spinning in circles for MEB referral for migraines

mitchellm

PEB Forum Regular Member
Registered Member
my PCM at campbell recently told me that it would be best if i’d get a referral from my neurologist for chronic migraines. however, my neurologist is a civilian that was referred to me by tricare due to campbell not having a neurologist on base. that being said, she said she couldn’t refer me but my PCM says he can’t refer me because it has to come from my neurologist. what should i do here? how would i go about getting the referral?
 
@mitchellm

Soldiers can get referred in 2 ways: 1) get a P3/4 assigned or 2) be referred as a result of an MAR2. The vast majority of IDES referrals in the Army come from profile assignments. Your PCM can refer you, but may not be familiar with the process, in those terms. Instead of asking for an IDES referral, perhaps you should simply ask to be assigned a profile. This may help your doctor understand the civilian-provider issue: they can’t assign profiles; hence, you must have the PCM do so.

Hope this helps. Joel
 
Your PCM is likely unaware of their ability to refer you. No one studies theMEB/PEB processes in Med School. I had to educate my PCM on multiple things during the PEB process.
 
@mitchellm

Soldiers can get referred in 2 ways: 1) get a P3/4 assigned or 2) be referred as a result of an MAR2. The vast majority of IDES referrals in the Army come from profile assignments. Your PCM can refer you, but may not be familiar with the process, in those terms. Instead of asking for an IDES referral, perhaps you should simply ask to be assigned a profile. This may help your doctor understand the civilian-provider issue: they can’t assign profiles; hence, you must have the PCM do so.

Hope this helps. Joel
How do USA Reservist get refered. I do not see an Army PCM, the only time I do anyting Army related Meical is my yearly PHA, but that is done by a Civilian Dr.
 
How do USA Reservist get refered. I do not see an Army PCM, the only time I do anyting Army related Meical is my yearly PHA, but that is done by a Civilian Dr.
You can fill out with the help of your treating physician a profile packet which then is sent off by your unit to a medical team. If they issue you a P3 profile you will be sent to a fit for duty exam. If the exam doctor thinks you are unfit they will put you in IDES.

What is the condition? Do. you have a LOD for it? Just know that for Reservists and Guard a lot of times you get kicked out with no severance or medical retirement because they will state that it was a preexisting condition. So if no LOD or treatment records the profile and fit for duty exam with trigger a referral into a non duty related IDES process.
 
You can fill out with the help of your treating physician a profile packet which then is sent off by your unit to a medical team. If they issue you a P3 profile you will be sent to a fit for duty exam. If the exam doctor thinks you are unfit they will put you in IDES.

What is the condition? Do. you have a LOD for it? Just know that for Reservists and Guard a lot of times you get kicked out with no severance or medical retirement because they will state that it was a preexisting condition. So if no LOD or treatment records the profile and fit for duty exam with trigger a referral into a non duty related IDES process.
Question on the reservist thing. I am already service connected for migraines at 50%, which is the highest VA rating. This was from my AD time prior to transferring to the reserve. Am still serving as a TPU reservist. If I want to pursue a medical retirement, should I submit a profile packet to get a permanent profile for migraines? I am also service connected for PTSD (combat). Unsure what the best method would be to initiate the process.
 
Question on the reservist thing. I am already service connected for migraines at 50%, which is the highest VA rating. This was from my AD time prior to transferring to the reserve. Am still serving as a TPU reservist. If I want to pursue a medical retirement, should I submit a profile packet to get a permanent profile for migraines? I am also service connected for PTSD (combat). Unsure what the best method would be to initiate the process.
Yes packet for profile is the way it starts. Your medical team determines the profile if any. No guarantee that they MEB you though. That's up to your branch. Also, a lot of times your branch will deny that the condition was caused by your time in service so it could result in being kicked out with no severance or medical retirement by being referred as a non duty related IDES. So if you are close to 15 good years or 20 good years I would try to reach that landmark instead of attempting to get a profile.
 
@Bulldog03

Expanding on what @Provis said, Reservists need to keep this in mind: the longer the timespan from when you were injured/wounded or contracted an illness, the more evidence the MEB doctor has for concluding the symptoms that you are claiming make you unfit are a result from something other than the original medical issue. A common line of reasoning I see from the MEB - as well as other decision makers in the LOD arena - looks something like this:

Soldier initially reported X injury on Y date. This was his course of treatment . . . . On Z date the Soldier passed the APFT with score PPP. On ZZ date, the Soldier passed the ACFT with score CCC. Although the Soldier reported X injury and symptoms during his PHA each year, Solder was never issued a profile for the condition and there is no evidence the Soldier missed IDT, AT or was denied deployment orders because of X. Therefore, X was not in the line of duty and was not exacerbated by service.

Every case is very different, so I don’t want you to think I am saying you would receive this type of result. I am simply trying to give you a bit of insight into how Reservist LOD adjudication works from an adjudicator's viewpoint.

I hope this helps.

S/f,

Joel

Disclosure: I was a Marine JAG, Active Duty and Reserve IPEB & FPEB attorney, federal government civilian FPEB & TDRL-focused attorney at the Navy PEB, and now a private attorney focused solely on IDES cases. This post is meant as procedural insight only and should not be construed as legal advice related to a specific case or a legal analysis of facts thereof.
 
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my PCM at campbell recently told me that it would be best if i’d get a referral from my neurologist for chronic migraines. however, my neurologist is a civilian that was referred to me by tricare due to campbell not having a neurologist on base. that being said, she said she couldn’t refer me but my PCM says he can’t refer me because it has to come from my neurologist. what should i do here? how would i go about getting the referral?
I just went through a similar situation. I am Army AGR assigned on a Marine Corps base with a Navy Civilian PCM. My neurologist wrote a note in her clinical report that said I should be referred b/c of migraines etc. This report was added to MHS Genesis. I then requested a virtual appt with my PCM. She saw the note and completed the profile packet ultimately producing my P3 on MEDPROS. It was a hassle but it worked.
 
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