditions secondary to your DDD lumbar, they will have to be reviewed for a determination of "medically acceptable" or "medically unacceptable" by the MEB. If the MEB only determine your DDD Lumbar as medically unacceptable and the PEB yields an "unfit" determination, then you can request a Formal PEB hearing to have all of the secondary effect medical conditions to be potentially determined "unfit" for continued military service, too.

Q2. I forgot to tell the MSC about my radiculopathy, but it is annotated numerous timess in my record. Can I still have this considered?
A2. The DoVA D-RAS should thoroughly review your Service Treatment Records (STR), C&P Examination results, civilian medical documentation and other received medical documentation (if any) to make a proposed DoVA rating. Simply stated, if it's annotated numerous times within your STR, then the radiculopathy (subjective or objective) should be considered in the overall rating of the medical condition.

Q3. That being said, is it possible that that the PTSD could be found unfitting, even though it was not a referred condition?
A3. The PEB is supposed to review all annotated medical conditions by the MEB to yield a fitness determination. From my IDES experiences via an U.S. Army perspective, the chances of this happening is less likely if the MEB doesn't yield a medically unacceptable determination. The PEB concentrated only on the medically unacceptable conditions to render their fitness or unfitness determination.

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

Best Wishes!
 
Thank yo for your respon
Warrior644 said:
Welcome to the PEB Forum! :)

From my experiences within the DoD IDES MEB/PEB process, I offer responses to your inquiry as follows:

Q1. Will the numbness in the foot, erectile dysfunction, urinary issues and sciatica be rolled into the DDD Lumbar, since they are a result thereof? Or, will they be looked at seperately and be determined as fit/unfit?
A1. In my opinion, there exist a potential "roll-up" as secondary medical effects. If there exist medical conditions secondary to your DDD lumbar, they will have to be reviewed for a determination of "medically acceptable" or "medically unacceptable" by the MEB. If the MEB only determine your DDD Lumbar as medically unacceptable and the PEB yields an "unfit" determination, then you can request a Formal PEB hearing to have all of the secondary effect medical conditions to be potentially determined "unfit" for continued military service, too.

Q2. I forgot to tell the MSC about my radiculopathy, but it is annotated numerous timess in my record. Can I still have this considered?
A2. The DoVA D-RAS should thoroughly review your Service Treatment Records (STR), C&P Examination results, civilian medical documentation and other received medical documentation (if any) to make a proposed DoVA rating. Simply stated, if it's annotated numerous times within your STR, then the radiculopathy (subjective or objective) should be considered in the overall rating of the medical condition.

Q3. That being said, is it possible that that the PTSD could be found unfitting, even though it was not a referred condition?
A3. The PEB is supposed to review all annotated medical conditions by the MEB to yield a fitness determination. From my IDES experiences via an U.S. Army perspective, the chances of this happening is less likely if the MEB doesn't yield a medically unacceptable determination. The PEB concentrated only on the medically unacceptable conditions to render their fitness or unfitness determination.

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

Best Wishes!
Click to expand...

Thank you for the response. I saw my neurologist today and had an EMG conducted. The EMG confirmed "S1 radiculopathy on RIGHT>LEFT", "signs of muscle denervation", and "LEFT Peroneal Palsy". The palsy has caused foot droop on the left side, and I will be fitted for an AFO brace tomorrow.

That being said, I feel that this will do nothing but help my claim. Unfortunately, my general med C&P isn't until 1 AUG.
 
HiOffcr said:
Thank yo for your respon
Thank you for the response. I saw my neurologist today and had an EMG conducted. The EMG confirmed "S1 radiculopathy on RIGHT>LEFT", "signs of muscle denervation", and "LEFT Peroneal Palsy". The palsy has caused foot droop on the left side, and I will be fitted for an AFO brace tomorrow.
That being said, I feel that this will do nothing but help my claim. Unfortunately, my general med C&P isn't until 1 AUG.
Click to expand...
You are welcome! :)

I agree! The results from your neurology appointment's EMG test is good solid medical evidence for addition to your current DoD IDES case file DoVA claim. No worries, it's all good! ;)

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

Best Wishes!
 
Has your MEB been completed and forwarded to the IPEB? Did you request an impartial review of your MEB (foot stomp--- you should do this, if your case has not already been forwarded).
 
If you just met with the MSC, I am going to assume that you have yet to complete your C&P evaluations with the VA or QTC (VA contractor).

Typically the QTC appointments are sceduled based upon your referred and claimed conditions. You will most certainly have an evaluation with a general practioner for the bulk of the C&P evaluation and any condition(s) that were not claimed to the MSC can also be addressed.

Before the QTC evaluation, take a look at AR 40-501 Chapter 3 and read every condition. See if any apply to you. This is the regualtion for the Standards of Medical Fitness. (here is a link http://www.apd.army.mil/pdffiles/r40_501.pdf) You should also look a the Veterans Affiars Schedule to Rating Disabilities (VASRD) (here is a link http://www.benefits.va.gov/warms/bookc.asp)

Go through every singlew condition and see if they apply to you. In addition to the conditions, look at the symptoms of each condition and see if they apply to you.

Now that you have done your homework, put together an outline of reach and every symptom you have. Symptoms are more important than conditions.

As you go through your evaluations with the C&P physicians make sure they are made aware of every single symptom and how it affects you. Also let hem know exactly how they symptoms came about or were agravated duting your military service.

I'll begin with one of the conditions you have listed (Urinary frequency/urgency/incontinence)

AR 40-501 Chapter 3
3-17. Genitourinary system
The causes for a referral to an MEB are as follows:
e. Incontinence of urine, due to a disease or defect not amenable to treatment and of such severity to necessitate the absence of duty.

For this condition to be considered unittting you must have symptoms that are causing you to be absent from work and or unable to perform your duty. The type of evidence that would support this would be the commanders statement, frequent use of sick call, frequent quarters from the symptoms.

Most likely the condition will not be found unfitting in its self, but it there could be a combination of it and other symptoms that are a result of another condition (nerve damage from the DDD) that when are combined could then be determined to cause you to be absent from work and/or perform your duty. (floor stomp).

Now moving onto the VASRD you would go to the Genitourinary System and look up the rating structure for disfunction (Voiding Disfunction).

The satandards for rating would be:

Requiring the use of an appliance or the wearing of absobent materials which must be changed more than four times per day...60%

Requiring the wearing of absorbant materials which must be changed 2 to 4 times per day...40%

Requiring the wearing of absorbant materials which must be changed less than 2 times per day...20%

Now you can go down the line and look at Urinary Frequency and apply the same principles to the symptoms that you have.

I do not advocate any embelishment during your appointment so make sure you have the medical evidence to back up anything that you inform the physicians about and also make sure you get the symptoms put into your medical records.

Medical evidence for the incontinence can be that you have saved the pads used, bagged and dated them to take to you urologist when you have your follow up visits, a log of how frequent that you must void during the daytime and/or nightime. If you make a log, present it to the urologist or nurse case manager to ensure it is documented in AHLTA.

You can also cite any medications that you are using for the condition.


Use this model that I have just given for every single condition and every single symptom of the condition. I would recommend that you never talk about the percentages that go with the symptoms to anyone as they may use that to paint a picture of malingering.

Silenty gather the evidence and make sure that it makes it to your C&P doctors.
 
Jason Perry said:
Has your MEB been completed and forwarded to the IPEB? Did you request an impartial review of your MEB (foot stomp--- you should do this, if your case has not already been forwarded).
Click to expand...

No, it has not been forwarded. I have only completed my TBI and Mental Health Eval. I have an optometry apt in July and my General Med on 1 August. I definitely plan on having an impartial review done.
 
According to the examiner that did my General Med C&P, she bent me over the table and gave it to me good. 65 out of 90 on flexion. Funny, because I distinctly remember about 15° - 20°, as I took no meds and she even had to take my shoes, socks, and ankle brace off/on. Seriously, who get's an MEB after having a back issue for 7 years but can flex 65°?
 
HiOffcr said:
According to the examiner that did my General Med C&P, she bent me over the table and gave it to me good. 65 out of 90 on flexion. Funny, because I distinctly remember about 15° - 20°, as I took no meds and she even had to take my shoes, socks, and ankle brace off/on. Seriously, who get's an MEB after having a back issue for 7 years but can flex 65°?
Click to expand...

Well, the potential answer is if the treating physician believes that you are unable to perform full military duty, or that you are unlikely to be able to do so within a reasonable period of time (normally 12 months), you will be referred to a MEB at the medical treatment facility where your treatment is being provided.

Moreover, if your physical condition falls below medical retention standards, the attending physician will refer you to the PEBLO to start a MEB. The attending physician does this by relating the nature and degree of your medical impairment to retention standards and the duties that you may reasonably be expected to perform in your respective branch/ Military Occupational Specialty and grade.

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

Best Wishes!
 
You must log in or register to reply here.
Top