MEB/PEB/Diagnosis questions

A

AverageJoe

Member
Registered Member
First time posting here, please bear with me.

16 Years AD, 17 Total, AGR with the Guard
About a year ago, I went for a fit for duty where I was evaluated for PTSD (as diagnosed by my civilian psych) but after a 45 minute test series, he found anxiety, depression and schziod personality (which I asked him if he was crazy diagnosing me with). I was to be reevaluated at a later time which never happened. My temp profiles have been issued in this sequence: insomnia, anxiety/insomnia, anxiety/depression, PTSD x3, and finally a perm for just anxiety, sending me to the MEB. I have a LOD pending at NGB for PTSD, Anxiety and depression which so far they have found sufficient evidence of PTSD, it was just waiting on surgeon approval. I’m AGR, so they did not have to wait for the LOD to be completed to send to the MEB. Also, the symptoms manifested themselves mid way and after being deployed to Afghanistan.

Throughout my “treatment” with both my civilian psych and VA, I have always avoided raising red flags, such as suicidal ideations as my whole goal was to just get cleared. I thought I could just push myself thru this. But that has not been the case and my issues have gotten worse.

Now some questions and any possible suggestions:
Is there any difference to benefits being diagnosed with PTSD vs Anxiety/depression? Should I push them for the PTSD diagnosis or is that something that will not be considered because the perm profile was issued for anxiety alone?
Second, should I write a letter to board explaining the severity of symptoms and the reasoning for not trying to raise red flags, downplaying what has been going on?

Any other suggestions you may have. This is keeping me awake at all hours of the night, not to mention the panic attacks trying to figure this out. I know there are a million different scenarios, but I do not know where mine is leading to.
 
Welcome to the forum, AverageJoe.

My 2 cents.
While you always want a diagnosis that is as accurate as possible, sometimes it takes awhile for clinicans to work out the full picture. PTSD falls under the umbrella of anxiety disorders, and a perm profile for anxiety would not differ from that for PTSD. What you do want noted in the LOD is if they are due to combat (broad definition). That may make a difference later in terms of CRDP.
The ratings criteria the VA uses for anxiety, depression, and PTSD are all exactly the same - you will only get one rating for mental health, so they will use the highest.

Have you had your VA examinations and NARSUM yet? If not, you will have ample opportunity to discuss symptoms with examiners. Be honest, be real, do not downplay.
Unless I am misunderstanding, you are very early in the process, and this is a great board to get the info you need.
I'm sure others will chime in with more details.
Best of luck...Bob
 
AverageJoe said:
First time posting here, please bear with me.

16 Years AD, 17 Total, AGR with the Guard
About a year ago, I went for a fit for duty where I was evaluated for PTSD (as diagnosed by my civilian psych) but after a 45 minute test series, he found anxiety, depression and schziod personality (which I asked him if he was crazy diagnosing me with). I was to be reevaluated at a later time which never happened. My temp profiles have been issued in this sequence: insomnia, anxiety/insomnia, anxiety/depression, PTSD x3, and finally a perm for just anxiety, sending me to the MEB. I have a LOD pending at NGB for PTSD, Anxiety and depression which so far they have found sufficient evidence of PTSD, it was just waiting on surgeon approval. I’m AGR, so they did not have to wait for the LOD to be completed to send to the MEB. Also, the symptoms manifested themselves mid way and after being deployed to Afghanistan.

Throughout my “treatment” with both my civilian psych and VA, I have always avoided raising red flags, such as suicidal ideations as my whole goal was to just get cleared. I thought I could just push myself thru this. But that has not been the case and my issues have gotten worse.

Now some questions and any possible suggestions:
Is there any difference to benefits being diagnosed with PTSD vs Anxiety/depression? Should I push them for the PTSD diagnosis or is that something that will not be considered because the perm profile was issued for anxiety alone?
Second, should I write a letter to board explaining the severity of symptoms and the reasoning for not trying to raise red flags, downplaying what has been going on?

Any other suggestions you may have. This is keeping me awake at all hours of the night, not to mention the panic attacks trying to figure this out. I know there are a million different scenarios, but I do not know where mine is leading to.
Click to expand...

Welcome to the PEB Forum! :)

In my opinion, @PsychOfficer provided good insightful information.

In addition, I would offer that you definitely need to continue your behavioral healthcare medical treatment via VA and/or civilian providers. To that extent and by all means, if your behavioral medical conditions symptomatology become worst to a point where it's totally intolerable, then please seek medical emergency/urgent care immediately without hesitation.

From a procedural viewpoint and to aide with building your knowledgebase, the DoD IDES MEB/PEB process is explained in detail as follows:

After referral into the DoD IDES MEB/PEB process by your military PCM who initiated a permanent physical profile with PULHES of 3 or 4 in any one category, the Military Treatment Facility (MTF) who has approval authority for DoD IDES MEB referrals shall review the originally PCM-initiated permanent physical profile request.

Upon acceptance into the DoD IDES MEB/PEB process, during the MEB Phase is when all of your medical conditions are reviewed to determine which are "medically unacceptable" or "medically acceptable" conditions.

To that extent, the MEB Physician is supposed to review all applicable medical condition(s) associated with a PULHES category of 3 or 4 in the AHLTA EMR database system, and then make an informed objective medical evidence determination to either maintain, down select, or upgrade the specific category code in the PULHES.

Upon approval by the DoD IDES MEB Physician(s) at the MTF of the PCM-initiated permanent physical profile referral, the MEB Physician shall either generate a new permanent physical profile with updated PULHES (most favorable course of action in my opinion) or transpose the PCM-initiated permanent physical profile with PULHES as written (least favorable course of action in my opinion).

In continuation of the DoD IDES process, a Narrative Summary (NARSUM) is dictated after receipt of the DoVA C&P Examination results which outlines in detail all medically unacceptable and medically acceptable conditions. It's unknown what type of C&P Exam clinician you will get on the day(s) of the evaluation. In my opinion, some DoVA C&P Examination clinicians are good-to-go while others seem not to care about the military service member.

With that said, you may receive good or bad results from either of the aforementioned type of DoVA C&P Exam clinicians; there are no guarantees. Depending on the type of C&P Exam, the clinician will just ask a lot of questions and/or perform a physical evaluation.

If the MEB determines that medically unacceptable conditions exist, then the IDES case file is forward to the PEB for a fit for duty or unfit for duty determination.

If the PEB determines any unfit medical conditions, then the IDES case file is forward to the DoVA D-RAS for ratings of all PEB referred unfitting conditions (e.g., DoD disability rating(s)) and all DoVA claimed conditions. It's important to note that DoD must adopt the DoVA D-RAS rating(s) for each PEB-referred unfitting condition(s).

Upon receipt of the IPEB findings inclusive of DoD and DoVA proposed ratings, the DA Form 199 (or similar Service specific document) is generated. When the DA Form 199 (or similar Service specific document) is finally signed [e.g. after resolution of a PEB appeal/review and/or an one-time VA Rating Reconsideration (VARR) request, if warranted], then it's forwarded to the Transition Point Processing System (TRANSPOC) II.

Moreover, TRANSPOC II performs transition processing functions in which it generates the DD Form 214 (Certificate of Release from Active Duty or Discharge) document, and schedules the generation of retirement/separation orders from US Military.

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

Best Wishes!
 
AverageJoe.
Sound like We are in the same boat. I have been in the process for 4 months now and nobody in my chain of command can tell me S*&$. I have to go to Ft Lewis and see the MEB Doc for a Fit for Duty Board. My understanding is we have to be found unfit then the MEB process starts. I have 15.5 years AD. You will fine out that being an AGR it hard to get answers to some of your question because of our status Title 32 active. I would like to keep in contact with you so we can exchange information. Bat
 
Have either of you checked into the possibility of the WTU at Fort Leonard Wood? We have active, reserve, and ANG types here. I can provide contacts and possibly assist - its worth looking into - as difficult as the process is, it is easier if you are in a WTU. Bob
 
I think we would have to give up our title 32 active orders for title 10. I don’t know if that would be a good thing or a bad thing. So far I have had it pretty good. Ft Leonard Wood is a long way from Oregon. Going to an active duty Post I don’t think I could handle it.
Thanks Bat
 
Thanks for the replies, I admit I have learning more about this process from reading the forums than anything my state has done.

Psychofficer, WTU isn't a possibility, I have not heard of any T32 AGR being sent. We just kind of are in limbo throughout the process and are expected (as hard as it is at times) to maintain our position and duties until seperated. As far as I have seen there is very little to no consideration to what you are going thru, unless it becomes an emergency situation. I'd like to say more, but I have seen it in the past and now are experiencing what others have said. Just makes for a really bad situation, WTU would be far more fitting.
 
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