Admin Sep for 300+ days on profile

D

Dmitry

PEB Forum Regular Member
Registered Member
3 year AD SPC
Past week seen by PCM(new one), She says because i have profile for so long time and nothing Sirius with me they want to give Medical Chapter because army use too much resources on me and its doesn't looks I'm gonna be batter, also she says chapter because I'm "not medbord'abl currently"
Have Diagnosis for 4 condition currently obtain treatment for 2
Knee pain (profile for, obtaining injections for it)
Migraine (injections with botox for it and bunch of pills)
Hypertension (on pills for it)
Neck pain (taking lidocaine patches the best what i can doo for this)

She speak only about 1 condition - like other doesn't exist,
She told to me if i want to stay in military for some time i need go to orthopedics (who give profile and extend it) and ask about permanent profile or they just will chapter me out since nothing Sirius here
i Have 4 Year contract and good relations with CO CMD, great opinion about me and my work from my XO. and I guess they may see many times my migraine and how bad it is.

So i don't really know what to do, working on my point tot promotion and my PCM telling me chapter. I feel lost.
 
Contact service provided (free) legal counsel ASAP. Also ask for a second opinion on medical conditions.

If a medical provider (or than in battled) talked to me about using to many resource, I'd go to the ombudsman and request a new PCM.
 
Dmitry said:
3 year AD SPC
Past week seen by PCM(new one), She says because i have profile for so long time and nothing Sirius with me they want to give Medical Chapter because army use too much resources on me and its doesn't looks I'm gonna be batter, also she says chapter because I'm "not medbord'abl currently"
Have Diagnosis for 4 condition currently obtain treatment for 2
Knee pain (profile for, obtaining injections for it)
Migraine (injections with botox for it and bunch of pills)
Hypertension (on pills for it)
Neck pain (taking lidocaine patches the best what i can doo for this)

She speak only about 1 condition - like other doesn't exist,
She told to me if i want to stay in military for some time i need go to orthopedics (who give profile and extend it) and ask about permanent profile or they just will chapter me out since nothing Sirius here
i Have 4 Year contract and good relations with CO CMD, great opinion about me and my work from my XO. and I guess they may see many times my migraine and how bad it is.

So i don't really know what to do, working on my point tot promotion and my PCM telling me chapter. I feel lost.
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agree with @chaplaincharlie ! I would consider IG complaint & or congressional inquiry if the other options don't pan out. It sounds like you should be MEB'd.
 
You definitely need a new PCM. You should be able to go to Tricare and request a new PCM.
I'm concerned that they have a diagnosis of knee pain and neck pain. While pain can be a diagnosis in of itself...it is often secondary to something...such as chronic pain secondary to a bulging disc. Or if it is a primary diagnosis it would be in relation to something like fibromyalgia.

If you are having knee and neck pain, have they figured out why? Neck pain can be anything from cervical issues to radiating pain from a shoulder tear.

She is probably only speaking about one, because it is the one your are profiled for...which leads me to my next question. Why are you only profiled for one condition?
Every service follows medical standards. If you are not meeting retention standards based on medical standards, she should be recommending you for a medical board. By saying you have used up too many resources, are not anticipated to get better, and have been on a profile for a considerable amount of time... she essentially validated the need for a medical board.

If I remember correctly, the Army allows their service members to be utilized in another career field if appropriate. Unsure if that is currently the case, but if you are wanting to remain in I would do some research with an IDES lawyer to see if that is an option.

Best of luck.
 
Retired44 said:
You definitely need a new PCM. You should be able to go to Tricare and request a new PCM.
I'm concerned that they have a diagnosis of knee pain and neck pain. While pain can be a diagnosis in of itself...it is often secondary to something...such as chronic pain secondary to a bulging disc. Or if it is a primary diagnosis it would be in relation to something like fibromyalgia.

If you are having knee and neck pain, have they figured out why? Neck pain can be anything from cervical issues to radiating pain from a shoulder tear.

She is probably only speaking about one, because it is the one your are profiled for...which leads me to my next question. Why are you only profiled for one condition?
Every service follows medical standards. If you are not meeting retention standards based on medical standards, she should be recommending you for a medical board. By saying you have used up too many resources, are not anticipated to get better, and have been on a profile for a considerable amount of time... she essentially validated the need for a medical board.

If I remember correctly, the Army allows their service members to be utilized in another career field if appropriate. Unsure if that is currently the case, but if you are wanting to remain in I would do some research with an IDES lawyer to see if that is an option.

Best of luck.
Click to expand...
Just an FYI. He's active duty so Tricare isn't involved in that sense. Definitely request a new PCM at your MTF.
 
I get clinical notes for last visit

PCM notes
34 yo ADM w a myriad of symptoms, but currently here to discuss his hx of over 300 days on profile for R knee pain in the last one year. MRI Knee showed some mild fraying, but nothing to cause such significant pain that he currently reports. He has seen ortho and pain management in the past. The most recent pain management appointment with injection caused an increase inhis pain. He saw ortho in November, with plans to return to ortho within 2-3 months (now time frame) to discuss next steps. No plans for surgery. At today's visit, we discussed that his pain is likely chronic wear and tear related to his repetitive loading/carrying items. Nothing on mri lumbar spine or knee that would cause such significant pain. Discussed his plans for army career/promotion/med chapters vs. med boards vs. permanent profile. At this time, he will see pain management one more time this month, then schedule with ortho for the next steps, as he is predicting the pain management will not help him. Discussed that he should talk to ortho about recommendations for a permanent profile vs. MRDP with lack of objective findings on imaging/hx to cause his current pain in his right knee. I placed a 30 day profile to allow him to obtain all the appropriate appointments, and will follow up in 4-6 weeks. With his myriad of symptoms/ROS findings, question whether there is an underlying diagnosis of fibromyalgia.

During this appointment i have strong filling i speaking with investigator, she not discus all this things with me, she says you on profile chart too long and CMD team start asking questions, so go to who ever give this profile to you and ask them to change it.

Orthopedic Surgery notes
RADS: Right knee MRI demonstrates no discernible meniscal collateral or cruciate injuries. There is some hypointensities at T1 and mild hyperintensity T2 in the trochlea suggestive of chondromalacia A/P: 34-year-old male with right knee pain mostly over the medial aspect due to most likely chronic repetitive loading and carrying. Discussed with patient we could consider diagnostic and therapeutic injection but we could also consider referral to pain management. Given his imaging and exam findings I would not offer a surgical procedure that would provide any meaningful relief. However this could change given the results of an injection or continued physical therapy his pain were to localize to a specific location he may have a less common diagnosis such as a plica this would be surgically addressed only after a prolonged nonoperative course including failure of injections. Patient stated he will trial pain management and a 90-day profile returns in 2 to 3 months consider injection if his pain is not improved

Case manager in MTF saying i cannot change PCM, i ask again "so i don't have any legal rights to change PCM?" - she says its correct.

I will go to Legal for advise, not sure what also i can do.

And the worst thing I'm currently at school for CBRN classes for 2 weeks, so i cannot even miss more then 4 H, or they will drop me.
 
At some point i start feel not wary well after exercises, prolonged weakness and fatigue, 15-20 min of moderate exercises pic 2, pic 1 before they start given BP meds.

IMG_4592.JPG
20210125_074630.JPG

1H rock march its looks even worst, upper dark read other is white
What its can be?
and i have dermatitis u can see it on my head.
 
I think they suppose to cancel me first before starts something, for last 2 y in my Unit, i never have an NCO, and in this CO, i never have any type of canceling, like a monthly, initially or something
 
Unfortunately medicine is sometimes an investigative process. The clinical note is not well written, but the conclusion does mention what is called a rule out ( a possibility that stands until proved wrong) of fibromyalgia. You might ask for a second opinion from a Rheumatologists.
 
Please try to get a referral to a rheumatologist. And go to Patient Advocate. 4 years ago, my PCM at the time was blatantly rude and did not take me seriously at all. At one point told me to just take Tylenol for my migraines and said “I don’t know what else to tell you. Do you even want to be in the Army?” Low and behold, PCSd, got a better PCM, and was eventually diagnosed with fibromyalgia among other things. Your doctor sounds like my old one.
 
Dmitry said:
I get clinical notes for last visit

PCM notes
34 yo ADM w a myriad of symptoms, but currently here to discuss his hx of over 300 days on profile for R knee pain in the last one year. MRI Knee showed some mild fraying, but nothing to cause such significant pain that he currently reports. He has seen ortho and pain management in the past. The most recent pain management appointment with injection caused an increase inhis pain. He saw ortho in November, with plans to return to ortho within 2-3 months (now time frame) to discuss next steps. No plans for surgery. At today's visit, we discussed that his pain is likely chronic wear and tear related to his repetitive loading/carrying items. Nothing on mri lumbar spine or knee that would cause such significant pain. Discussed his plans for army career/promotion/med chapters vs. med boards vs. permanent profile. At this time, he will see pain management one more time this month, then schedule with ortho for the next steps, as he is predicting the pain management will not help him. Discussed that he should talk to ortho about recommendations for a permanent profile vs. MRDP with lack of objective findings on imaging/hx to cause his current pain in his right knee. I placed a 30 day profile to allow him to obtain all the appropriate appointments, and will follow up in 4-6 weeks. With his myriad of symptoms/ROS findings, question whether there is an underlying diagnosis of fibromyalgia.

During this appointment i have strong filling i speaking with investigator, she not discus all this things with me, she says you on profile chart too long and CMD team start asking questions, so go to who ever give this profile to you and ask them to change it.

Orthopedic Surgery notes
RADS: Right knee MRI demonstrates no discernible meniscal collateral or cruciate injuries. There is some hypointensities at T1 and mild hyperintensity T2 in the trochlea suggestive of chondromalacia A/P: 34-year-old male with right knee pain mostly over the medial aspect due to most likely chronic repetitive loading and carrying. Discussed with patient we could consider diagnostic and therapeutic injection but we could also consider referral to pain management. Given his imaging and exam findings I would not offer a surgical procedure that would provide any meaningful relief. However this could change given the results of an injection or continued physical therapy his pain were to localize to a specific location he may have a less common diagnosis such as a plica this would be surgically addressed only after a prolonged nonoperative course including failure of injections. Patient stated he will trial pain management and a 90-day profile returns in 2 to 3 months consider injection if his pain is not improved

Case manager in MTF saying i cannot change PCM, i ask again "so i don't have any legal rights to change PCM?" - she says its correct.

I will go to Legal for advise, not sure what also i can do.

And the worst thing I'm currently at school for CBRN classes for 2 weeks, so i cannot even miss more then 4 H, or they will drop me.
Click to expand...
That’s insane. Sounds like my doctor. “Nothing showed up on the MRI to cause pain *except* a labral tear and hip impingement. But nope, everything else is totally fine! No reason to be in pain over all that!” Military doctors are ridiculous, there’s no “correct” amount of pain. Are they in your body? Then how do they know how much pain it causes?
 
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