PA and Temp Profile issue

Dakota6

Dakota6

PEB Forum Regular Member
Registered Member
My civilian PA has never written me a full 3 month profile, in the last 2 years, I've been on profile for 80 days total. Even though I've been going through rehab and pain management for 12+ months. You'd think he would have written me 3 month profiles taking the PM doc's advice?

But he always writes 14/21 days. Which makes total profiles look high (4), but the actual time on profile is very low in career. I originally thought he did this to protect me from fit for duty, but now I'm not sure.

I'm having multilevel ACDF, he approved the extended con leave. First 45 days or more I'll be completely immobile with neck brace. Can't start physical therapy until at least 60 days. I schedule apt with him and tell him command wants temp profile to cover their pt stats.

Meet briefly, he's tracking the surgery (as he blessed off on con leave days earlier), writes it in eprofile.

He wrote a 30 day profile that says I can "ride in mil vehicle for 12+ hrs a day", and "wear uniform 12+ hrs a day".

Expected date of FMC is 30 days (lol what?). Says I can lift up to 24lbs. (again...lol?)

What the hell is he thinking? How do I bring this up with out ruining relationship with my PA?
 
Dakota6 said:
My civilian PA has never written me a full 3 month profile, in the last 2 years, I've been on profile for 80 days total. Even though I've been going through rehab and pain management for 12+ months. You'd think he would have written me 3 month profiles taking the PM doc's advice?

But he always writes 14/21 days. Which makes total profiles look high (4), but the actual time on profile is very low in career. I originally thought he did this to protect me from fit for duty, but now I'm not sure.

I'm having multilevel ACDF, he approved the extended con leave. First 45 days or more I'll be completely immobile with neck brace. Can't start physical therapy until at least 60 days. I schedule apt with him and tell him command wants temp profile to cover their pt stats.

Meet briefly, he's tracking the surgery (as he blessed off on con leave days earlier), writes it in eprofile.

He wrote a 30 day profile that says I can "ride in mil vehicle for 12+ hrs a day", and "wear uniform 12+ hrs a day".

Expected date of FMC is 30 days (lol what?). Says I can lift up to 24lbs. (again...lol?)

What the hell is he thinking? How do I bring this up with out ruining relationship with my PA?
Click to expand...

I would say the PA thinks he is gaming the system, but what I read in AR 40-501 (see below) is that if you get temp profiles for the same condition, it really doesn't matter what the duration of each temp profile is, as much as the duration in overall calender time the profiles cover. If you go past six months, you are supposed to be referred to a specialist to determine your path forward. By no means would the PA qualify as a specialist.

c. Temporary profiles. Soldiers receiving medical or surgical care or recovering from illness, injury, or surgery, will
be managed with temporary physical profiles until they reach the point in their evaluation, recovery, or rehabilitation
where the profiling officer determines that MRDP has been achieved but no longer than 12 months. A temporary
profile is given if the condition is considered temporary, the correction or treatment of the condition is medically
advisable, and correction usually will result in a higher physical capacity. Soldiers on active duty and RC Soldiers not
on active duty with a temporary profile will be medically evaluated at least once every 3 months at which time the
profile may be extended for a maximum of 6 months from the initial profile start date by the profiling officer.
(1) Temporary profiles exceeding 6 months duration, for the same medical condition, will be referred to a specialist (for that medical condition) for management and consideration for one of the following actions:
(a) Continuation of a temporary profile for a maximum of 12 months from the initial profile start date;
(b) Change the temporary profile to a permanent profile;
(c) Determination of whether the Soldier meets the medical retention standards of chapter 3 and, if not, referral to an
MEB.
(2) The profiling officer must review previous profiles before making a decision to extend a temporary profile and
refer the Soldier to a medical specialist for management if the temporary profile has been in effect for 6 months. Any
extension of a temporary profile must be recorded on DA Form 3349, and if renewed, item 8 on the DA Form 3349
will contain the following statement: "This temporary profile is an extension of a temporary profile first issued on
(date)."
(3) Temporary profiles will specify an expiration date. If no date is specified, the profile will automatically expire at
the end of 30 days from issuance of the profile. In no case will Soldiers carry a temporary profile that has been
extended for more than 12 months. If a profile is needed beyond the 12 months, the temporary profile will be changed
to a permanent profile. Exceptions to the 12-month temporary physical profile restriction must be approved by theedical treatment facility (MTF) commander or their designated senior physician approval authority (often the deputy commander for clinical services).
 
So he shouldn't even be issuing the profile. But how do I get an off post civilian ortho to do a profile. I guess physical therapy will have to issue it.

Even if profile is for same condition was over 12 months, this profile shouldn't be related. It's recover from surgery. Different reason IMO. Open to interp. I guess
 
I'm thankful I have a good supportive command. But my supervisor was a bit confused when he received the con leave support paper work stating I needed 3 months, and on bed rest for half of that. Then receive this profile saying I can ride in a military vehicle and wear uniform.
 
Dakota6 said:
I'm thankful I have a good supportive command. But my supervisor was a bit confused when he received the con leave support paper work stating I needed 3 months, and on bed rest for half of that. Then receive this profile saying I can ride in a military vehicle and wear uniform.
Click to expand...

It sounds like you PA, as are many of the Army PA's is doing his own thing. The key for you is to get to the doctor he answers to. Medical decisions by a PA are supposed to be reviewed by an MD, but what I see happen often is it just doesn't happen. When the Army aggressively increased the number of PA slots, it did not increase MD slots. So it comes down to more unsupervised PA's.

The civilian doctor can't write a profile. They do not have access to MODS, nor do they have the authority to right a profile. What they can do is write a memorandum stating what they think your limitations should be, and whether you will recover enough to perform military duties. I would provide the PA with a copy of this memo, but then also find out who your profiling officer is and send it to him as well. You may also consider sending a copy to your state medical officer as well. Bottom line is you have to get around this PA because he is not doing the right thing.

Seeing as you are an O4 I would guess you can probably put together a pretty good Army memo. Sit down and right one out that states the problem, what your treatment thus far has been, and how the profiles have not addressed your limitations. I would also reference AR 40-501, and chapter 7 on profiling requirements, and the fact none of that has happened in your case. Send this up through the chain of command, and see if that helps as well.
 
Dakota6 said:
I'm thankful I have a good supportive command. But my supervisor was a bit confused when he received the con leave support paper work stating I needed 3 months, and on bed rest for half of that. Then receive this profile saying I can ride in a military vehicle and wear uniform.
Click to expand...
Con leave for a ACDF is almost always 60 days (I have had two of them). You are only granted 30 days at a time, the hospital commander requests the additional 30 days.

During my 60 days of con leave each time, there was still an expectation to make your medical appointments.

I had an appointment 3 days post surgery, 10 days post surgery and then began physical therapy (just a consult) at the 30 day mark.

Actual physical therapy began at 60 days and it lasted for 6 months. You should be given a profile that has no running, jumping, sit-ups, Kevlar, LBV, road march, 18 pounds maximum lift. You will be prescribed pain medications so they may list no alcohol too. It is important to NOT smoke during recovery as it interferes with the bone grafts healing.

Remind your supervisor that in order to ride in a tactical vehicle, you must wear a Kevlar helmet, this will be a no-go for at least 180 days.
 
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