Warning: This is LONG, but well worth it. You might want to grab a beer or some popcorn before sitting down for this, or skip to the RECAP.
I'm an AD AF pilot. I’ve been patrolling this site for a year now and I’ve learned some valuable lessons about both the DoD and VA systems. I wanted to share my experience and hopefully provide some situational awareness to those looking for help or just starting out in this process. For background, my current medical state is Rheumatoid Arthritis (knees, elbows, L wrist, multiple fingers, jaw and ANA/CCP/RF+) and Systemic Lupus (Joint pain, morning stiffness, fatigue, photosensitive malar rash, a variety of bloodwork, Raynaud’s (1-2x week), oral ulcers, low grade fever). I ‘flare’ 4-5 times a year for about ten days and have missed work and even been reassigned to desk job where I essentially make my own hours to manage my diseases as I also have steady state of manageable pain. I was a pilot for 4 years, so it’s been quite a dramatic shift. With that- down the rabbit hole we go.
I was first told my I-RILO was going to a full MEB in early July 2016. At the time, my diagnosis was “Undifferentiated Connective Tissue Disease” (UCTD) with Raynaud’s Phenomenon. My paperwork including my eventual NARSUM only read “Polyarthritis.” Within a month I had had my various VA appointments, including the C&P. I walked out of the C&P surprised at how easy going my Physicians Assistant was. He was nice, listened to what I had to say, and even talked about making sure that I got the most out of this experience. After my C&P, but before the report was filed, I was diagnosed with Rheumatoid Arthritis (RA); I promptly sent my Rheum Notes to the PA who was writing my C&P. Imagine my surprise when the actual filed report had more than 30 errors and inconsistencies, including such basic facts as “is there evidence of an auto-immune disease- no.” While he directly refuted statements I had made in the exam, and noted things like “no evidence of pain” (which was, in my admittedly subjective opinion, obviously not true), more shocking to me were the direct contradictions of my Rheumatologist’s notes. He only included phrases in the exam and from the notes that fit a narrative that I was healthy, despite my Rheum’s RA diagnosis, an increase in medication, and notes that my condition was not stable but in fact developing. When I called the VA to discuss these errors, I was told “get a lawyer.”
So I tried. I called the OAC, but was harshly told that they were busy and that I wouldn’t be assigned counsel until after my IPEB had returned with findings. The airmen on the phone advised that I write the Letter of Exception memo and proceed. Which of course, I did, since I thought I had no other recourse (my PEBLO advised that an impartial review only changes the NARSUM, which was mostly correct after I threw a hissy fit over things like incorrect medications, name misspellings, inaccurate dates and diagnosis. The “amendment” that they wrote satisfied my NARSUM needs). This occurred over August and September.
In November, I was diagnosed with Systemic Lupus (SLE). It was in addition to, not replacing, my RA diagnosis- an “overlap” disease. I approached my PEBLO to mail these new notes to my IPEB, but was told that once the package left my base, there was nothing they could add. I would have to wait until the IPEB returned, then appeal via the FPEB. When I called OAC, I again was told to call back once the IPEB returned its findings. On 28 December, the IPEB results were in- 20% for RA, separation with severance. The UCTD (now officially dx’d as Lupus) was rated as “vascular rhinitis” (What!?) and 0%. Again, I called the OAC and was told they’d call me back after the holidays, but they at least took down my name and phone number this time. I elected to proceed to the FPEB, obviously.
After hounding the OAC for two weeks, finally I was given a FPEB date of May and the name of a counsellor, but I could never get ahold of him. It took until mid-February for the OAC to acknowledge that he was too busy for me, and that I’d be assigned a new one soon and my FPEB was moved to April. I called my “new” counsel several times but never got ahold of them. Finally, only a week before my next Rheumatology visit in March, I demanded to speak to a counsellor and finally got one, although not my assigned counsel. Within 60 seconds of hearing my story and looking at my IPEB results, he notified me that I needed to request a “Recall,” which would retract my paperwork and restart the process from scratch. The basis was AFI36-3212 2.3.1 and 3.37, which essentially noted that the PEBLO had made an error in preventing me from sending updated data to the IPEB, and that the Hospital Commander had erred by not recalling my package to include it. I was dumbfounded. How could this have happened?
I finally heard from my official counsel a few days later and the recall was officially initiated. He tried to work some magic with the FPEB to allow my diagnosis to now include SLE, but was told to do it the official way. My package was recalled in March 2017. I have worked with my Patient Advocate, and even he expressed concern over how things had gone thus far. He has been helpful so far, but there is little he can actually do now. The VA tried to tell me they wouldn’t re-do my C&P exam, but I threw a very polite and composed tantrum until they conceded. It is now mid-April, and I just re-completed my C&P exams and am waiting for the official report to be completed and sent to the IPEB.
RECAP: MEB started before I was officially diagnosed with RA and SLE. My first C&P was an outright misrepresentation of my diseases. When I tried to submit updated paperwork, I was rebuked. The OAC failed to assign me counsel until it was nearly too late. Now I’ve had to restart an already arduous process from scratch and have watched my estimated separation/retirement date slip more than a year.
I hope to include updates as they happen, but for now, I just want to summarize a few points of advice for people:
NEVER take “no” for answer. Always be polite and professional, but don’t let PEBLOs or VA officials bully you down the wrong path. You might have to walk out of the meeting without achieving your goals, but call your lawyer, do your research, and game plan your next move. I assumed my PEBLO and even the OAC staff knew what they were talking about, and it added months to my timeline because I didn’t verify in a regulation or memo that they were correct.
Scour all over the internet for both IDES/MEB advice, but also your disease. If you haven’t been to http://www.militarydisabilitymadeeasy.com/, then go now. Familiarize yourself with the terms, lingo, and process timeline, and then hit up the VASRD. I printed out the codes and ratings for my possible conditions and highlighted terms and figures that were applicable to my case in order to remain focused on my intent- communicate the nature of my disease to the IPEB so that they accurately rate my conditions for what I deserve.
Document EVERYTHING. Save every email, military and civilian, that mentions your case, no matter how trivial. Keep a log of your disease symptoms so you can show your doctors/specialists, and have them include the terms, phrases, and measurements used in the VASRD so there is no excuse for a mistranslation. As an example, I had my Rheum use “exacerbation” vs “flare.” Create hardcopies of any applicable paperwork, notes, or lab/test results. I organized an old mobility folder that’s grown to nearly 2 inches thick and it has saved my butt more than I could possibly count. I actually have 2 hardcopies and 1 electronic of that folder so if someone needs a copy of something I have, I can give it to them without having to worry about getting it back.
So there you have it. This turned out much longer than I intended, but I feel like there are some lessons to be learned here. My case is hopefully an outlier, and I wish you better luck in yours. Please feel free to comment here or PM me for more specific questions- I’m here to help.
-GoFlyMike
I'm an AD AF pilot. I’ve been patrolling this site for a year now and I’ve learned some valuable lessons about both the DoD and VA systems. I wanted to share my experience and hopefully provide some situational awareness to those looking for help or just starting out in this process. For background, my current medical state is Rheumatoid Arthritis (knees, elbows, L wrist, multiple fingers, jaw and ANA/CCP/RF+) and Systemic Lupus (Joint pain, morning stiffness, fatigue, photosensitive malar rash, a variety of bloodwork, Raynaud’s (1-2x week), oral ulcers, low grade fever). I ‘flare’ 4-5 times a year for about ten days and have missed work and even been reassigned to desk job where I essentially make my own hours to manage my diseases as I also have steady state of manageable pain. I was a pilot for 4 years, so it’s been quite a dramatic shift. With that- down the rabbit hole we go.
I was first told my I-RILO was going to a full MEB in early July 2016. At the time, my diagnosis was “Undifferentiated Connective Tissue Disease” (UCTD) with Raynaud’s Phenomenon. My paperwork including my eventual NARSUM only read “Polyarthritis.” Within a month I had had my various VA appointments, including the C&P. I walked out of the C&P surprised at how easy going my Physicians Assistant was. He was nice, listened to what I had to say, and even talked about making sure that I got the most out of this experience. After my C&P, but before the report was filed, I was diagnosed with Rheumatoid Arthritis (RA); I promptly sent my Rheum Notes to the PA who was writing my C&P. Imagine my surprise when the actual filed report had more than 30 errors and inconsistencies, including such basic facts as “is there evidence of an auto-immune disease- no.” While he directly refuted statements I had made in the exam, and noted things like “no evidence of pain” (which was, in my admittedly subjective opinion, obviously not true), more shocking to me were the direct contradictions of my Rheumatologist’s notes. He only included phrases in the exam and from the notes that fit a narrative that I was healthy, despite my Rheum’s RA diagnosis, an increase in medication, and notes that my condition was not stable but in fact developing. When I called the VA to discuss these errors, I was told “get a lawyer.”
So I tried. I called the OAC, but was harshly told that they were busy and that I wouldn’t be assigned counsel until after my IPEB had returned with findings. The airmen on the phone advised that I write the Letter of Exception memo and proceed. Which of course, I did, since I thought I had no other recourse (my PEBLO advised that an impartial review only changes the NARSUM, which was mostly correct after I threw a hissy fit over things like incorrect medications, name misspellings, inaccurate dates and diagnosis. The “amendment” that they wrote satisfied my NARSUM needs). This occurred over August and September.
In November, I was diagnosed with Systemic Lupus (SLE). It was in addition to, not replacing, my RA diagnosis- an “overlap” disease. I approached my PEBLO to mail these new notes to my IPEB, but was told that once the package left my base, there was nothing they could add. I would have to wait until the IPEB returned, then appeal via the FPEB. When I called OAC, I again was told to call back once the IPEB returned its findings. On 28 December, the IPEB results were in- 20% for RA, separation with severance. The UCTD (now officially dx’d as Lupus) was rated as “vascular rhinitis” (What!?) and 0%. Again, I called the OAC and was told they’d call me back after the holidays, but they at least took down my name and phone number this time. I elected to proceed to the FPEB, obviously.
After hounding the OAC for two weeks, finally I was given a FPEB date of May and the name of a counsellor, but I could never get ahold of him. It took until mid-February for the OAC to acknowledge that he was too busy for me, and that I’d be assigned a new one soon and my FPEB was moved to April. I called my “new” counsel several times but never got ahold of them. Finally, only a week before my next Rheumatology visit in March, I demanded to speak to a counsellor and finally got one, although not my assigned counsel. Within 60 seconds of hearing my story and looking at my IPEB results, he notified me that I needed to request a “Recall,” which would retract my paperwork and restart the process from scratch. The basis was AFI36-3212 2.3.1 and 3.37, which essentially noted that the PEBLO had made an error in preventing me from sending updated data to the IPEB, and that the Hospital Commander had erred by not recalling my package to include it. I was dumbfounded. How could this have happened?
I finally heard from my official counsel a few days later and the recall was officially initiated. He tried to work some magic with the FPEB to allow my diagnosis to now include SLE, but was told to do it the official way. My package was recalled in March 2017. I have worked with my Patient Advocate, and even he expressed concern over how things had gone thus far. He has been helpful so far, but there is little he can actually do now. The VA tried to tell me they wouldn’t re-do my C&P exam, but I threw a very polite and composed tantrum until they conceded. It is now mid-April, and I just re-completed my C&P exams and am waiting for the official report to be completed and sent to the IPEB.
RECAP: MEB started before I was officially diagnosed with RA and SLE. My first C&P was an outright misrepresentation of my diseases. When I tried to submit updated paperwork, I was rebuked. The OAC failed to assign me counsel until it was nearly too late. Now I’ve had to restart an already arduous process from scratch and have watched my estimated separation/retirement date slip more than a year.
I hope to include updates as they happen, but for now, I just want to summarize a few points of advice for people:
NEVER take “no” for answer. Always be polite and professional, but don’t let PEBLOs or VA officials bully you down the wrong path. You might have to walk out of the meeting without achieving your goals, but call your lawyer, do your research, and game plan your next move. I assumed my PEBLO and even the OAC staff knew what they were talking about, and it added months to my timeline because I didn’t verify in a regulation or memo that they were correct.
Scour all over the internet for both IDES/MEB advice, but also your disease. If you haven’t been to http://www.militarydisabilitymadeeasy.com/, then go now. Familiarize yourself with the terms, lingo, and process timeline, and then hit up the VASRD. I printed out the codes and ratings for my possible conditions and highlighted terms and figures that were applicable to my case in order to remain focused on my intent- communicate the nature of my disease to the IPEB so that they accurately rate my conditions for what I deserve.
Document EVERYTHING. Save every email, military and civilian, that mentions your case, no matter how trivial. Keep a log of your disease symptoms so you can show your doctors/specialists, and have them include the terms, phrases, and measurements used in the VASRD so there is no excuse for a mistranslation. As an example, I had my Rheum use “exacerbation” vs “flare.” Create hardcopies of any applicable paperwork, notes, or lab/test results. I organized an old mobility folder that’s grown to nearly 2 inches thick and it has saved my butt more than I could possibly count. I actually have 2 hardcopies and 1 electronic of that folder so if someone needs a copy of something I have, I can give it to them without having to worry about getting it back.
So there you have it. This turned out much longer than I intended, but I feel like there are some lessons to be learned here. My case is hopefully an outlier, and I wish you better luck in yours. Please feel free to comment here or PM me for more specific questions- I’m here to help.
-GoFlyMike
