Who Initiates the MEB?

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isitdoneyet2025

PEB Forum Regular Member
Registered Member
Hello everyone,

I have one simple question: who initiates the MEB?

Background: I’ve been dealing with chronic back pain for almost two years, over the course of two duty stations. It wasn’t until I PCS’d to where I’m at now that I was able to get an MRI. The MRI confirmed that I have a protruding L5/S1 disc that has caused stenosis and has made contact with the S1 nerve root. This has led to sciatica and other nerve radiculopathy symptoms. Over time (and to this day), my pain has gotten worse and has progressed to other areas of my body.

Over the past two years I’ve done different medications (which my PCM referred to as a med trial), physical therapy for a year and counting, a TENS unit, dry needling; and pain management has given me stronger meds, two rounds of trigger point injections, and a lumbar epidural steroid injection. None of which has helped.

I finally decided enough was enough with the injections (they’re painful and make symptoms worse), and I advocated for myself at pain management today. I listed my grievances and asked for a MEB. I explained how my pain has gotten worse, and how my job makes my symptoms/pain worse.

Great news—by the end of the appointment, the doctor at pain management agreed with initiating a MEB, and said he would put his recommendation in my notes.

Bad news—he stated he’s never done a MEB before and recommended that I consult with my PCM. He said that if the PCM has issues, the PCM can reach back out to him.

The doctor at pain management said he would have the notes and paperwork inputted today. A few hours after the appointment, I checked MHS Genesis, and sure enough the notes say:

“Low back pain, unspecified
27y0 female SSG with chronic low-back pain.
- Lack of good effect with prior therapies to include PT, dry needling, recent ESI and trigger point injections
Given degree of pain and its limiting nature it is reasonable to undergo MEB; Pt will discuss with her PCM
  • Hold off on further injections at this time, but consider acupuncture
  • Continue low-impact exercise and stretching”
So with all of that being said, who initiates the MEB and is this verbiage sufficient enough to initiate one? I feel so defeated because the ‘my patient history’ section mentions my MRI and the results showing stenosis & contact with the nerve root, as well as sciatica symptoms..but my diagnosis nor plan/assessment portion state that I have sciatica or nerve radiculopathy.

Please advise, because I’m feeling frustrated and defeated constantly waiting weeks for appointments to get answers.
 
Just had time to read your whole post. I would recommend building your own case. The quality of your packet will be key. Ensure all your diagnoses, treatments, timelines, etc are all clear and correct. Consider preparing a personal statement that shows when these injuries originated and how. And then especially show how it interferes with your daily life and specifically with your military career/specific job.

And yes, what you wrote is a good start. And no, the doctors statement would be a weak start by itself.
 
DaveK said:
Just had time to read your whole post. I would recommend building your own case. The quality of your packet will be key. Ensure all your diagnoses, treatments, timelines, etc are all clear and correct. Consider preparing a personal statement that shows when these injuries originated and how. And then especially show how it interferes with your daily life and specifically with your military career/specific job.

And yes, what you wrote is a good start. And no, the doctors statement would be a weak start by itself.
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Thank you for reading the entire post—I know it was long. Pain management doesn’t have an open appointment until August 12th; my PCM doesn’t have an open appointment until June 26th (even though it’s virtual). Do you believe it’s worth calling back and getting pain management to update what he wrote? I guess my concern is I know it’s his first MEB and I don’t want it to seem like this is all from me. I want his full support and he was on-board in person, but his wording seems lax on paper.

Additional follow-up question: If my PCM initiates a MEB as-is with current documentation, and I draft up a personal statement, when would my statement come into play?
 
At the very least I would get copies of everything you are mentioning especially regarding the MRIs. The main reason for developing one's own case is to ensure that each provider and processor along the way can clearly see all pertinent elements. Many people have years of files making it easy to miss important details.

Yes, calling pain management could help if they are willing to make a statement for you. Basically, in general your records need to show that you injuries/ailments interfere specifically with your military job.

And you are very early yet not even in the process. Your PCM will be the one to submit you to IDES. Focusing on that is key. The perception of your command will also play in.
 
DaveK said:
At the very least I would get copies of everything you are mentioning especially regarding the MRIs. The main reason for developing one's own case is to ensure that each provider and processor along the way can clearly see all pertinent elements. Many people have years of files making it easy to miss important details.

Yes, calling pain management could help if they are willing to make a statement for you. Basically, in general your records need to show that you injuries/ailments interfere specifically with your military job.

And you are very early yet not even in the process. Your PCM will be the one to submit you to IDES. Focusing on that is key. The perception of your command will also play in.
Click to expand...
Thank you so much. Thankfully my command is on board, as they see how much pain I’m in and they don’t expect too much out of me. I just feel bad that I’m occupying a slot that someone else could be fulfilling and working twice as hard. Thank you again.
 
isitdoneyet2025 said:
Thank you so much. Thankfully my command is on board, as they see how much pain I’m in and they don’t expect too much out of me. I just feel bad that I’m occupying a slot that someone else could be fulfilling and working twice as hard. Thank you again.
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Do not feel bad. We all went through it at some point occupying a spot.
 
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