MEB stated Fibroymalgia EPTS

L

lance-tek

PEB Forum Regular Member
PEB Forum Veteran
Registered Member
Greetings,

BLUF: I am in the IDES process, I was denied s/c for Fibromyalgia by the MEB (Army).

The facts are as follows:
March 2011 - November 2011 I was deployed to Iraq
December 2011 - September 2012 I was in the WTU for shoulder and ankle injuries
September 28, 2012 I was REFRAD to the National Guard
May 16, 2013 - Jan 4 2014 I was on T10 again for surgery for residual issues (another surgery) in my shoulder

August 2014 - I recieved a diagnosis for Fibromyalgia

Feb 2015 Referral for MRDP
July 2015 Referral for MEB
November 2015 my MEB began
Jan 2016 - MEB denied myappeal that Fibromyalgia did not Exist Prior To Service (EPTS).

I'm now started the PEB process and am leery of the final outcome.

I was referred to the MEB for Behavioral Health by the Army MRDP. When I was contacted by my rep for the VA I claimed the BH, Fibro, Shoulder, Headaches, TMJ, Neck, Back, Ankle, etc. (there's a lot). Of everything I claimed the MEB only found BH, shoulder and Fibromyalgia as unfitting. But claimed that the Fibromyalgia EPTS.

I have a 90% rating from the VA already. This is because I had a claim filed by the WTU when I left Active Duty (T10) service and was returned to the National Guard. My 90% rating includes 40% for Fibromyalgia (which is a presumptive condition for the VA).

The army MEB contends that there were no signs or symptoms while I was on active duty and the diagnosis (by the Rheumatologist at the VA) did not come until eight months after I had left active duty. Also, I have no LOD for fibromyalgia or it's symptoms.

I did submit medical evidence to support my claim in my appeal. In this were the other diagnosis I have which are part of Fibromyalgia as well as the appointments regarding pains throughout my body. And, a diagnosis for "Chronic Pain" from early on with the VA (starting Feb 2013). I had an Army appointed attorney to help with my appeal but I don't think he was very helpful.

I am posting because I hoping to find some information or something that will reassure me that the PEB will not deny Fibromyalgia. And, I hope to obtain supporting information for my (presumed) appeal to the iPEB and every appeal after. I know Fibromyalgia doesn't get diagnosed overnight. Also, it took 17 months for mine to get diagnosed. I am just wanting to make sure the Army doesn't screw me yet again.

Thanks,

-lance
 
MEB appeals are not often successful, from my understanding.

lance-tek said:
there were no signs or symptoms while I was on active duty
Click to expand...

Is the main thing you need to ensure the PEB knows you disagree with. The PEB does listen to your arguments about EPTS a bit better than the MEB, so there is a chance of getting it fixed. I would also ensure the PEB directly addresses the fact that the VA determined it was service connected, that is a huge plus in your favor.
 
If the PEB states the fibro is EPTS, request the clear and unmistakable evidence that the condition not only preexisted service but also that it was not further aggravated by service.

Mike
 
Mike,

That is a great letter which I am sure will be helpful in the event that the iPEB agrees with the MEB. I'm probably going to be waiting for a while to find out but, in the meanwhile I am definitely trying to get prepared for the worst (but hoping for the best) in this matter. Of course there are multiple other smaller issues that I was denied consideration on by the MEB that I am preparing to argue as well. So, I am being kept quite busy...

Thanks!
 
lance-tek said:
Greetings,

BLUF: I am in the IDES process, I was denied s/c for Fibromyalgia by the MEB (Army).

The facts are as follows:
March 2011 - November 2011 I was deployed to Iraq
December 2011 - September 2012 I was in the WTU for shoulder and ankle injuries
September 28, 2012 I was REFRAD to the National Guard
May 16, 2013 - Jan 4 2014 I was on T10 again for surgery for residual issues (another surgery) in my shoulder

August 2014 - I recieved a diagnosis for Fibromyalgia

Feb 2015 Referral for MRDP
July 2015 Referral for MEB
November 2015 my MEB began
Jan 2016 - MEB denied myappeal that Fibromyalgia did not Exist Prior To Service (EPTS).

I'm now started the PEB process and am leery of the final outcome.

I was referred to the MEB for Behavioral Health by the Army MRDP. When I was contacted by my rep for the VA I claimed the BH, Fibro, Shoulder, Headaches, TMJ, Neck, Back, Ankle, etc. (there's a lot). Of everything I claimed the MEB only found BH, shoulder and Fibromyalgia as unfitting. But claimed that the Fibromyalgia EPTS.

I have a 90% rating from the VA already. This is because I had a claim filed by the WTU when I left Active Duty (T10) service and was returned to the National Guard. My 90% rating includes 40% for Fibromyalgia (which is a presumptive condition for the VA).

The army MEB contends that there were no signs or symptoms while I was on active duty and the diagnosis (by the Rheumatologist at the VA) did not come until eight months after I had left active duty. Also, I have no LOD for fibromyalgia or it's symptoms.

I did submit medical evidence to support my claim in my appeal. In this were the other diagnosis I have which are part of Fibromyalgia as well as the appointments regarding pains throughout my body. And, a diagnosis for "Chronic Pain" from early on with the VA (starting Feb 2013). I had an Army appointed attorney to help with my appeal but I don't think he was very helpful.

I am posting because I hoping to find some information or something that will reassure me that the PEB will not deny Fibromyalgia. And, I hope to obtain supporting information for my (presumed) appeal to the iPEB and every appeal after. I know Fibromyalgia doesn't get diagnosed overnight. Also, it took 17 months for mine to get diagnosed. I am just wanting to make sure the Army doesn't screw me yet again.

Thanks,

-lance
Click to expand...
EPTS for a reservist or guardsman is different from that for an active duty soldier. It simply means you didn't get the disability while you were on a duty status. For example, if I had been continuously assigned to a troop program unit as a reservist for 18 years and got into a car wreck going to my civilian job, it is EPTS.

You were not on active duty when you were diagnosed with fibromyalgia and that condition is a collection of undiagnosable pain points.

Unless you can show you were diagnosed with fibromyalgia while on active duty, its going to be a tough fight.

Wish you the best of luck!
 
I understand that they are saying it didn't "happen" on active duty. However, Fibromyalgia isn't something you contract. I have been in treatment for the other diagnosis that are part of the fibromyalgia symptom and diagnosis since I was in Iraq. It just didn't get labeled as Fibromyalgia until I left active duty. That's my argument in a nutshell. It's only one of many "issues" I have. But, it's a 40% issue and that will help a lot in reaching the desired outcome.

I'll surely keep this thread updated if anything changes.
 
It is not an issue of when it was diagnosed. It is an issue of when the condition began as witnessed by the VA's service connection for the condition. If the VA is stating it is service connected and the Army is saying EPTS, one of them is wrong.

Mike
 
True Mike. But the VA uses the standard of "it is as likely as not" and the military does not.
 
I just had one of my VA C&P claims close. The funny thing is that they only added or changed a couple of conditions. There are many (over 6 at least) that they just ignored completely but closed the claim anyway. This claim was not the IDES claim/case it was the one I had open prior to the IDES starting for me.

I recieved a letter in the mail about the claim. The letter stated something like "we have addressed the following conditions:" and then it was blank. The next paragraph talked about appealing. It's so messed up...

The items they rated me for (didn't deny anything just didn't rate it either) did not change my total disability with the VA (I was at 90% already). I still haven't heard from my PEBLO stating the iPEB is complete and that claim still shows up on eBenefits too. My current VA percentage is actually 93% even. A 30% rating for migraines would bump me to 100%. It is possible to get there I guess.

I am going crazy waiting on the iPEB decision. It's been three weeks now since I received an unfit for duty rating. I'm hoping that tomorrow brings news of a decent and fair rating.

I've heard mixed things. Does the iDES/Army rate for Sleep Apnea?

Thanks,

-lance
 
lance-tek said:
...I've heard mixed things. Does the iDES/Army rate for Sleep Apnea?

Thanks,

-lance
Click to expand...
Indeed, yes albeit the specific disability rating by the DoVA D-RAS is dependent upon the symptomology criteria as annotated in the 38 CFR VASRD.

In retrospect, I was awarded a DoVA 50% official rating for OSA with CPAP upon the receipt of my VA disability ratings via the DoD IDES process; it was a non DoD IDES PEB-referred unfitting condition. Take care! :cool:

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

Best Wishes!
 
I just got confused by my own ignorance and simple mindedness more than likely. But, I read your post initially to read "Yes the Army/DoD will also give a rating for Sleep Apnea (if appropriate)" Then I continued to read and became unclear if you were saying yes the Army/DoD does rate OSA as does the VA or if you were saying "yes the VA will rate OSA if appropriate".

So, I ask simply for clarity: Is it possible that I get a rating from both the Army/DoD and the VA for Sleep Apnea?

My PEBLO told me that the Army only referred me to the VA for three conditions, though I have over a dozen different diagnosis. She explained that there are some things the army doesn't say limit my ability to perform my duties. I am diagnosed with OSA by the VA (not rated yet) but I don't see how they won't S/C my OSA. But, OSA was not one of the conditions the Army is asking for a rating on.

I don't know that I agree with the Army leaving out certain conditions that I can find in chapter 3 the AR 40-501 which I have. However, in the end it only matters for a rating percent. The Army isn't going to provide any treatment to me for any of the unfitting conditions (unlike the VA where I will argue for everything I feel is accurate).

I'm still waiting and still frustrated :-/

Thanks,

-lance
 
It is up to the Army to demonstrate two things: that the fibro EPTS and it was not aggravated by service. If the IPEB does not grant you benefits for fibro ask for a FPEB and have an attorney ask for their evidence.
 
chaplaincharlie said:
It is up to the Army to demonstrate two things: that the fibro EPTS and it was not aggravated by service. If the IPEB does not grant you benefits for fibro ask for a FPEB and have an attorney ask for their evidence.
Click to expand...

That sounds pretty straight forward and simple!

I'm kinda flying solo and I only have a radio to get support, or in this metaphor, a heading. I truly appreciate all of the support and replies. I hope this case wraps up favorably and quickly. I have anxiety issues and waiting is like a knife being twisted in my gut!

I guess it could be a while (and I don't know why). I have been told to expect two months in total for this step. The iPEB only gave my determination (not fit for duty) on February 5th. But, the conditions they are wanting the VA to rate are already rated... why then is the case not progressing to notification of the preliminary rating decision? ...so confusing


-lance
 
lance-tek said:
... I hope this case wraps up favorably and quickly. I have anxiety issues and waiting is like a knife being twisted in my gut! ...-lance
Click to expand...

If you read and read between the lines on this forum, you will see you are not alone. The "not knowing" and not knowing when are common things expressed on this forum. Remember many others are walking through this process, you are not alone.

Best wishes
Mike
 
lance-tek said:
That sounds pretty straight forward and simple!...I hope this case wraps up favorably and quickly. I have anxiety issues and waiting is like a knife being twisted in my gut!... -lance
Click to expand...

chaplaincharlie said:
If you read and read between the lines on this forum, you will see you are not alone. The "not knowing" and not knowing when are common things expressed on this forum. Remember many others are walking through this process, you are not alone.

Best wishes
Mike
Click to expand...
Most definitely indeed; very well expressed @chaplaincharlie! ;)

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

Best Wishes!
 
chaplaincharlie said:
It is up to the Army to demonstrate two things: that the fibro EPTS and it was not aggravated by service. If the IPEB does not grant you benefits for fibro ask for a FPEB and have an attorney ask for their evidence.
Click to expand...
What says that the burden of proof is on the military to show a condition is not service incurred or aggravated (for a reservist not on extended active duty)?
 
Ed,

See para b from the section below from AR 600-8-4, LOD.

2–6. Standards applicable to LD determinations

Decisions on LD determinations will be made in accordance with the standards set forth in this regulation.

a. Injury, disease, or death proximately caused by the soldier’s intentional misconduct or willful negligence is "not in LD—due to own misconduct." Simple or ordinary negligence or carelessness, standing alone, does not constitute misconduct.

b. An injury, disease, or death is presumed to be in LD unless refuted by substantial evidence contained in the investigation.


Mike
 
I only wish I knew about this stuff before I got to this point. I only have 2 LODs but multiple disabilities. The National Guard (at least in my state) isn't known to really take care of medical issues in the units. They wait until you are transferred to the Discharge Company (where you go during the IDES process). The think that the Medical Discharge Company can do the LODs (which is potentially years after the injury/disability).

So, most of my stuff I have to fight for with the Army and the VA. :-/

Mike, you have given me some great information to work with. I hope I don't need it but I'll have to wait and see...

-lance
 
maparker said:
Ed,

See para b from the section below from AR 600-8-4, LOD.

2–6. Standards applicable to LD determinations

Decisions on LD determinations will be made in accordance with the standards set forth in this regulation.

a. Injury, disease, or death proximately caused by the soldier’s intentional misconduct or willful negligence is "not in LD—due to own misconduct." Simple or ordinary negligence or carelessness, standing alone, does not constitute misconduct.

b. An injury, disease, or death is presumed to be in LD unless refuted by substantial evidence contained in the investigation.


Mike
Click to expand...
I'm quite aware of those provisions Mike. But it isn't, and can't be, that simple for Reservists not on extended active duty. I remember a case I had where a Reservist from the 77th ARCOM had an epileptic seizure (the first one he ever had) while on weekend drill. He fell and broke his nose. The broken nose was determined to have been incurred in line of duty. The epilepsy was considered to be NLD-NDOM (EPTS).
 
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