Got my Ratings after a mere 14 month long Medical Board

rugbymurf

PEB Forum Regular Member
So Folks,

Finally got my ratings last week. I was found unfit on the basis of 4 conditions back in October, PTSD, Depression, Cervical Disc Degeneration, and Chronic Fatigue Syndrome. There were another 17 conditions listed that were found to be fitting and were rated by the VA also. I am in the Pilot Program, so I got both ratings back. I got 60% from the Army and 90% from the VA. With placement on the TDRL. Which of course isn't bad. EXCEPT! I had someone check up on the packet in the VA, and it was done by one of the new batch of people they got in to clear the backlog, who didn't realize that unfitting PTSD is 50% automatically, and initially rated it at 30%. This indicates to me that it is very likely that my condition would be considered to be at a lower rating when re-evaluated. The breakdown was 50% for PTSD/Depression, and 10% for my neck. And curiously, 0% for the Chronic Fatigue Syndrome even though it was bad enough to be an unfitting condition at the PEB. Bizarre!

I was surprised to see that one of my most debilitating conditions - Migraines, was rated at 0%. I take Topomax daily to limit my headaches and when I get them I'm floored and take meds to shorten the duration, but I'm out for a day at least. But because I'm a nurse and because I've either been too sick to get to the ER or Urgent care, or have been at the hospital and have just walked into my doc for care and gone home, they didn't see sufficient evidence of "debilitating" attacks. Oh, also, I'm at the WTU in Fort Meade, and it takes 2 months to see a doctor. Unless your condition conveniently coincides with the one hour sick call between 8 and 9. So care is generally unavailable. I used to be able to get care for my migraines before I went to the WTU, but sadly care is really not accessible there. It's a shame. So the message is, no matter how bad you feel, go to the Urgent Care or ER. That's all they count. Get someone to drive you.

Also curiously, several of the conditions which were submitted originally and which appeared on my PEB paperwork such as: a right foot condition, a left knee condition, Allergic Rhinitis, (all of which are not unfitting, but may be "worth" 10% or something with the VA), just disappeared off the paperwork altogether by the time the VA came to rating. I guess someone in the VA decided that they didn't matter to them so they didn't rate them.

So informal rebuttal in progress right now. The Attorney looked at it all and said there was plenty to argue about there. And that in his experience, most people are having their PTSD ratings lowered upon re-rating on the TDRL, so it's worth making sure that I hold out for the most I can get now, because it will almost certainly drop.

It sucks to feel like you have to grovel and scrape to get what you are due. But that's how it is.

Murph
 
Hi, I am a new member. I am going though the same process you just finished right now and woud like some advices please. first, I was Navy-active for 5 years and now im in the National Guard Army since july 2006 with 1 year active for MOS trainig and 1 year deployment - OEF.
you know? I understand you very well. I have a bad disc by my neck and tear tendons on my left shouder. i am on pain everysecond and besides i also have headaches everyday. everthing started on the middle of my tour while in Afghanistan. besides arthrtis i also had a prior liver surgery in the navy back in 2002 - the cyst removed left me a big scar. I have ptsd and depression too...

question: can you get tdrl or pdrl and va comp at the same time? do i have to go Drill while on tdrl? i also heared that u may keep tricare, is it free for my family and me or no? please I need answers and details if possible. or, what is PEBLO?
Thank you all!
Frank
 
question: can you get tdrl or pdrl and va comp at the same time?
Generally, no. Exceptions are when you have more than 20 years of service (CRDP) or when your conditions are combat related (CRSC).

do i have to go Drill while on tdrl?
You cannot go to drill. You would be retired, albeit temporarily.

i also heared that u may keep tricare, is it free for my family and me or no?
If retired (PDRL or TDRL) you keep TriCare eligibility. There is a small fee of a few hundred dollars depending on what type of coverage you elect. It covers you and eligible family members.

what is PEBLO?
Physical Evaluation Board Liaison Officer

Good luck, Frank!
 
Hey folks - update,

Turned in my "request for formal hearing with personal appearance". I guess I didn't understand exactly what I was doing. I was responding to the Informal 199, by non-concurring with the findings, and requesting a formal. The PEBLO recommended that I didn't "show my hand" before the Formal Board, and just arrive with a huge volume of paperwork (because with the amount of stuff that was messed up, there is a lot to look at, plus additional developments in the 14 months of my MEB), and then in an hour just face off with them. The principle being that they will be overwhelmed and just won't have an answer and will just cave to everything I want. My MEB attorney on the other hand said that this is not good practice. He said that a) pointing out the things that are missing, the PEB may send the packet back to the VA to get them to fix it, thus kind of getting a reconsideration without using mine up, and b) Nobody likes to have someone try to blindside them or just get one over on them. By trying to just overwhelm them with information it almost infers that you are trying to hide something or make them miss something, and then kind of stare them down and make them feel bad/unprepared/caught unaware. You don't endear anyone to you that way. So I did enclose the reasons for my request for a formal board. And they are manifold (there are over a dozen enclosures).

The Attorney feels that unlike many of the "simpler" cases, which get scheduled fairly quickly, because of the number of issues with mine, they may put it aside and take a little time on it before scheduling the formal board. So, it could be a month before I have it. And of course, they may just send it back to the VA to get some stuff looked at again (or rated for the first time because they somehow missed it on the consolidated narsum).

And so I wait. I'll give some follow up when I get some kind of next step.

Murph
 
Between the two positions, I tend to agree with the MEB attorney. However, I would add this. I don't think you can assume that they would read everything that you bring if it is hundreds of pages. Probably, the medical member would go through it and unless there were some clear things indicating you should prevail, you can count on angering that member of the PEB. What could happen, too, is that they go through the records, say that they will consider them and then wait to see if you raise anything specific in the records. But, burying the evidence you want to show in a bunch of other records is not a good approach. Bottom line, if your point is not apparent, they may miss it and you will have pissed them off.

I don't think you can count on the scheduling happening that way. It could, but the logical sequence of how they schedule cases suggests that they will deal with your case in due course. Either way, there is variability in how quickly cases are scheduled, so you may be in for a slightly longer or shorter wait. Hate to say it, but you will know when they notify you.
 
Hi Jason,

You are pretty much on the same page as the Attorney. It's not hundreds of pages by any means. The actual request is 3 pages including the list of enclosures, and while there are over a dozen enclosures, they tend to be one page factual stuff like MRI results with the specific conditions raised etc. So it's by no means hundreds of pages. Probably not even 50. It's also very clearly indexed to make it much less work for them. And the attorney basically said we are only raising the issues that we have the clear evidence to support (for instance, forget about the Migraines, not enough ER/Urgent care evidence, they won't budge, you'll only annoy them). So it is a handful of things that are clear and clearly supported.

The other issue is the items in the consolidated NARSUM that the PEB found to be service connected and that the VA just "lost". The attorney is requesting that the PEB get the VA to rate those conditions since they were found to be service connected, even if not unfitting. He thinks that this shouldn't be much of an issue because they generally expect the VA to rate stuff that they found and not to take the liberty of "losing" it themselves.

As for scheduling, yeah, I've been doing the waiting thing for 14 months now and I don't really have any expectations anymore. That way I'm less easily disappointed. I'm on their time. Clearly.

I'll keep you guys updated.

Murph
 
Hi Folks,

Well, I went to the formal PEB on Friday. I took the JAG Soldier's Counsel for advice. Who were actually really really good. It's a little nerve wracking, and I felt that the doctor was a little adversarial and cynical. But after it was all over, the board decided that my shoulder (which was rated at 20% by the VA) should have also been found unfitting, and my left foot also (which was rated at 10%). This means I now have 6 unfitting conditions. PTSD and Depression which combined are 50%, Left Shoulder 20%, neck 10%, left foot 10%, and actually, they never got the 199 on Friday afternoon so I'm not sure if the Chronic Fatigue stayed "unfitting" or not. Either way, my military rating now is 70%. Which I feel is fair. So I'm going to sign it next week. My VA rating is 90%. However I will be requesting a reconsideration as they just arbitrarily "lost" 3 conditions from the list of conditions on the consolditated Narsum, and since then I have been diagnosed with Sleep Apnea also. Plus they dropped the bilateral nature of the morton's neuroma. So basically there are 5 conditions which need to be added to the VA ratings. With the funny VA math, it may not even change that rating at all, but they need to be on there. They were on the original claim form and the MEB and PEB paperwork.

So overall, I am very satisfied. I have to say, I felt that the other two members of the board were swayed more by the nature of my career than strictly the medical evidence. They could see that I have never tried to do anything the easy way or try to avoid work in any way. I've done all the hardest stuff, and got an award for Valor in Afghanistan for my actions in a firefight. Which I think didn't hurt. So when I told them that I really felt that those two injuries would stop me from performing my duties, they took me at my word. I was just frank and honest with them with all their questions. Not defensive. I didn't lay anything on thick. And it came out in my favor. The head of the board thanked me for my long and distinguished career and particularly my deployments. I had a much better feeling about it than I thought I would.

So it's now just a matter of me signing it, the PDA signing off on it (assuming that they do), and I'm guessing that by about May 1, I'll have orders for a "be out by this date" date.

Rugbymurf
 
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