MH MEB, Add physical conditions?

M

MyNeckAndMyBack

Well-Known Member
PEB Forum Veteran
Registered Member
Firstly, I've been lurking this forum for five or six months and have learned a wealth of information, so thanks to everyone, especially the mods, for helping out.

Last October, I was referred to the DAWG for potential MEB due to taking medicine deemed incompatible with military service (lamictal/lamotrigine, anti-seizure med also used for psychiatric disorders). In addition, I have been under constant behavioral health treatment for over a year, which also triggers a review. This includes bi-weekly to weekly counseling and regular medication reviews and updates with the psychiatrist (quarterly). The DAWG then referred me for IRILO and my NARSUM appointment is on 15 Jan. This is for generalized anxiety disorder, major depressive disorder, and minor PTSD. Not sure if it's important, but I'm in the Air Force and just hit 16 years last August.

I also have a slew of physical ailments:

Two tears in right hip joint
Minor tear in left shoulder joint
Chronic, recurring sciatica
Plantar fasciitis
Bilateral flat feet
Ankle ligament reconstruction (both), lingering pain in right ankle (referred to additional MRI)
Reactive airway disease (annual RILO required)

However, none of these events so far have triggered an MEB or DAWG review.

My questions:

1) Should I speak to my PEBLO about adding these physical conditions to the overall package to be sent to AFPC?
2) If not, should I add them to my Commander's Letter to provide a fuller picture of my overall health to AFPC?
3) For my NARSUM meeting, should I be careful to describe the full range of my psychiatric issues, including symptoms at both their best and worst times?

If it isn't immediately clear, my intention is to be found unfit and medically separate or retire. I'm mentally and physically burned out and feel like a huge drain on resources.

Appreciate any help you folks can provide.
 
MyNeckAndMyBack said:
Firstly, I've been lurking this forum for five or six months and have learned a wealth of information, so thanks to everyone, especially the mods, for helping out.

Last October, I was referred to the DAWG for potential MEB due to taking medicine deemed incompatible with military service (lamictal/lamotrigine, anti-seizure med also used for psychiatric disorders). In addition, I have been under constant behavioral health treatment for over a year, which also triggers a review. This includes bi-weekly to weekly counseling and regular medication reviews and updates with the psychiatrist (quarterly). The DAWG then referred me for IRILO and my NARSUM appointment is on 15 Jan. This is for generalized anxiety disorder, major depressive disorder, and minor PTSD. Not sure if it's important, but I'm in the Air Force and just hit 16 years last August.

I also have a slew of physical ailments:

Two tears in right hip joint
Minor tear in left shoulder joint
Chronic, recurring sciatica
Plantar fasciitis
Bilateral flat feet
Ankle ligament reconstruction (both), lingering pain in right ankle (referred to additional MRI)
Reactive airway disease (annual RILO required)

However, none of these events so far have triggered an MEB or DAWG review.

My questions:

1) Should I speak to my PEBLO about adding these physical conditions to the overall package to be sent to AFPC?
2) If not, should I add them to my Commander's Letter to provide a fuller picture of my overall health to AFPC?
3) For my NARSUM meeting, should I be careful to describe the full range of my psychiatric issues, including symptoms at both their best and worst times?

If it isn't immediately clear, my intention is to be found unfit and medically separate or retire. I'm mentally and physically burned out and feel like a huge drain on resources.

Appreciate any help you folks can provide.
Click to expand...

When your are MEB'd, you will have a appointment with the PEBLO, he will coordinate a meeting with a VA VSO that will ask you to claim ALL medical conditions - the VA cares about all conditions connected with military service... your MEB and PEB will care about unfitting medical conditions. Later you will have VA appointments with a physician to evaluate all the conditions you claimed that are backed up as service connected by LODs/IRILO.

Anything proven to be service connected and disabling will get a VA rating - anything unfitting will get a DoD rating applied using the VA rating recommendation.

There is much more to the process, but this info gets you about halfway through an MEB.

When meeting with the VA VSO, he is not your doctor, dont tell him what medical conditions you think you have, tell him what is hurt/numb/non-functional and what else you have a valid diagnosis for. For example I told my VA VSO I think I may have carpal tunnel but it wasn't diagnosed, he literally said " I am not a doctor, tell me that your wrist hurts or your fingers are numb, the doctors will tell you if you have carpal tunnel or not." Basically you are not diagnosing yourself when talking to the VA VSO, you are telling him what parts of your body are broken, the VA physician will evaluate you based off anything you claim.
 
heathro1281 said:
When your are MEB'd, you will have a appointment with the PEBLO, he will coordinate a meeting with a VA VSO that will ask you to claim ALL medical conditions - the VA cares about all conditions connected with military service... your MEB and PEB will care about unfitting medical conditions. Later you will have VA appointments with a physician to evaluate all the conditions you claimed that are backed up as service connected by LODs/IRILO.
Click to expand...

Thanks for the information. I was under the impression that meetings with the VA VSO will not occur until after DP2NP refers me officially to the IPEB. Maybe I'm unclear on the process; it was my understanding that right now, the only items I need to accomplish are the Commander's letter and NARSUM, which will then be submitted to DP2NP, who then determines whether to refer me to the DES and start the "official" MEB. Is this inaccurate?
 
The MEB or Medical Evaluation Board is who determines that you will go forward to VA, IPEB and determinations.

The term MEB is also used to umbrella the whole PROCESS.

In reality and generaly speaking the MEB determines yes you need to enter the IDES process, you see the VA folks, appointments are met and then the PEB (physical evaluation board) board meets and decides if you continue to the next step -
.......................Fit finding and you are done. Go Back to work
……………………..Unfit and the VA will start ratings, the VA send them back to the PEB

The IPEB convenes and you get your DoD Ratings and VA ratings and the acceptance or appeal stages begin.... then more stuff happens.

This is all generic and the basics of the different terms.


In my case, the beginning isnt accurate, I went to the MEB they didnt like what my Med Group put together, but my Med Group sent me to a PEBLO assuming the MEB was going to agree and start the process, so technically I saw the PEBLO and VA VSO before my MEB was officially started. So there was a delay while my Med Group tried again to get the package right, then the MEB said I was to start the process and I continued where I left off with going to my VA C&Ps.
 
So, let me know if I have this straight. In my case, presuming unfit, it looks like:

NARSUM + CC's letter to PEBLO, who forwards to the MEB
MEB makes initial fitness determination
Unfit = entry into IDES, start of VA evals
VA sends eval data to IPEB
IPEB makes final fitness determination

Is this correct? And as to my original question, given my desire to separate/retire, would it be possible and in my best interest to bring up the physical conditions now or is that not possible, since they weren't referred as potentially unfit?
 
That's is how it is supposed to work. Your little short list is accurate in general.

You do not "bring up conditions" to be MEB'd it is supposed to be done by your PCM who will determine what conditions have turned them on to recommending your MEB, they also add any possible unfitting conditions they believe aides in the MEB process. Now you may be cool with your PCM and in the discussion you may get to tell them what all you believe should be sent to the MEB. But he should do all of that for you, my doctor didn't and he just asked me what I want to go to the board but it is because I wanted to be MEB'd. The MEB is not supposed to be something the member requests, it is supposed to be a last resort and result of continued profiles and nondeployablity…. this is the confusing part for people.

Let me repeat. Service members are not supposed to self impose a MEB, but it happens. So if you get to tell him what you want to go to the board, then by all means suggest everything you want.

At your meeting with the VA VSO to start your VA claims you WILL TELL THEM EVERYTHING. I went in thinking I was going to list about 10 things, after some help I left with 27 claims. Bolstered by things like : right ring finger numbness, right pointer finger numbness, left pinky numbness, … so what I thought I was claiming as just 1 case of carpal tunnel turned into 7 different individual claims alone.
 
Right. I'm aware that I don't initiate or self impose a MEB, but rather was asking if I should get my PCM involved with the physical ailments, since this is a mental health MEB and I'm not sure anything other than the mental health stuff will be brought up to the board. I'm not actually meeting with my PCM for the NARSUM since it's for mental health as well; I'm AF assigned to an Army base and receiving psychiatric care at the Army clinic, as well as an off-base therapist, but am meeting with an AF doc for my NARSUM. This doc is at the med group for the closest AF base but is not someone with which I've had any contact whatsoever. Perhaps I should have been more clear about that.
 
I am trying to say you can talk to your PCM about whatever you want to add to the board, but he only has to MEB for whatever he believes is unfitting. You could have a 1000 fitting physical ailments along with 1 possible unfitting MH condition, all you will be boarded for is the 1 possible unfitting condition.

You can have your physical ailments added to the MEB, the PCM still doesn't have to add them unless they are possibly unfitting or causing an extended profile. But you will be evaluated during the board for every condition you tell the VA, that's the only real control you have. I hope the PCM will add everything you. There isn't not necessarily just a MH board... everything can be evaluated. The big question is has your physical conditions caused nondeployment or extended profiles? Are any of your physical conditions unfitting for reenlistment?
 
Ah, I see. Thanks for the clarification.

I don't have extended profiles, other than post-surgery ones, but frequent profiles. I don't believe any are unfitting either, but I could be wrong.

Thanks for the clarification though. It's a little weird with the service disconnect and everything. The Army providers don't really know what to do most of the time and the AF isn't great about communicating their needs, so it makes things doubly confusing for those outside of the healthcare loop.
 
Search for an Air Force regulation that deals with MEB. The Army has Ar40-501 standards for medical fitness and chapter 3 specifically spells out what conditions should trigger a MEB.

The Air Force should have a similar reg that you could reference and use for talking points with your PCM in order to add unfitting conditions.
 
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