C&P exams requested, how long of a wait?

[ceilingfan]

Actually, the packet will go out for fitness determination at PEB before ratings--so the PEBLO is a bit inaccurate there. As PsychOfficer pointed out, review with legal before signing anything and make copies of everything. Moreover, you should not just receive a single form to review and sign; instead, you should get the entire MEB packet (including form 3947, medical records, C&P write-ups, commanders letter, last three performance reviews--ie counseling statements, and NARSUM) to review.

Weekend shouldn't count towards days.

Don't worry about an incompetent PEBLO. You have yourself, this forum and legal who are going to make sure everything is squared away.

 

[Warrior644]

Update on spouse: Thank you for the suggestion of calling the ombudsman. It wasn’t something I thought would work as quickly as it did. The ombudsman at JBLM was awesome, and even though he was somewhat limited in his options (and was having to work a furlough schedule), he was able to get in touch with the PEBLO.

This is what we have found out via the ombudsman: the phone number we had for the PEBLO was no longer valid; the spouse’s file is in the special group being worked by a group of soldiers brought in for the backlog, and so the PEBLO is not technically a civilian. We were provided with the new phone number, and if the PEBLO didn’t call within a certain time frame, we were to call back.

The PEBLO did call. His statements are he is not inclined to make phone calls if he has no information, and he had been waiting on information from the MSC who had been on vacation (sadly enough we had the information he needed available, and had he been in regular contact he would have known that).

That was all two weeks ago. On Monday, PEBLO called spouse and stated spouse should receive something in his email in a couple of days that will need to be reviewed, signed, and returned. When spouse asked for clarification, he was told it was a “form that needed a signature, so the packet can go out for ratings. Ratings will take 4-6 months”. The form apparently did not have a name that the PEBLO was willing to volunteer. Spouse has not yet received it.

Would this likely be the NARSUM? And would that quote be indicative of unfitting determinations? Isn’t there a time limit on how long spouse has to review the NARSUM and rebut it? If there is a time limit is it calculated by business days or calendar days? (My concern is we will receive it Friday afternoon, and the long weekend will hinder our ability to have it gone over in a timely manner.)

Yes these are questions the PEBLO should answer, but his reluctance to be in contact, and his hemming and hawing over every question have us very concerned about the accuracy of his answers.

Indeed, you will be permitted to review the NARSUM and any addenda regarding a medical condition that has been prepared for referral to the PEB.

After completion of the MEB, you will review the findings and recommendations, and have seven calendar days (holidays and weekends included, unfortunately) to make your election (concur, non-concur or request independent provider review). If you disagree with the MEB or feel there is information missing or not adequately addressed, you may submit a rebuttal with the assistance of the Soldiers' MEB Counsel (SMEBC).

That said, you must submit a written request to have an impartial health professional review the MEB contents to ensure that all injuries/illnesses are properly addressed.

The MTF commanders shall designate an impartial physician, not associated with your medical board process. In most cases, the impartial reviewer should be your primary care physician. They have five calendar days to review and advise you about the MEB contents, and must have working knowledge of the DoD IDES process.

To preserve impartiality, physician reviewers should not engage in direct clinical care or refer you for further evaluation. Such actions should be referred to the MEB physician if they concern MEB content, or to the appropriate provider if the requested care is unrelated.

The impartial physician will review all medical documentation pertaining to the medical board to ensure each injury/illness has been addressed on the DA Form 3947 (Medical Evaluation Board Proceedings).

Upon complete review of the medical board's documentation, the impartial physician will contact you to go over the findings in person or via telephone. The impartial physician will then submit his or her findings in writing to your PEBLO.
Moreover, upon receipt of these findings, you will be provided a seven calendar day period to concur or not concur with the MEB findings. Any rebuttal or comments provided are referred back to the original physician, who will address the issues and make changes as appropriate.

The reviewing physician receives the rebuttal and can decide to let the MEB stand as written, send the MEB findings back for further medical information, or forward them to the PEB with attachments or additional notes. All responses to your rebuttal or comments must be completed within seven calendar days of receipt.

To that extent, I am speaking from personal experience while in the DoD IDES process. My previous involvement with a rebuttal by submitting a MEB IMR, and follow-on MEB Soldier's Appeal was successful.

With that all said, have you already contacted the SMEBC to inform them that their assistance may be forthcoming?

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer."

Best Wishes!

 

[Shay's Red]

So here is an inventory of what spouse received via email:

3947 with incorrect birthdate
Narsum
3349- Permanent profile with MAJOR changes
7652-commanders' statement
Med Profile-med list with no current medications listed, only has old meds listed (which is incorrect, because he's diabetic for Pete's sake)
0819 with incorrect birthdate and no signatures
C&P
Election form with a 5 calendar day due date (i.e. it is due 3 September)

No medical records

So here is the issue. As soon as he got the email, he called me to ask me to make the JAG appointment because he had major questions and the PEBLO explained nothing. (He got the election form in a separate email after speaking to the PEBLO and was not told that he had to make election by 3 September, I read it while on the phone with JAG)

The military has a four day starting today, and none of the JAG offices (JBLM, Bragg, or Jackson) had times available on Tuesday. So he took the first available with JBLM on 5 September. The JAG office tried to contact the PEBLO to request an extension but was unable to reach anyone.

He has emailed his PEBLO stating the quandary of entitled to legal counsel, and due to the holiday legal counsel is unavailable, and PEBLO due to the holiday isn't around to say ok, let's give an extension.

Here are my questions:

1. How do we address the errors in the paperwork that we can identify without legal counsel?
2. Can we send a response/who should we send a response to requesting an extension formally?
3. Is the lack of access to legal counsel a good enough reason to be granted an extension?
4. How do we read the range of motion test results?
5. How do we determine if the issues reach the level of disagreeing with results?

He was found unfitting for two of four conditions referred. He doesn't disagree with the unfitting decision on the insulin dependent diabetes (I mean he is a realist), but he's concerned about the ramifications of the other decisions. He doesn't necessarily want to dispute the findings if the decisions/language is standard operating procedure. But he doesn't want to be found in agreement just because he can't get them reviewed before the deadline.

Suggestions, recommendations, and referrals? I'll take anything I can get.

 

[Jason Perry]

So here is an inventory of what spouse received via email:

3947 with incorrect birthdate
Narsum
3349- Permanent profile with MAJOR changes
7652-commanders' statement
Med Profile-med list with no current medications listed, only has old meds listed (which is incorrect, because he's diabetic for Pete's sake)
0819 with incorrect birthdate and no signatures
C&P
Election form with a 5 calendar day due date (i.e. it is due 3 September)

Birthdate- I would talk to the PEBLO (or email). This should be an easy admin fix.
Med Profile- I would either ask PEBLO to request new med profile or I would provide a copy that you get.

So here is the issue. As soon as he got the email, he called me to ask me to make the JAG appointment because he had major questions and the PEBLO explained nothing. (He got the election form in a separate email after speaking to the PEBLO and was not told that he had to make election by 3 September, I read it while on the phone with JAG)

The military has a four day starting today, and none of the JAG offices (JBLM, Bragg, or Jackson) had times available on Tuesday. So he took the first available with JBLM on 5 September. The JAG office tried to contact the PEBLO to request an extension but was unable to reach anyone.

He has emailed his PEBLO stating the quandary of entitled to legal counsel, and due to the holiday legal counsel is unavailable, and PEBLO due to the holiday isn't around to say ok, let's give an extension.

Likely, I think he will get extension. But, if not, I would request an impartial medical review. This will buy you at least 5 more days AFTER the IMR counsel is provided.

Here are my questions:

1. How do we address the errors in the paperwork that we can identify without legal counsel?

Not sure exactly what you are asking (i.e., if you mean going it alone the whole way through, or just between now and when you do get to speak with counsel).

2. Can we send a response/who should we send a response to requesting an extension formally?

AR 40-400, Para. 7-10 is somewhat vague on this:
"i. Item 24.
(1) If the patient is located in the vicinity of the MTF, he or she will be advised of the approved findings by the
PEBLO and asked to check the appropriate box. If the patient disagrees with the findings, he or she will be asked to
prepare a statement citing reasons for disagreement. The statement will be attached. The patient is authorized 3
working days to decide his or her election. Extensions of time beyond 3 working days may be granted for reasonable
cause such as desire to consult with legal counsel, and so forth. If the patient does not make an election, the case will
be forwarded as if approved by the member. Refusal or inability on the part of the patient to make an election will
require an explanatory note in the board proceedings."

However, I would address a memo to the MEB Approving Authority. I don't think the formalities would matter too much, though. (I.e., I don't think it would be denied were it to be addressed to "Medical Evaluation Board.").

3. Is the lack of access to legal counsel a good enough reason to be granted an extension?

Yes. See above bolded language.

4. How do we read the range of motion test results?

Not sure what you are asking.

5. How do we determine if the issues reach the level of disagreeing with results?

Generally, I would disagree with anything that is likely to impact an issue that will make a difference as to final outcome. It can be hard to know what is important or not. Good idea to consult with legal counsel on questions.

He was found unfitting for two of four conditions referred. He doesn't disagree with the unfitting decision on the insulin dependent diabetes (I mean he is a realist), but he's concerned about the ramifications of the other decisions. He doesn't necessarily want to dispute the findings if the decisions/language is standard operating procedure. But he doesn't want to be found in agreement just because he can't get them reviewed before the deadline.

Does he think additional conditions are medically unacceptable/fail retention standards? That is an important issue that warrants disagreement. Reference AR 40-501, Chapter 3 for the standards. Might be helpful if he compares the standards to what was written and see if they have missed facts that would change the outcome.

 

[Shay's Red]

I really appreciate the input and assistance. It definitely makes for a list of better prepared questions, and there is only so much my research skills can uncover. Opposed to making a new forum, I am going to continue on this forum with updates .

Update:

We did receive the extension, as the attorneys' office contacted the PEBLO, insisting that the deadline was unreasonable for the circumstances.

After talking with a couple of attorneys provided, the spouse received answers on most of his questions. Some of the answers he didn't like to hear, but some were reassuring, and in my experience that means the information is likely sound. He wrote a statement on his own behalf, and I edited to remove some of the overt anger. (Once again, the idea is to maintain professionalism to the hilt, even though the battles are wearing both of us down). He opted to take the advice and not challenge the findings at this time, and if needed he will challenge them at the PEB level.

His knees which were the original referring condition were found to meet standards if modifications were made. This actually was surprising because the NARSUM writing doctor disagreed with his surgeon at this time. The spouse was informed that the two doctors were likely looking at it with different standards and that is the reason for the discrepancy. The NARSUM doctor looking at the possibility for improvement; the surgeon looking at the need for future surgeries.

He is an insulin dependent diabetic which was found not to meet standards. There was no solid way to challenge this, because every attempt to remove him from insulin has failed. The oddest part is, the diabetes arose suddenly while he was in the process for the knees, and if the process had been timely the diabetes would have been a non issue. He was told there was no way for him to remain in the service, and well this was something he has known and has had to digest since the diagnosis. He is not happy about leaving the military, but as several retirees of various sorts have pointed out, very few are happy to leave.

The language of the medical board documents that had him concerned, are indeed standard language, and to anyone's knowledge, they did not have far reaching ramifications. This was indeed a relief.

The timeline at this point is at least another 4-6 months to await ratings and such. He was given a best guess by the attorney, but as it is just a guess it is no guarantee. The spouse has been instructed to bug the tar out of whomever will listen to get the extension in place until it is determined when his separation will take place.

The PEBLO has been notified of a trip upcoming that will put him out of our home state for about 2 weeks around Christmas. There appeared to be no problem with this particular trip as it is scheduled during a time many are on holiday exodus.

So I am hopeful that there will be fewer hiccups in this waiting period than in waiting periods past.

 

[PsychOfficer]

Thanks for the update. Unfortunately, the 4-6 month wait for ratings is probably a reasonable guess about an unreasonable process. I am glad that things have at leaast settled down a bit. Bob

 

[Warrior644]

-

I really appreciate the input and assistance. It definitely makes for a list of better prepared questions, and there is only so much my research skills can uncover. Opposed to making a new forum, I am going to continue on this forum with updates .

Update:

We did receive the extension, as the attorneys' office contacted the PEBLO, insisting that the deadline was unreasonable for the circumstances.

After talking with a couple of attorneys provided, the spouse received answers on most of his questions. Some of the answers he didn't like to hear, but some were reassuring, and in my experience that means the information is likely sound. He wrote a statement on his own behalf, and I edited to remove some of the overt anger. (Once again, the idea is to maintain professionalism to the hilt, even though the battles are wearing both of us down). He opted to take the advice and not challenge the findings at this time, and if needed he will challenge them at the PEB level.

His knees which were the original referring condition were found to meet standards if modifications were made. This actually was surprising because the NARSUM writing doctor disagreed with his surgeon at this time. The spouse was informed that the two doctors were likely looking at it with different standards and that is the reason for the discrepancy. The NARSUM doctor looking at the possibility for improvement; the surgeon looking at the need for future surgeries.

He is an insulin dependent diabetic which was found not to meet standards. There was no solid way to challenge this, because every attempt to remove him from insulin has failed. The oddest part is, the diabetes arose suddenly while he was in the process for the knees, and if the process had been timely the diabetes would have been a non issue. He was told there was no way for him to remain in the service, and well this was something he has known and has had to digest since the diagnosis. He is not happy about leaving the military, but as several retirees of various sorts have pointed out, very few are happy to leave.

The language of the medical board documents that had him concerned, are indeed standard language, and to anyone's knowledge, they did not have far reaching ramifications. This was indeed a relief.

The timeline at this point is at least another 4-6 months to await ratings and such. He was given a best guess by the attorney, but as it is just a guess it is no guarantee. The spouse has been instructed to bug the tar out of whomever will listen to get the extension in place until it is determined when his separation will take place.

The PEBLO has been notified of a trip upcoming that will put him out of our home state for about 2 weeks around Christmas. There appeared to be no problem with this particular trip as it is scheduled during a time many are on holiday exodus.

So I am hopeful that there will be fewer hiccups in this waiting period than in waiting periods past.

Good deal and appreciate the update which seems particularly positive in the overall grand scheme!

Indeed, please continue to press-the-issue(s) at the PEB if warranted. That said, in my opinion, it shall remain an interesting talk point in reference to how an individual's "interpretation" of a particular situation is perceived and/or evaluated.

Nonetheless, never default acceptance to potential injustice while championing for well-earned and well-deserve military disability compensation to include future military healthcare benefits after separation/retirement.

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer."

Best Wishes!