PRE IDES NARSUM - feedback requested

A

Airforcematt

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Hey guys - I just got ahold of a copy of my NARSUM and I'd like to have some feedback from ya'll on it if possible. It seems like here overseas I have to meet a "Local MEB" which will make a decision of Return to duty/Refer to IDES, anyone ever seen anything like that? Seems a bit off to me as I've never seen anything about it on this forum or any other source I've read up on.

I've attached my NARSUM, anyone care to hazard a guess on a fit/unfit for this?

Since the NARSUM has been completed the Mental health piece has changed, the diagnosis is now
Anxiety Disorder
The profile has also been changed - I'm now no longer allowed to walk greater than a half mile.
 

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First part of my question is answered after I dug around in AFI 41-210 a bit. In the AF there is a pre IDES referral board held at the local level to decide on if the case should be referred into the IDES.

Still would be greatful for feedback from folks on my NARSUM. I'm hoping for an unfit finding but have my doubts it'll happen.
 
afmatt,

The process works as follows. Your PCM identifies a "physical disability" and refers the case to MEB (medical evaluation board). This is accomplished by your base PEBLO office. A three person panel reviews your medical records and recommends a fit/unfit finding to AFPC. Regardless of their finding, AFPC has the final say. In my case my local PEBLO found me fit, but AFPC did not concur and wanted a full PEB (physical evaluation board). If you are found unfit and AFPC concurs you will meet with a VA rep to claim and be evaluated for any service connected issues you would like to claim through the VA. This can be anything in your medical records from a twisted ankle you had two years ago to headaches. If you are interested in an unfit finding I suggest you review your medical records yourself before the VA rep does. This will ensure you are well informed of what is in your medical records so the VA rep does not miss anything you would like to claim. Also, go ahead and request a copy of your medical records. This is usually done at the referrals office in your medical clinic. Hope I haven't lost you yet! While dealing with the VA your case is referred to the IPEB (informal physical evaluation board) office at Lackland AFB, Texas. They will review your medical records and determine a fit/unfit finding. If found unfit at this point they will make an offer. The key is to be rated at 30% or greater. This means a medical retirement. Anything 20% or less and they will offer you a severance package. If you do not agree with their findings you can request a FPEB (formal physical evaluation board). This allows you to go meet a new board and address the findings. I'll stop with the info there because at this point it can get a little confusing to explain any further. If you just started this process it will be at least six months before you get results from the IPEB. Mine started in early March and I was just notified of the IPEB's findings this Monday. Hope this info helped!

The website below lists all the VA's ratings.
http://www.benefits.va.gov/warms/bookc.asp#p
 
Thanks for the info Chika! For some reason I thought that the MEB process was at a level higher than the base and that I had to go through the VA C&P exams prior to my package going to the MEB. Guess I was mistaken :)

Will def follow your advice on getting my med records - been meaning to do that for a while. Need to get the ball rolling.

Anyone care to weigh in on my NARSUM? Interested in hearing what folks think of it. I may have a chance to have changes made to it as it was kicked back for not having range of motion numbers for my back so any feedback on possible improvements would be greatly appreciated! :)
 
Check out AFI36-3212 PHYSICAL EVALUATION FOR RETENTION, RETIREMENT, AND SEPARATION
and DOD Directive 1332.18 Physical Disability Evaluation.

These should help with your own determination of fit/unfit.
 
Matt,
To be honest with you my NARSUM looks and is formatted differently. So I don't know what is correct. However I was found unfit and my ratings have gone back to AFPC so my docs must of done something right. Good luck with the whole process and be prepared for a long ride.
 
your narsum looks way different then mine. my narsum basically had a list of my injuries/illnesses on the first page,then a bunch of pages explaining behind it.
 
Chica said:
Check out AFI36-3212 PHYSICAL EVALUATION FOR RETENTION, RETIREMENT, AND SEPARATION
and DOD Directive 1332.18 Physical Disability Evaluation.

These should help with your own determination of fit/unfit.
Click to expand...

Thanks for the resources - I'll do some digging into them here shortly :)

Mathew Wilson said:
your narsum looks way different then mine. my narsum basically had a list of my injuries/illnesses on the first page,then a bunch of pages explaining behind it.
Click to expand...

Yeah - things seem to be run a LOT differently here overseas at the MEB level. I'm not sure that it's as smooth a process as it is stateside. I'm in the early phases now - we'll see how it develops.
 
I have not recieved my NARSUM yet as I am still in the early stages of this process, however, I would recommend that you take it to legal and have them review it at least for legality reasons. This might also affod you the opportunity to ask all the questions that you have.
 
good post. but just reminds me of something... Everybody plans to save and save and save until the end, work all your good years so you can retire when you are old and do nothing, and waste away... it is good, but isn't it funny people save money until they are too old to do anything with it.. regardless we all die.
 
Thanks for all the feedback guys - The NARSUM in the first post was kicked back because it didn't include ROM for my back - just went and did that today. Had a very nice sit down with my PCM and explained a couple concerns I had about the NARSUM and he gladly made some changes for me. I told him that I thought that my Anxiety disorder should be added as a referred condition as it is causing as much or more issues at work than my back and he said he'd talk to Mental Health. Not sure how quickly things will move forward from here - have a feeling my new NARSUM will have to wait to see the local board at the end of November but we'll see.
 
I don't think this is your NARSUM. This looks like a summary that the MEB is using to decide whether you meet retention standards or not. This is what the MEB puts together after they get your stuff from the PCM. If they decide you are not medically qualified, they will refer you to the PEB. If that happens you will be assigned a PEBLO, See a VA rep, complete VA C&P exams and then you will get a NARSUM. The NARSUM is what they are going to use to communicate all your conditions to the PEB and whether or not they believe them to "Meet Retention Standards" or "Fail To Meet Retention Standards" on each condition.
 
Guys, the NARSUM is different for every service...
 
Based on reading what he attached and his statement "I have to meet a "Local MEB" which will make a decision of Return to duty/Refer to IDES". I made my remark it is not a NARSUM. Long before he gets a NARSUM he is going to be referred to IDES and be assigned a PEBLO and have VA exams.
 
As I understand it in the Air Force the document for the MEB which is generated as part of the fit/unfit return to duty/refer to IDES is called a NARSUM, just like the one for the PEB. The document is setup in such a way that if a member is found unfit then the NARSUM will be used as the basic framework for the more formal NARSUM completed after the VA C&P exams. Quote clarifying this from the related AFI is below.



AFI41-210
4.51.1.2.1. The ―Review-in-Lieu-of (RILO) MEB will be used as the pre-IDES
screening process. Cases submitted for pre-IDES screening will be referred to as
―Initial RILO packages and will contain a Narrative Summary (NARSUM),
associated consult reports and/or studies, a current AF Form 469 (reviewed IAW AFI
10-203), a commander‘s letter, and a standardized cover sheet checklist
Click to expand...
 
My NARSUM is in the process of being re-written. One of the conditions listed is "Anxiety with depressive mood" - I feel that since the anxiety is causing me significant issues in the workplace and at home that it qualifies as a boardable condition. I sent my PCM an email about this and he sent me the below response.


Yes, I have spoken with [Mental Health Doctor] and he said that anxiety is not a
boardable condition. Only major depression or psychosis.

V/R

PCM
Click to expand...

As I understand AFI 38-123 section 5.3.12 Anxiety IS a boardable condition if it's having an effect on your work AND/OR if it's a recurring problem (both true in this case)

Can anyone who's seen something similar confirm/deny this for me?
 
Did some further digging into AFI 48-123 - quotes below, emphasis is mine.




5.3.12. Axis I Diagnosis, and Other Mental Conditions. MEB is indicated in those
instances when a mental health condition precludes satisfactory performance of duty [I'm currently not allowed to work unsupervised due to my Anxiety] or
worldwide assignability or deployment. An MEB must be done when a condition has caused
or is expected to cause significant duty impairment or limitations for greater than one year
and for conditions in which there is recurrent impairment [This has been an issue since 2008] or recurrent impairment is
expected

5.3.12.2. Mental conditions requiring MEB:
5.3.12.2.1. Conditions that are expected to have persistent duty impairment (more
than 1 year despite treatment).
5.3.12.2.2. Conditions associated with recurrent duty impairment (2 or more episodes
of impairment in 12 months).
5.3.12.2.3. Conditions which require continuing psychiatric support (e.g. weekly
psychotherapy in order to function) beyond one year.
5.3.12.2.4. Conditions requiring use of lithium, anticonvulsants, or antipsychotics for
mood stabilization.
5.3.12.2.5. Individuals who experience recurrent depression or anxiety disorders, [Again, I was seen for this in 2008, dealt with it on my own for a couple years then seen here for it the past few months as it started reaching a level I couldn't handle on my own]
require psychiatric medication for greater than one year, who have been hospitalized
for a psychiatric condition, require an evaluation by a military mental health provider.
These cases warrant careful consideration of fitness for duty, worldwide assignability
and deployability, given that adequate mental health support may not be available in
all locations. Serious psychiatric illnesses (refer to criteria in 5.3.12.2.1-4 above) that
result in hospitalization require a MEB. For ANG members on long-term
antidepressant maintenance therapy even if asymptomatic or in remission, a WWD
evaluation must still be forwarded to ANG/SGPA for consideration
Click to expand...

Is there any other relevant regulation where I can find more information about what is considered fit/unfit for the USAF and/or DOD? Any other USAF folks been down this road before?
 
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