Referred Conditions, DOD%, and VA Claim Concerns - Please Help!

D

Dory

New Member
Registered Member
Hello all.

BLUF: How important is the DOD% and making sure the referred condition(s) are accurate if over 20 years active duty Navy?

I'm pretty sure my entire IDES process is crazy, but they all say its just me.... so here goes:

1. BACKSTORY & REFFERAL

I was diagnosed with Non-Hodgkin's Lymphoma in 2021 and when through 6 months of an intensive chemotherapy that included staying in the hospital for 5 days of continuous pump chemo plus and additional lumbar puncture CNS chemo, every 21 days. I am putting this out there early because I think its important to know that.... but my PCM apparently doesn't agree.

My treatment was through a civilian oncologist and I have been in remission since July 2022 (yay!). I was determined to stay active duty but chemo caused a slew of long term and chronic effects. There have been quite a few issues who is supposed to treat these issues, with my oncologist saying that is my PCM swim lane and my PCM saying that my oncologist should be treating chemo-related side effects. As a result, none of the chemo-related issues were ever truly addressed, aside from being sent to MH because I have severe medical anxiety and am in constant fear of cancer returning. My MH provider finally referred me to IDES in May 2024 with Generalized Anxiety Disorder as the referred condition.

2. MEDICAL RECORD & REFERRED CONDITION

It wasn't until my PEBLO called for my first counseling that I found out that NONE - NOT ONE PAGE of my oncology record was ever put in my military medical record (who knows what my case manager was doing for 2 years let alone how my PCM was "treating" me without even knowing what type of chemo I had) I had to scramble to print 1400 pages of this record of and give them to medical records to be uploaded to MHGENISIS. I was told this was done, although I can't see them in my account... more on that later.

Anyway, when I discussed this with the PEBLO and she told me I was only referred for anxiety and to speak to my provider about listing all of the conditions that make me unable to do my job individually. I had this discussion with my PCM, who told me she did not have to list every conditions and that because she was MH, she only had to refer MH conditions. But, after speaking with my PCM, she included these snippets into her NARSUM:

- "on going symptoms of poor sleep, excessive worry, restlessness, easily fatigued, headaches, increased body tension, poor memory, difficulty concentrating and irritability with depressed mood"
- "overall body tension and constant pain with inability to focus on work or home"
- "'brain fog' that has come after chemo treatment makes it extremely difficult for her to do her military occupation"
- "continued issues with sleep"
- "has undergone 2 years of psychotherapy and medication management without success. Continues to experience difficulties with sleep, focusing, memory, and feeling on edge"

Still with me? Well there's more....

3. MSC & VA APPTS
Now, my MH provider assured me that because she had written these things into her referral report, they would be considered as 'referred conditions'. So onto the next step, I complete the VA Claim for with the MSC. Now, I take ownership for letting myself be mislead during this part.... but lets also be clear that the 'brain fog' chemo causes makes it hard for me to process information, think through problems, and articulate my thoughts. Regardless, I listed the conditions that my MSC told me to on my VA claim (30 something items) but I never stopped to look at them all together to see if anything was missing. I did let the MSC know that I was waiting on the results of a sleep study I had that week, and he told me to let him know when I got the results and we could add it to the claim.

When I got my list of VA appointments, I realized none of the conditions that were in my oncology record were being evaluated, specifically all of the conditions that my MH provider had wrote about in the NARSUM. I tried to call the MSC to ask if he had access to that when he made the list of conditions, but he never answered the phone. The next week, I got the sleep study results confirming sleep apnea, and emailed the MSC to let him know the results and ask him to add it to the claim. When I didn't hear back from him, I tried to call but couldn't get through. I emailed again the following week and tried to call - no luck. The following Monday I tried to call again, and failing to get through again, contacted my PEBLO, who then emailed the MSC asking him to respond.... no luck. The day before my final exam, I contacted the PEBLO and asked to speak to another MSC and she said she would have her supervisor look into it.

Wouldn't you know that when the supervisor got involved, the MSC emailed him back immediately to tell him all my exams were complete and that he was just waiting on my results. There were quite a few emails between us (with the PEBLO and supervisor cc'd) but the MSC said that he wouldn't add any claims or appointments unless my provider added it to my "0819" and that I can always add claims after I get a DD214. I don't even know what a 0819 is.

I also let him know that we ran out of time during my last appoint (with 17 DBQs) and that we didn't get to several DBQs or the Self-Health Assessment. Then I asked him to call me to discuss the appointment because the VA examiner had literally pushed my body during the ROM measurements when I couldn't move any farther. Like put his hand on my shoulder and pushed me down to bend farther during my back ROM, pushed my leg across my body during hips, pulled down on my ankle, etc.

MSC said that was part of the required regulations and that these were contracted specialists who specialize in doing claims. Maybe that's correct but seems to go against everything I read on here.... He also said if the provider ran out of time he would annotate it is his notes. Guess not cause I was never rescheduled

4. CURRENT STATUS

PEBLO eventually called me and said not to worry about all of this and that I would have IMR or appeal options later. But she isn't sure if that covers the missing claims or the referred conditions. But I can appeal if I don't like my rating. I have an appt to discuss with my lawyer next week.

5. FINALLY.... THE POINT

Does all of this sound normal? Honestly, I'm over 20 years so if the VA gives me 10% for ANY conditions I will be retired with YOS pension, so does all of this fight for referred conditions and DOD% even matter?

My AdminO tells me the DOD% is important because that % of my pension will not be federally taxed (not the VA%, but an amount of my pension equal to whatever % the DOD gives me for my referred conditions will be tax free).

If it does all matter and the fight is worth it.... what do I do from here?

Thank you all so much for your help and advice.

P.s. feel free to leave a review of this short novella on amazon ;)
P.s.s. Now you know why there was a BLUF haha
 
Dory said:
Hello all.

BLUF: How important is the DOD% and making sure the referred condition(s) are accurate if over 20 years active duty Navy?

I'm pretty sure my entire IDES process is crazy, but they all say its just me.... so here goes:

1. BACKSTORY & REFFERAL

I was diagnosed with Non-Hodgkin's Lymphoma in 2021 and when through 6 months of an intensive chemotherapy that included staying in the hospital for 5 days of continuous pump chemo plus and additional lumbar puncture CNS chemo, every 21 days. I am putting this out there early because I think its important to know that.... but my PCM apparently doesn't agree.

My treatment was through a civilian oncologist and I have been in remission since July 2022 (yay!). I was determined to stay active duty but chemo caused a slew of long term and chronic effects. There have been quite a few issues who is supposed to treat these issues, with my oncologist saying that is my PCM swim lane and my PCM saying that my oncologist should be treating chemo-related side effects. As a result, none of the chemo-related issues were ever truly addressed, aside from being sent to MH because I have severe medical anxiety and am in constant fear of cancer returning. My MH provider finally referred me to IDES in May 2024 with Generalized Anxiety Disorder as the referred condition.

2. MEDICAL RECORD & REFERRED CONDITION

It wasn't until my PEBLO called for my first counseling that I found out that NONE - NOT ONE PAGE of my oncology record was ever put in my military medical record (who knows what my case manager was doing for 2 years let alone how my PCM was "treating" me without even knowing what type of chemo I had) I had to scramble to print 1400 pages of this record of and give them to medical records to be uploaded to MHGENISIS. I was told this was done, although I can't see them in my account... more on that later.

Anyway, when I discussed this with the PEBLO and she told me I was only referred for anxiety and to speak to my provider about listing all of the conditions that make me unable to do my job individually. I had this discussion with my PCM, who told me she did not have to list every conditions and that because she was MH, she only had to refer MH conditions. But, after speaking with my PCM, she included these snippets into her NARSUM:

- "on going symptoms of poor sleep, excessive worry, restlessness, easily fatigued, headaches, increased body tension, poor memory, difficulty concentrating and irritability with depressed mood"
- "overall body tension and constant pain with inability to focus on work or home"
- "'brain fog' that has come after chemo treatment makes it extremely difficult for her to do her military occupation"
- "continued issues with sleep"
- "has undergone 2 years of psychotherapy and medication management without success. Continues to experience difficulties with sleep, focusing, memory, and feeling on edge"

Still with me? Well there's more....

3. MSC & VA APPTS
Now, my MH provider assured me that because she had written these things into her referral report, they would be considered as 'referred conditions'. So onto the next step, I complete the VA Claim for with the MSC. Now, I take ownership for letting myself be mislead during this part.... but lets also be clear that the 'brain fog' chemo causes makes it hard for me to process information, think through problems, and articulate my thoughts. Regardless, I listed the conditions that my MSC told me to on my VA claim (30 something items) but I never stopped to look at them all together to see if anything was missing. I did let the MSC know that I was waiting on the results of a sleep study I had that week, and he told me to let him know when I got the results and we could add it to the claim.

When I got my list of VA appointments, I realized none of the conditions that were in my oncology record were being evaluated, specifically all of the conditions that my MH provider had wrote about in the NARSUM. I tried to call the MSC to ask if he had access to that when he made the list of conditions, but he never answered the phone. The next week, I got the sleep study results confirming sleep apnea, and emailed the MSC to let him know the results and ask him to add it to the claim. When I didn't hear back from him, I tried to call but couldn't get through. I emailed again the following week and tried to call - no luck. The following Monday I tried to call again, and failing to get through again, contacted my PEBLO, who then emailed the MSC asking him to respond.... no luck. The day before my final exam, I contacted the PEBLO and asked to speak to another MSC and she said she would have her supervisor look into it.

Wouldn't you know that when the supervisor got involved, the MSC emailed him back immediately to tell him all my exams were complete and that he was just waiting on my results. There were quite a few emails between us (with the PEBLO and supervisor cc'd) but the MSC said that he wouldn't add any claims or appointments unless my provider added it to my "0819" and that I can always add claims after I get a DD214. I don't even know what a 0819 is.

I also let him know that we ran out of time during my last appoint (with 17 DBQs) and that we didn't get to several DBQs or the Self-Health Assessment. Then I asked him to call me to discuss the appointment because the VA examiner had literally pushed my body during the ROM measurements when I couldn't move any farther. Like put his hand on my shoulder and pushed me down to bend farther during my back ROM, pushed my leg across my body during hips, pulled down on my ankle, etc.

MSC said that was part of the required regulations and that these were contracted specialists who specialize in doing claims. Maybe that's correct but seems to go against everything I read on here.... He also said if the provider ran out of time he would annotate it is his notes. Guess not cause I was never rescheduled

4. CURRENT STATUS

PEBLO eventually called me and said not to worry about all of this and that I would have IMR or appeal options later. But she isn't sure if that covers the missing claims or the referred conditions. But I can appeal if I don't like my rating. I have an appt to discuss with my lawyer next week.

5. FINALLY.... THE POINT

Does all of this sound normal? Honestly, I'm over 20 years so if the VA gives me 10% for ANY conditions I will be retired with YOS pension, so does all of this fight for referred conditions and DOD% even matter?

My AdminO tells me the DOD% is important because that % of my pension will not be federally taxed (not the VA%, but an amount of my pension equal to whatever % the DOD gives me for my referred conditions will be tax free).

If it does all matter and the fight is worth it.... what do I do from here?

Thank you all so much for your help and advice.

P.s. feel free to leave a review of this short novella on amazon ;)
P.s.s. Now you know why there was a BLUF haha
Click to expand...
BLUF. if you have over 20 years active duty the only thing that really matters is that your VA ratings are correct. The DOD% isn't going to matter much.

Are you stating that you had claims that weren't evaluated to include a DBQ that you listed on your application for VA compensation? If this is the case, they are in the wrong and I would contact my congress person etc. Now if you met with the MSC to fill out the paperwork and forgot to add some conditions. That's on you can you can apply for them after you get out. Any claims made within 1 year of retiring will be backdated to the when you left so there isn't any risk of losing out.

The reason the VA % matters the most is because you will earn all of your longevity pension + any va compensation as long as your total VA% is 50% or higher. So if you don't get rated for everything and that hurts your VA compensation that is a big deal. Like I said you can apply for conditions after you get out but IDES was created to do it all at one time.

My wife did forget to claim a few conditions. She filed claims right after she got out and they were backdated to the same date as her other claims in IDES.
 
Dory said:
Hello all.

BLUF: How important is the DOD% and making sure the referred condition(s) are accurate if over 20 years active duty Navy?

I'm pretty sure my entire IDES process is crazy, but they all say its just me.... so here goes:

1. BACKSTORY & REFFERAL

I was diagnosed with Non-Hodgkin's Lymphoma in 2021 and when through 6 months of an intensive chemotherapy that included staying in the hospital for 5 days of continuous pump chemo plus and additional lumbar puncture CNS chemo, every 21 days. I am putting this out there early because I think its important to know that.... but my PCM apparently doesn't agree.

My treatment was through a civilian oncologist and I have been in remission since July 2022 (yay!). I was determined to stay active duty but chemo caused a slew of long term and chronic effects. There have been quite a few issues who is supposed to treat these issues, with my oncologist saying that is my PCM swim lane and my PCM saying that my oncologist should be treating chemo-related side effects. As a result, none of the chemo-related issues were ever truly addressed, aside from being sent to MH because I have severe medical anxiety and am in constant fear of cancer returning. My MH provider finally referred me to IDES in May 2024 with Generalized Anxiety Disorder as the referred condition.

2. MEDICAL RECORD & REFERRED CONDITION

It wasn't until my PEBLO called for my first counseling that I found out that NONE - NOT ONE PAGE of my oncology record was ever put in my military medical record (who knows what my case manager was doing for 2 years let alone how my PCM was "treating" me without even knowing what type of chemo I had) I had to scramble to print 1400 pages of this record of and give them to medical records to be uploaded to MHGENISIS. I was told this was done, although I can't see them in my account... more on that later.

Anyway, when I discussed this with the PEBLO and she told me I was only referred for anxiety and to speak to my provider about listing all of the conditions that make me unable to do my job individually. I had this discussion with my PCM, who told me she did not have to list every conditions and that because she was MH, she only had to refer MH conditions. But, after speaking with my PCM, she included these snippets into her NARSUM:

- "on going symptoms of poor sleep, excessive worry, restlessness, easily fatigued, headaches, increased body tension, poor memory, difficulty concentrating and irritability with depressed mood"
- "overall body tension and constant pain with inability to focus on work or home"
- "'brain fog' that has come after chemo treatment makes it extremely difficult for her to do her military occupation"
- "continued issues with sleep"
- "has undergone 2 years of psychotherapy and medication management without success. Continues to experience difficulties with sleep, focusing, memory, and feeling on edge"

Still with me? Well there's more....

3. MSC & VA APPTS
Now, my MH provider assured me that because she had written these things into her referral report, they would be considered as 'referred conditions'. So onto the next step, I complete the VA Claim for with the MSC. Now, I take ownership for letting myself be mislead during this part.... but lets also be clear that the 'brain fog' chemo causes makes it hard for me to process information, think through problems, and articulate my thoughts. Regardless, I listed the conditions that my MSC told me to on my VA claim (30 something items) but I never stopped to look at them all together to see if anything was missing. I did let the MSC know that I was waiting on the results of a sleep study I had that week, and he told me to let him know when I got the results and we could add it to the claim.

When I got my list of VA appointments, I realized none of the conditions that were in my oncology record were being evaluated, specifically all of the conditions that my MH provider had wrote about in the NARSUM. I tried to call the MSC to ask if he had access to that when he made the list of conditions, but he never answered the phone. The next week, I got the sleep study results confirming sleep apnea, and emailed the MSC to let him know the results and ask him to add it to the claim. When I didn't hear back from him, I tried to call but couldn't get through. I emailed again the following week and tried to call - no luck. The following Monday I tried to call again, and failing to get through again, contacted my PEBLO, who then emailed the MSC asking him to respond.... no luck. The day before my final exam, I contacted the PEBLO and asked to speak to another MSC and she said she would have her supervisor look into it.

Wouldn't you know that when the supervisor got involved, the MSC emailed him back immediately to tell him all my exams were complete and that he was just waiting on my results. There were quite a few emails between us (with the PEBLO and supervisor cc'd) but the MSC said that he wouldn't add any claims or appointments unless my provider added it to my "0819" and that I can always add claims after I get a DD214. I don't even know what a 0819 is.

I also let him know that we ran out of time during my last appoint (with 17 DBQs) and that we didn't get to several DBQs or the Self-Health Assessment. Then I asked him to call me to discuss the appointment because the VA examiner had literally pushed my body during the ROM measurements when I couldn't move any farther. Like put his hand on my shoulder and pushed me down to bend farther during my back ROM, pushed my leg across my body during hips, pulled down on my ankle, etc.

MSC said that was part of the required regulations and that these were contracted specialists who specialize in doing claims. Maybe that's correct but seems to go against everything I read on here.... He also said if the provider ran out of time he would annotate it is his notes. Guess not cause I was never rescheduled

4. CURRENT STATUS

PEBLO eventually called me and said not to worry about all of this and that I would have IMR or appeal options later. But she isn't sure if that covers the missing claims or the referred conditions. But I can appeal if I don't like my rating. I have an appt to discuss with my lawyer next week.

5. FINALLY.... THE POINT

Does all of this sound normal? Honestly, I'm over 20 years so if the VA gives me 10% for ANY conditions I will be retired with YOS pension, so does all of this fight for referred conditions and DOD% even matter?

My AdminO tells me the DOD% is important because that % of my pension will not be federally taxed (not the VA%, but an amount of my pension equal to whatever % the DOD gives me for my referred conditions will be tax free).

If it does all matter and the fight is worth it.... what do I do from here?

Thank you all so much for your help and advice.

P.s. feel free to leave a review of this short novella on amazon ;)
P.s.s. Now you know why there was a BLUF haha
Click to expand...
Also, you can't appeal anything in IDES that isn't a referred condition. That is why you want everything correct from the start. If your referred condition is mental health and they screw up your back pain claim there isn't anything you can do. You have to wait until you get your official VA results after you are out and then you have 1 year to file an appeal with the VA. If the VA% is for an unfitting condition you can submit a VARR and they will reconsider the % while in IDES.
 
BLUF: How important is the DOD% and making sure the referred condition(s) are accurate if over 20 years active duty Navy?

I didn't read your novel, but based off the BLUF, are you saying you're being medically retired and are wanting to know if it is important what disability percentage the Navy gives you for the condition you're being medically retired for?

If that's your question... IT MATTERS! Why? Because if you are medically retired (meaning eligible for military retirement AKA >20 years service and separated due to medical condition) you can choose to have you military retirement pay be the standard high-3 OR you can choose your military retirement pay to be the disability rating you receive from the Navy but max is 75%.

Ex; the Navy medically retires you at 21 years. High-3 pay would give you 52.5% of your base pay. If the Navy rates you at 70% disabled for the condition for which you're being medically retired, then you can accept the 70% of your base pay as your retirement pay instead of 52.5% AND you can still claim VA disability for your other conditions. Regardless of which you choose, you will have to pay taxes on your retirement pay. The VA disability pay however is tax free.
 
AirForceGuy said:
BLUF: How important is the DOD% and making sure the referred condition(s) are accurate if over 20 years active duty Navy?

I didn't read your novel, but based off the BLUF, are you saying you're being medically retired and are wanting to know if it is important what disability percentage the Navy gives you for the condition you're being medically retired for?

If that's your question... IT MATTERS! Why? Because if you are medically retired (meaning eligible for military retirement AKA >20 years service and separated due to medical condition) you can choose to have you military retirement pay be the standard high-3 OR you can choose your military retirement pay to be the disability rating you receive from the Navy but max is 75%.

Ex; the Navy medically retires you at 21 years. High-3 pay would give you 52.5% of your base pay. If the Navy rates you at 70% disabled for the condition for which you're being medically retired, then you can accept the 70% of your base pay as your retirement pay instead of 52.5% AND you can still claim VA disability for your other conditions. Regardless of which you choose, you will have to pay taxes on your retirement pay. The VA disability pay however is tax free.
Click to expand...
Incorrect. There is a cap on how much compensation you can get. The maximum you can get is the combination of your longevity pension earned and VA disability. With 20 or more years active duty you get all of your longevity pension and all of your VA compensation (As long as total VA% is 50% or higher). So even if you choose 70% DOD you won't get more money.
 
Provis said:
Incorrect. There is a cap on how much compensation you can get. The maximum you can get is the combination of your longevity pension earned and VA disability. With 20 or more years active duty you get all of your longevity pension and all of your VA compensation (As long as total VA% is 50% or higher). So even if you choose 70% DOD you won't get more money.
Click to expand...

Where did you get that info from?
Here's the facts to back me up:

1725027542038.png
^this link describes being able to choose Method A or B

This link shows the infographic I posted above.
 
@Provis is spot on. Being over 20 active time you are capped regardless. You will get all VA compensation plus your earned DoD longevity pension. Being over 20 years AFS you qualify for regular and disability retirement. If you receive a disability retirement DFAS will calculate using your disability percentage and reduce it to longevity pay regardless. Example: 20 year AFS service member receives a disability retirement and rated 100% VA and 100% DoD. They would qualify automatically for Concurrent Receipt. Therefore they would receive all their VA compensation at 100% rate, their DoD pension will be calculated by DFAS at 75% max rate then reduced to 50% longevity rate. Reason being is because one cannot be compensated for the same disability twice. Therefore the VA compensates for the disability and DoD compensates for your time in service earned pension.
 
(b)Special Rules for Chapter 61 Disability Retirees.—
(1)Career retirees.—
The retired pay of a member retired under chapter 61 of this title with 20 years or more of service otherwise creditable under section 1405 of this title, or at least 20 years of service computed under section 12732 of this title, at the time of the member’s retirement is subject to reduction under sections 5304 and 5305 of title 38, but only to the extent that the amount of the member’s retired pay under chapter 61 of this title exceeds the amount of retired pay to which the member would have been entitled under any other provision of law based upon the member’s service in the uniformed services if the member had not been retired under chapter 61 of this title.
 
Provis said:
Also, you can't appeal anything in IDES that isn't a referred condition. That is why you want everything correct from the start. If your referred condition is mental health and they screw up your back pain claim there isn't anything you can do. You have to wait until you get your official VA results after you are out and then you have 1 year to file an appeal with the VA. If the VA% is for an unfitting condition you can submit a VARR and they will reconsider the % while in IDES.
Click to expand...
I think my biggest concern is that my MH provider started the IDES referral and therefore will only write the referral for MH. Plus she thinks/told me that it is not required for her to go through my record and list ALL conditions that make me unfit because that will be taken care of at the PEB stage.
 
To answer your BLUF: How important is the DOD% and making sure the referred condition(s) are accurate if over 20 years active duty Navy?

This depends on if your any of your claimed conditions are related to combat or simulating combat.

My background/story which is (unfortunately) similar and happening RIGHT now (I’m just several steps ahead of you in the process). I have over 20 years active duty. I was referred to an MEB for my back. I asked my PC’M about my other conditions that fit being categorized as meeting the MEB & unfit for duty criteria. PCM (incorrectly) told me that she only need to put one condition to trigger the MEB and that all conditions I list for the MEB/VA will be considered/reviewed to meet the “unfit” criteria. My NARSUM only found my back to be unfit. I appealed that. Long story short, my initial MEB appeal stated none of the conditions were referred so will not even be considered as unfit conditions. Additionally similar to you, I had 1) new conditions that came to light after completing my VA form and 2) some conditions I did list on my VA form were not even addressed/listed in the NARSUM.
I finally did my own research and stopped listening to the “advocates” assigned to me.

What I learned:

- You CAN submit new conditions to the VA during the MEB process. Those new conditions may not be addressed until after you separate/retire, but you can submit them NOW. My MSC pushed back. I told him it was his duty as a MSC to submit the forms and documentation I provide to him to the VA (and he can keep his advice of do it after I get out). So he submitted my new conditions. Again, they may not be reviewed/considered until later when I’m out, but hey the process is started
- Due to being retirement eligible, it is correct my/your retirement pay will be the same regardless of what percentage the DOD finds you unfit. THIS is the important & super relevant distinction; if your unfit conditions are related to combat or simulating combat you will qualify for Combat Related Special Compensation (CRSC). Then a portion of your retirement pay will be exempt from federal taxation. The amount exempt from federal taxation is DIRECTLY related to your DOD%. You can google CRSC DFAS for details. Of note, this is different than Concurrent Retirement and Disability Pay (CRDP) that has been referenced in other responses.

I verified my research to be correct with my MEB lawyer.

Decision Factors/Point: As you mentioned, my/your unfit condition and 20+ active years will qualify you for your normal retirement pay and your VA compensation based on the VA % and not your DOD%. If your VA % is over 50%, you qualify for CRDP (again is getting your retirement pay and VA disability/compensation payments).

If certain claimed conditions are not on your initial VA findings, you can continue to submit them after you get out. Or like me, I submitted them while I’m still serving, so they should absolutely be service-connected.

My MEB referred condition of back was determined unfit & combat related on my NARSUM. Yet again similar to you, my VA back aexam was inaccurate and contradictory to my 15+ years of medical records reference my back. And the VA ROM results were widely inaccurate. No way I bent 90+ degrees! Injury or no injury, I’m naturally extremely inflexible and haven’t been about to bend nowhere near my toes after about age 12! I knew my VA rating which at this point t translated to my DOD % was inaccurate and therefore would affect my taxation exemption amount of my retirement pay.

Additionally, my PTSD was combat related and verified by the my medical records and VA exam.

All that to say, I appealed everything at each step (MEB and Informal Physical Evaluation Board (IPEB) until I was allowed a formal PEB board in which I elected to be present (virtually). To be clear, I only appealed the combat related conditions (although I felt I had other DBQ/unfit conditions) because those were the only ones that would affect my pay (tax exemption). I had the board and my PEB lawyer presented my case. This was the ONLY step in which my non-referred condition was finally and truly reviewed for unfitness for duty. As I previously mentioned, I was told all my claimed conditions would be reviewed for fitness of duty; again this was the only time it truly happened (all other steps seemed to be a quick paper drill to move me along the process).

The board is complete and I was found unfit for my back and PTSD, both combat related.

After the formal PEB hearing and results is when you can request a VA reconsideration (VAR) of the ratings % from your C&P exams. I’m doing this step now for my back. I submitted new/additional medical documentation to refute the VA % for my back, specifically ROM exams from my Physical therapist, orthopedic doctor, an occupation health doctor, and my PCM.

To your answer your original BLUF question: There is a process to eventually get your VA ratings correct after you leave the service. If you retire (medical and regular) and your VA rating is over 50%, you will qualify for CRDP (regardless of DOD %). If any of your claimed conditions (referred or not) AND are related to combat or simulation combat, your DOD % for those conditions will affect your tax exemption status for your retirement pay.
 
Dory said:
I think my biggest concern is that my MH provider started the IDES referral and therefore will only write the referral for MH. Plus she thinks/told me that it is not required for her to go through my record and list ALL conditions that make me unfit because that will be taken care of at the PEB stage.
Click to expand...
Most conditions you claim will be fit for duty. I would focus on making sure all of your VA% are correct. If the PEB states an unfitting condition isn't combat related and you think it is then you can appeal it at FPEB. Your gross compensation can't be increased. There isn't much to gain or lose when medically retiring if you have earned a regular retirement as well. You might be able to net more if you have a DOD% higher than your longevity earned which would be 60% in your case AND if you have one or more unfitting conditions designated by the PEB as combat related.

I would be more concerned with getting 100% VA than anything else because if you get less than 100% VA you haven't maxed out your total gross compensation. The combat related unfitting condition would be the one bonus but you need more than just the combat related designation since you need your DOD% to be higher than your longevity pension earned. The end benefit of your pension being exempt from federal taxes depends a lot on your tax situation. For example if you retire from the military and retire from all work then you might not have any taxes due if married due to the standard deduction.
 
A few things to look at:

1. Did you serve in any place where Non Hodgkin's Lymphoma is VA presumptive? What is your DMOS? Is it hazardous which requires a breathing apparatus. What chemicals were you exposed to during your service?

2. Identify all residuals/disabilities related to Lymphoma and medication side affects.

3. Continue your mental health therapy and link it to your bout with cancer and other disabilities.

4. As stated above, continue to identify all disabilities and write a quick summary how each one limits you to conduct your military duties and daily living activities.
 
A presumptive condition could lead to combat related so it depends on where you served. All of this could lead to tax exemption.
 
bjenk said:
A few things to look at:

1. Did you serve in any place where Non Hodgkin's Lymphoma is VA presumptive? What is your DMOS? Is it hazardous which requires a breathing apparatus. What chemicals were you exposed to during your service?

2. Identify all residuals/disabilities related to Lymphoma and medication side affects.

3. Continue your mental health therapy and link it to your bout with cancer and other disabilities.

4. As stated above, continue to identify all disabilities and write a quick summary how each one limits you to conduct your military duties and daily living activities.
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Non Hodgkin's Lymphoma is presumptive under the PACT act and I did serve in the areas relevant to PACT. Most of my career was on the flight deck of carriers & exposed to aircraft fumes which I believe is listed under illness and injury caused by instrumentalities of war in the reference to combat related. I have also already been approved on the burn pit registry.

The fact is, no one will ever know what caused the cancer but non hodgkins has been linked to many chemicals, so I'm sure I would have a dog in the fight over it being combat related.

I talked to my lawyer and he walked me through the appeal process very similar to Magbt19's example above. I'm just tired. I'm tired of being sick, tired of being tired, and I know I just need some time to focus on me and my health.

Which is why, despite all of the drama going on in my process, the BLUF is whether or not expending energy on this is worth it. But I think I will let it play for now and use the appeal process very similar to Magbt19 where I need to.
 
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