new to all of this...need help

123suzyq

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Registered Member
I am an Air National Guard member, 22 yrs total service, 16.5 as an AGR. I just found out in August 2016 that I was undergoing an MEB without even be contacted about it.

My back issues started in December 2014, which started with a trip to the ER (not on base) to follow up with PCM, chiropractor (who refused to do imaging before starting treatment), back to PCM, physical therapy and traction. First MRI indicated a large disc extrusion, which was recommended to do a round of pain injections, and no relief.

Surgery was scheduled for August 2015 and 3 days post op I was completely sideways, could not stand up at all and in excruciating pain!! I tried my hardest to be seen by my surgeon before my followup and the neurosurgery clinic kept telling me he was booked and there were no cancellations. I needed to come to the ER on base if it was that bad...and at that point they PAGED him to the ER....

received a call a few days later that my follow up had been cancelled by them and was told my original surgeon QUIT! WTF!!

I have been through the ringer since this surgery, been through 3 more rounds of pain management, still in physical therapy, and they still can't give me an answer.

I am on my 3rd neurosurgeon, have had 3 more MRI's and now he thinks I have an SI issue. I have also been referred to an orthopedic surgeon, I have confirmed hip dysplasia from an XRay and in this nightmare that I have been living, and am looking for an off base referral because the neurosurgeon I am undercare with now is deploying and will PCS after his deployment.

I can't get any answers and I am in constant pain. I had severe burning in my legs and numbness in my toes prior to surgery and it has all come back.

anyone have any suggestions??
 

chaplaincharlie

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You provided a great summary of your care, which is no so great. Do you have specific questions we can answer?
 

123suzyq

PEB Forum Regular Member
Registered Member
well, my promotion is being help up also because of all this madness....I have been assigned a PEBLO and am trying to keep them up to date with all appointments, scans, etc.... if the MEB moves forward, how can I assure that I will evaluated properly and fairly, not half assed!! after all, I've dedicated 22yrs and would like to have something to show. One diagnosis has said lumbago with sciatica...but isn't that too much of a general diagnosis?? I live in constant pain, before and after surgery, and have had absolutely no relief! I guess I am needing as much help as possible so I know exactly what needs to be done. I keep reading websites, and the more I read the more I confuse myself
 

FloridaInjuredInCombat

PEB Forum Regular Member
PEB Forum Veteran
Registered Member
Keep in mind that the MEB decides which conditions do not meet retention standards and those are the conditions that go on to the PEB to be decided upon for benefits. With this in mind, you should know that Lumbar Radiculopathy (pain and numbness) in your legs, is a SEPARATE rateable condition for EACH leg.

In my case, I had to appeal the initial MEB finding to include the Lumbar Radiculopathy for EACH leg. That turned out to be very fortunate, since the initial PEB finding was only for 10% back ,and 10% for EACH leg, that alone put me over the 30% mark for Military Retirement.

Beyond that, try to get the best C&P exams you can, be honest, but also be very attentive to making sure your conditions are covered and recorded. If like many, including my own, the C&P report looks like a sick joke, you have the option of going to your OWN doctor(s) and getting a DBQ for that condition filled out by them. It mirrors the C&P exam report.

I strongly suggest you print it out yourself, and get it back from the doctor when they are done filling it out. Tell the doctor to hand it to YOU, NOT send it directly to the VA. That way you not only have some assurance that it's accurate and beneficial BEFORE it's in the VA's hands, but you can save it and use it during the PEB for an appeal as NEW EVIDENCE. If you or your doctor just sends it back to the VA, they can say it was taken into account, whether they read it or not, and you won't have it for an appeal.

The way the rating rules read, when there are two medical reports from equally matched sources, and they don't agree on the severity of the condition or rating warranted, the VA is required to use whichever report is MOST BENEFICIAL to the Veteran. The DBQ and C&P, provided your doctor or orthopedic surgeon (preferably someone who has a history of treating you) fills it out, are equal in the eyes of the VA, and should work to your benefit.

Last but not least, view this whole thing as a long campaign. Keep focused on your health, and keep pushing for proper treatment. Don't get wrapped around the axle about things if you can help it. Better to fight like hell when you have to, and try to keep it in perspective during times you have to wait it out. There's been more than a few who've gotten so frustrated with the circus they were willing to take any outcome to finish it, that's a decision filled with regret. Stick it out, and land punches. It's going to affect the rest of your life, so make it count. Good Luck.

Hope this helps...
 

123suzyq

PEB Forum Regular Member
Registered Member
what is the C & P? It's very frustrating being restricted to an MTF for treatment when the old adage applies: Hurry up and wait......well, that definitely has been the case for me, as I'm sure as the rest of active duty members....

the DBQ is what they do your evaluation on?? so I can ask for a copy, so in case I need to appeal the decision??
 

FloridaInjuredInCombat

PEB Forum Regular Member
PEB Forum Veteran
Registered Member
what is the C & P? It's very frustrating being restricted to an MTF for treatment when the old adage applies: Hurry up and wait......well, that definitely has been the case for me, as I'm sure as the rest of active duty members....

the DBQ is what they do your evaluation on?? so I can ask for a copy, so in case I need to appeal the decision??
C&P exams is short for the VA Compensation and Pension exams, the VA not the military does the physical exams and then determines the rating for each service connected injury or illness. The military uses the VA exams and rating determinations, and the military is the one who decides which injuries or illness "do not meet retention standards" (MEB) and which of those are "Unfitting" (done at the PEB).

The DBQ is the abbreviation for the VA Disability Benefit Questionnaires, I believe each group of ratable conditions has its own DBQ, which you can go to the VA website, search for and download. The DBQ is NOT a C&P exam, but it is the equivalent of a C&P exam that YOUR doctor can fill out for you. If the VA's C&P report is jacked up (and many are) the DBQ can be used as evidence during the PEB appeal to help you counter the jacked up C&P.

The short list of the IDES (MEB/PEB) program goes like this...

You're injuries require a MEB (medical evaluation board).

The MEB sends you to VA C&P exams, and has a military doctor interview you (NARSUM).

The MEB looks at it all and decides which of those conditions "do not meet retention standards".

You get the MEB report and have an opportunity to appeal. (appeal if there's ANY ratable condition that should have been on there, as only the MEB list makes it to be considered by the PEB).

Then the MEB sends the packet to the PEB, who then sends the packet back to the VA for the specific ratings.

The VA rates your conditions, and sends it back to the PEB.

The PEB (looking only at the conditions the MEB found "do not meet retention standards") and decides which conditions are UNFITTING. ONLY the UNFITTING conditions will be factored into what the DOD benefits will be.

You get the PEB report and have an opportunity to appeal. This is where the DBQ can be GOLD, as it can counter what the C&P exams got wrong.

Then after the PEB appeal, your final ratings are decided. You still "may" have an option to change them at a Board of Corrections, but that's a LOT steeper hill than getting them done right while you're still in.

If the DOD ratings come back UNDER 30% you'll get a one time severance pay, and no further military coverage or pay. If the DOD ratings come back 30% or higher, you WON'T get the one time severance pay, but instead, you'll be MEDICALLY RETIRED, with Tricare medical (not dental) insurance and base privileges, and likely a small retirement check for life (after whatever the VA disability check is deducted).

The VA ratings and disability benefits (pay) is SEPARATE from the DOD, while the DOD only counts the Unfittting conditions, the VA counts ALL service connected disabilities. That's why the VA combined disability ratings are usually noticeably higher than the DOD combined disability ratings.

At this point your focus should be on two things....

One, getting the best treatment you can to minimize the damage. In my case the military delayed and delayed the spinal surgeries needed, and likely added to the permanent damage done. Your health is priority number ONE.

Two, make sure EACH STEP in the IDES (Integrated Disability Evaluation System) process is done CORRECTLY (or at least as correct as you can fight for). That is because EACH STEP is vital to the outcome. If the C&P exam report is jacked it will mess up the MEB, and if the MEB doesn't list ALL the conditions it should as "not meeting retention standards" it will limit your outcome at the PEB.

Chess not Checkers, you have to look ahead and be prepared.

Now that I've probably scared the hell out of you, here's the good news. You already know more than most, as most are completely in the dark and find out by falling into the landmines blindfolded. Your best ally is the PEB Forum, that and (hopefully) a good JAG attorney willing to fight on your behalf at both the MEB and PEB appeal.

Each appeal has about a 10 day window, so it's best to know as much as you can beforehand, including getting the C&P report directly from the VA the second it's posted (you can request that at any VA office), and have the DBQ(s) filled out and READY before you are due to receive your initial PEB findings, as the DBQ takes time you're not going to have in that 10 day window.

Last but not least, keep it in perspective, and know it's going to take longer than you think and it's GOING to be frustrating and seemingly endless at times. That's the process, don't get wrapped around the axle, fight when you have to, be prepared for the next hurdle, BUT REST when you can. Don't get so stressed that you jump at the chance to end it with whatever they give you, that is a sure way to short change yourself.

Chess not Checkers...

Hope this helps...
 

KENNON

New Member
Registered Member
I need help/advice: I just received PCS orders report date less than 90 days, and I have been diagnosed with dysplastic hip. I'm in pain all the time, I just had my first hip injection and that did not help at all. the doctors keep telling me I'm to young for a hip replacement, I'm 40yo and a MEB is very possible. now they are telling me PT and see where it goes from there I have had this problem for 7 years now and it has got worse over the years. and that is how long I've been getting the run around from military doctors. QUESTION 1: what do I say or do to get my surgery 2: what will this be rated if they MEB me without surgery. 3: how can I get my orders canceled so I don't have to start over after I PCS. I need to get this done asap this has really been depressing for me. I really want my surgery so I can retire in 6 years.
 

FloridaInjuredInCombat

PEB Forum Regular Member
PEB Forum Veteran
Registered Member
I need help/advice: I just received PCS orders report date less than 90 days, and I have been diagnosed with dysplastic hip. I'm in pain all the time, I just had my first hip injection and that did not help at all. the doctors keep telling me I'm to young for a hip replacement, I'm 40yo and a MEB is very possible. now they are telling me PT and see where it goes from there I have had this problem for 7 years now and it has got worse over the years. and that is how long I've been getting the run around from military doctors. QUESTION 1: what do I say or do to get my surgery 2: what will this be rated if they MEB me without surgery. 3: how can I get my orders canceled so I don't have to start over after I PCS. I need to get this done asap this has really been depressing for me. I really want my surgery so I can retire in 6 years.
I apologize for the slow reply, I just saw this post tonight. If they're telling you to try therapy, that may be your best course, simply because if you don't' give it a shot, they might use your refusal to the treatment recommended as ammo against you. That said, don't be afraid to go back and talk it over with your doctor, explain the pain, explain your medical and career concerns, and you haven't already request a referral to a orthopedic surgeon for an opinion by that specialist. A lot of it depends on you TACTFULLY working the system to your benefit. If they flat out refuse to let you see a surgeon about it, check in with a Patient Advocate to see if they can get it approved.

I have no idea how to change PCS orders, but if they do PCS you, make sure you have a HARD COPY of ALL the medical records you have to date, and KEEP them with you and bring them to the next doctor so that they're able to see what's been done already. The medical records have a "Bad Habit" of either not getting into the digitized records or disappearing without a trace down the road, KEEP A GHOST COPY OF EVERYTHING in your medical records to avoid that. And by keep I mean to the end of time.

The VA C&P exams (what the MEB and PEB key off of) are based on several factors including Range of Motion, loss of ability to perform duty / tasks, etc... I don't think they place to much stock on the Pain you're going through. Best to look up what the SPECIFIC rating thresholds for your injury / condition are so that you know EXACTLY what they're looking at and rating you off of BEFORE you get to the C&P (VA Compensation and Pension) exams. For instance, a spinal injury is rating nearly exclusively off of Range of Motion (forward flexation in degrees), so even if you're unable to work, and in severe pain, if you can bend forward (for a spinal injury) the VA will say you're good to go. Its wrong but that's the system. You should be able to find the SPECIFIC rating criteria off of the VA website. Others in this forum might know the exact link to that.

Hope this helps…
 
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