Meb results in, but PTSD diagnosed after initial package

SMFC said:
Also, besides the health insurance commisary and bx why fight so hard for retirement?
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Retirement and the monthly compensation amount, in most cases will out weigh over time, the money rec'd from severance pay. In my case, my severance pay would have been well over 100,000.00 (after taxes). However, my permanent disability retirement check will eclipse that amount in 3 1/2 years. So over time, my permanent retirement is worth more than severance, it's steady income (COLA, too), it has insurance/medical benefits and so on attached with it so I don't have to worry about the ALL the costs of medical treatment I will be needing for the rest of my life, and it cannot be down graded like what can happen with VA ratings over time (they can go up or down).

v/r,
nwlivewire
 
So PEBLO is telling me to get these items added to the IDES process and rated so that they can be considered i have to agree with their findiings and waive the right to the formal board and the documentation will need to be provided for the new conditions and its a one time reconsideration

Someone mentioned a mandatory 50% from dod for ptsd, what the norm for the va after seperation? Same thhing for sleep apnea and whatnot
 
So i dont think im going to accept the severance and do the reconsideration with the new conditions included. We will see what happena
 
SMFC said:
Also, besides the health insurance commisary and bx why fight so hard for retirement?
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Take a few minutes and apply for health insurance with pre-existing conditions. When you see the monthly payment and co-pays I have a feeling a bright light will go off above your head. Also, by taking severance, unless your conditions are combat related or you are rated 0% DoD and unfit, will be re-couped over time. If you can live on less than 2k a month (assuming you max out VA 100%-10%=90% until re-coupement is complete) or able to work then maybe health insurance and retirement isn't that important. Based on your 50% VA rating, which is all you can rely on right now, can you survive on it? Also, if they give you a severance check, how quickly will you burn through it? Don't forget about a lot of subtle benefits like 10% discounts at Home Depot, etc. You will have a military ID if retired and most places, including hotels, honor that with a military discount. Also, what happens if the VA reduces your compensation in the future? At least you could have a DoD check as back-up. Even if severance is "good enough" for you, appealing and buying more time will allow your VA claims to move along further and faster rather than when off active duty.

Also, Space-A travel, MWR, healthcare for current or future family members and AAFES. Just a few extras.
 
SMFC said:
So PEBLO is telling me to get these items added to the IDES process and rated so that they can be considered i have to agree with their findiings and waive the right to the formal board and the documentation will need to be provided for the new conditions and its a one time reconsideration

Someone mentioned a mandatory 50% from dod for ptsd, what the norm for the va after seperation? Same thhing for sleep apnea and whatnot
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Having to agree with findings and waive formal board doesn't sound like the best option to me. Hopefully others chime in, but I would argue your case at the formal, in person.

Also, PTSD doesn't have to be compensated at 50% or more by the VA after you leave service, but for PEB purposes if it's an unfitting condition is required to be 50% or higher. Sleep apnea seems to be a common claim. Look it up under VASRD for rating criteria.
 
I worded that question too broad. I was mostly looking at the healthcare benifit as far as my wife goes. All your point are valid and i agree with you and i thank you for your input. I understand how important that retired id card is and its something that should be fought for. From what ive been told and some of the things ive read i cant present new issues at the formal board, maybe thats inccorect
 
That's incorrect. You'll be able to. Between now and then what you need to do in order to have the VA evaluate them is another story. Talk with your PEBLO and your VA rep. Between the two of them someone has to be able to tell you.
 
Worst case, keep in mind the IDES system is still new to me (I went through Legacy), you are/were being evaluated at the MTF or with civilian providers for those conditions. You can take those medical records, give them to the PEBLO and have him/her forward them to PEB to go along with your file. The new records would then be available for the PEB to review and you or legal counsel could talk about them at FPEB.
 
The VA rep told me there is no way i would get the new conditions evaluated and through the process in time. So if i can present the new items at a FPEB how does that board rate them? i thought the VA would have to review them prior.
 
From the schedule rating it pretty much says sleep apnea requiring the use of CPAP machine is 50% and i use it nightly that would seem to be an easy item to review
 
Most of the time from reading it seems the VA will rate sleep apnea, but it's not usually an unfitting condition. If you can prove that sleep apnea causes significant other problems/symptoms I think it could then be "potentially" unfitting. I am going to make an assumption here because I don't know and don't want to give bad advice. Hopefully someone will chime in and break it down.

I would assume they would rate per VASRD(required by law), but since VA didn't rate the condition they would either make the rating themselves or "suspend" your PEB until VA had time to examine you. I don't know, just making an assumption. I will try digging and see what comes up. The IDES process was developed to help and not hinder. I can't imagine the PEB would be allowed to potentially, "hurt" a SM because the VA didn't rate a condition. It brings up another valid point as well. What would happen if you went to the PEB and they found that ultimately you had an unfitting condition that the VA and NARSUM never discovered?

By appealing to FPEB it gives you time to consult with legal counsel and build a stronger case. Even if you were to appeal and your rating not increase, it could be helpful for future appeals because you exhausted other avenues of appeal.

Sorry I can't be more helpful at present time, but when I have more specifics I will update and hope others with expertise can chime in here and clarify this for us.
 
If you mean that the VA did not address or rate the condition at all, then it would play out like this. If you were able to convince the PEB that this "unrated" condition was unfitting, then I think there are a few ways this could play out. I would think that the PEB would need to send the case back to the VA for clarification. If the PEB does not or refuses to, then I think the member could use the "one time VA rating reconsideration" option while they are still in the IDES (if they have not previously exercised this option). Finally, if it is just not possible to get the issue rated while still in service, then the member is left to go through normal VA appeals channels and then, if/when they win, to go back to the military through the Board for Correction of Military Records to get the military rating changed. A lot of this hinges on the assumption that the PEB finds a VA non-rated condition to be unfitting. This would be pretty rare (where I would actually think it would come into play more often is when there is a variance in the diagnosis between the agencies and one of them has inappropriately adjudicated the condition), but if it does happen, I don't see how the PEB could conclude the case without a VA rating (else, how could they determine what percentage to assign on the DoD side). But, I have seen stranger things happen, too.
 
Jason said:
If you mean that the VA did not address or rate the condition at all, then it would play out like this. If you were able to convince the PEB that this "unrated" condition was unfitting, then I think there are a few ways this could play out. I would think that the PEB would need to send the case back to the VA for clarification. If the PEB does not or refuses to, then I think the member could use the "one time VA rating reconsideration" option while they are still in the IDES (if they have not previously exercised this option). Finally, if it is just not possible to get the issue rated while still in service, then the member is left to go through normal VA appeals channels and then, if/when they win, to go back to the military through the Board for Correction of Military Records to get the military rating changed. A lot of this hinges on the assumption that the PEB finds a VA non-rated condition to be unfitting. This would be pretty rare (where I would actually think it would come into play more often is when there is a variance in the diagnosis between the agencies and one of them has inappropriately adjudicated the condition), but if it does happen, I don't see how the PEB could conclude the case without a VA rating (else, how could they determine what percentage to assign on the DoD side). But, I have seen stranger things happen, too.
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You see, this confuses me. One of my two unfitting conditions had to do with my ankle. My military podiatrist ROM's he measured and recorded, according to the VASRD, it was 40%. That alone was an automatic military retirement. The VA contracted QTC to do my exams and when it came to my ankle, the doc didn't even do a ROM of my ankle and marked within normal limits. After I received copies of my QTC exams, I immediately contacted my PEBLO telling her that the exam was not performed correctly, but shethen told me to contact my VA rep. I did that and all he told me was that's not normal but never even mentioned that I could be re-evaluated due to the MAJOR difference in my ROM. I didn't suddenly recover. This was a condition I have lived with since 2006. But never once did he tell me about a "one time VA re-evaluation or rating." I spoke to QTC over the phone and put in a complaint and nothing happened. All I got was a call back saying everything was good with my ROMs. My PEBLO ensured me, my NARSUM would highlight this discrepancy and include my actual ROMs my podiatrist had recorded. But since I was just told my findings by my VA rep at 20% DoD, obviously something went wrong. My main unfit condition wasn't even my ankle. It had to do with my eye from a combat related injury! So when the PEB at Lewis gets my findings from Seattle, will my rating automatically be reviewed to see if the VA rated me correctly based of my ROM and kick it back to be corrected due to the extreme difference between my two ROMs?

The reason I ask is I have no more patience. I know others have more, but I am not one. I've been fighting my eye condition for 2 1/2 years alone and just cant take it. Also, I had an additional condition I requested to be considered and evaluated on by the VA long before my NARSUM was written and the same VA rep told me it would have to wait until my PEB was complete and could be added as a separate VA claim upon exit from service. I am outraged at this point after reading this thread because that additional condition was PTSD and if the PEB saw that was included, like you mentioned, they could have saw that as an unfitting condition as well. Just beyond frustrated at this point. I know, I know, if I want to fight it I have to request a FPEB, but I don't think my family can take it any longer and I am not sure I can either.

I suppose I could go ahead and just leave with my 20% DoD, exit the service, then hit up the VA and have them review my records, do a ROM again and since this was an unfitting condition, I could have it corrected like you said: through the Board for Correction of Military Records to get the military rating changed. It clearly wasn't a new condition but an actual unfitting condition on my NARSUM with real ROMs of both my ankles. I know that's taking a fat chance, and I would have to repay my severance over time, but it might be an option. Thoughts?
 
I am not sure if you are tracking correctly the difference between a condition that fails retention standards (a MEB term) and unfitness:

It clearly wasn't a new condition but an actual unfitting condition on my NARSUM with real ROMs of both my ankles.
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NARSUMs do not state fitness or unfitness.

So, from the starting point of I am not clear about your situation, it is really hard to give specific thoughts. But, it is almost always preferred to deal with cases earlier (and it can be problematic if you accept findings). So, just a gut reaction, I would stick things out and fight.

Good luck!
 
Jason said:
I am not sure if you are tracking correctly the difference between a condition that fails retention standards (a MEB term) and unfitness:


NARSUMs do not state fitness or unfitness.

So, from the starting point of I am not clear about your situation, it is really hard to give specific thoughts. But, it is almost always preferred to deal with cases earlier (and it can be problematic if you accept findings). So, just a gut reaction, I would stick things out and fight.

Good luck!
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Sorry. The condition was one of my conditions that failed to meet retention standards, and I was found unfit for that condition at the PEB. The problem was the ROM the doctor did was quoted in the NARSUM and quoted the AR stating I failed to meet retention standards. When the VA did my eval, the doc never did a ROM on my feet even though that was one of two conditions my MEB was for. Instead she just marked a ROM within normal limits contradicting what my podiatrist had stated. Due to the difference between the two, my MEB doc ensured this was noted on the NARSUM.
 
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