Started MEB, new to the process and need guidance.

Hello ALL,

I was referred for an MEB a few weeks ago and I just saw my PEBLO and VA/IDES Coordinator. Honestly, everything is overwhelming at this moment. I was fed with new information on the process from the beginning phases until the final out. How I got to this point was that my PCM and Ortho recommended me for an MEB due to my (left) lower extremity fasciotomy that was performed earlier this year (30APR13). Physical Therapy didn't see any progression and thought it would be best to utilized aquatics into the routine, but that didn't work out. At the moment I believe I'm in the beginning Phase 1 or Phase 2 and I go to ACAP and my legal briefing next week (10DEC13).

During my VA/IDES Appointment, the coordinator and I exchanged information (SSN, Marriage License, Birth Cert, Bank Info, etc). There's record of my surgery in there, but also listed a few more things i.e. left foot, right foot, hypertension, etc.

I know every case is different, but would like some advice or feedback from some soldiers who went through an MEB with the same issue (Lower Extremity, Fasciotomy, Foot Drop, etc). Thank you in advance!


Timeline:

30APR13 - Left Leg Surgery
2MAY13 - Physical Therapy
SEP13 - Physical Therapy/Aquatics
NOV13 - referred to MEB by PCM/Ortho
NOV13 - Medboard Clinic
4DEC13 - Met w/PEBLO
5DEC13 - Appt w/ IDES/VA Coordinator
10DEC13 - ACAP
10DEC13 - Legal Briefing
 
Last edited:
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sole_taker said:
Hello ALL,

I was referred for an MEB a few weeks ago and I just saw my PEBLO and VA/IDES Coordinator. Honestly, everything is overwhelming at this moment. I was fed with new information on the process from the beginning phases until the final out. How I got to this point was that my PCM and Ortho recommended me for an MEB due to my (left) lower extremity fasciotomy that was performed earlier this year (30APR13). Physical Therapy didn't see any progression and thought it would be best to utilized aquatics into the routine, but that didn't work out. At the moment I believe I'm in the beginning Phase 1 or Phase 2 and I go to ACAP and my legal briefing next week (10DEC13).

During my VA/IDES Appointment, the coordinator and I exchanged information (SSN, Marriage License, Birth Cert, Bank Info, etc). There's record of my surgery in there, but also listed a few more things i.e. left foot, right foot, hypertension, etc.

I know every case is different, but would like some advice or feedback from some soldiers who went through an MEB with the same issue (Lower Extremity, Fasciotomy, Foot Drop, etc). Thank you in advance!


Timeline:

30APR13 - Left Leg Surgery
2MAY13 - Physical Therapy
SEP13 - Physical Therapy/Aquatics
NOV13 - referred to MEB by PCM/Ortho
NOV13 - Medboard Clinic
4DEC13 - Met w/PEBLO
5DEC13 - Appt w/ IDES/VA Coordinator
10DEC13 - ACAP
10DEC13 - Legal Briefing
Click to expand...

Was the fasciotomy thigh or calf? was it due to trauma or exercise induced? which/how many compartments were affected? is the foot drop a constant or periodic? is the foot drop a symptom of the fasciotomy or from sciatic nerve involvement from back/pelvis?
 
Fasciotomy was anterior/bilateral, left leg. It was due to exercise induced. Areas affected left foot (foot drop) and calf/leg swelling. Foot drop is constant (from the morning I wake up to sun down). Foot drop occurred when running and leg would be swollen in minutes.
 
I finally got my QTC (C&P) done (31DEC13) and now we wait...:(
 
Ok so calf fasciotomie from exercise induced,

What is not clear in your post, is the foot drop still present?

If the foot drop is present still, then it will be 30-40% minimum as it is based on the nerve damage, they may/may not pyramid with the muscle damage.

External popliteal nerve (common peroneal)
8521 Paralysis of:
Complete; foot drop and slight droop of first phalanges of all toes, cannot dorsiflex the foot, extension (dorsal flexion) of proximal phalanges of toes lost; abduction of foot lost, adduction weakened; anesthesia covers entire dorsum of foot and toes40
Incomplete:
Severe30
Moderate20
Mild10
 
as for the muscle damage, from my reviews, fasciotomies are typically at the 20% rating for the calf but have seen them at the 10 quite often as well.


5312 Group XII. Function: Dorsiflexion (1); extension of toes (2); stabilization of arch (3). Anterior muscles of the leg: (1) Tibialis anterior; (2) extensor digitorum longus; (3) extensor hallucis longus; (4) peroneus tertius
Severe30
Moderately Severe20
Moderate10
 
TSgt Twitch said:
Ok so calf fasciotomie from exercise induced,

What is not clear in your post, is the foot drop still present?

If the foot drop is present still, then it will be 30-40% minimum as it is based on the nerve damage, they may/may not pyramid with the muscle damage.

External popliteal nerve (common peroneal)
8521 Paralysis of:
Complete; foot drop and slight droop of first phalanges of all toes, cannot dorsiflex the foot, extension (dorsal flexion) of proximal phalanges of toes lost; abduction of foot lost, adduction weakened; anesthesia covers entire dorsum of foot and toes40
Incomplete:
Severe30
Moderate20
Mild10
Click to expand...


During my C&P, I told the doctor that my pain (foot/leg) still remain. In fact, the pain has gotten worst. When I elaborated on how the injury happened and how the pain is still there he seemed to be in a rush to write his notes. I felt like that was just a waste of time!
 
ALL,

I got my NARSUM back from my PEBLO and they only found 1 "unfitting" or Medically Unacceptable (Anterior and Lateral Compartment Syndrome, Left Lower Extremity). And the following claimed items that were Medically Acceptable were:

Left Ankle Sprain
Right Ankle Sprain
Essential Benign Hypertension
Bilateral Hallux Valgus
Bilateral Foot Degenerative Joint Disease w/Calcaneal Spurs

At this point, it seems like my chances of getting Medically Retired are getting slim. And everyone knows that to get medically retired you have to get a 30% or higher. I also believe that the doctor that examined me at the QTC fudged my whole summary. Doctor stated that I was having pain and then having no pain at an another time. This to me didn't make any sense. Anyhow, I'm going to review this thoroughly and having LEGAL review it. Can anyone else share their experiences or advice on this update? Thank you all.
 
sole_taker said:
Hello ALL,

I was referred for an MEB a few weeks ago and I just saw my PEBLO and VA/IDES Coordinator. Honestly, everything is overwhelming at this moment. I was fed with new information on the process from the beginning phases until the final out. How I got to this point was that my PCM and Ortho recommended me for an MEB due to my (left) lower extremity fasciotomy that was performed earlier this year (30APR13). Physical Therapy didn't see any progression and thought it would be best to utilized aquatics into the routine, but that didn't work out. At the moment I believe I'm in the beginning Phase 1 or Phase 2 and I go to ACAP and my legal briefing next week (10DEC13).

During my VA/IDES Appointment, the coordinator and I exchanged information (SSN, Marriage License, Birth Cert, Bank Info, etc). There's record of my surgery in there, but also listed a few more things i.e. left foot, right foot, hypertension, etc.

I know every case is different, but would like some advice or feedback from some soldiers who went through an MEB with the same issue (Lower Extremity, Fasciotomy, Foot Drop, etc). Thank you in advance!

Timeline:

30APR13 - Left Leg Surgery
2MAY13 - Physical Therapy
SEP13 - Physical Therapy/Aquatics
NOV13 - referred to MEB by PCM/Ortho
NOV13 - Medboard Clinic
4DEC13 - Met w/PEBLO
5DEC13 - Appt w/ IDES/VA Coordinator
10DEC13 - ACAP
10DEC13 - Legal Briefing
Click to expand...

sole_taker said:
ALL,

I got my NARSUM back from my PEBLO and they only found 1 "unfitting" or Medically Unacceptable (Anterior and Lateral Compartment Syndrome, Left Lower Extremity). And the following claimed items that were Medically Acceptable were:

Left Ankle Sprain
Right Ankle Sprain
Essential Benign Hypertension
Bilateral Hallux Valgus
Bilateral Foot Degenerative Joint Disease w/Calcaneal Spurs

At this point, it seems like my chances of getting Medically Retired are getting slim. And everyone knows that to get medically retired you have to get a 30% or higher. I also believe that the doctor that examined me at the QTC fudged my whole summary. Doctor stated that I was having pain and then having no pain at an another time. This to me didn't make any sense. Anyhow, I'm going to review this thoroughly and having LEGAL review it. Can anyone else share their experiences or advice on this update? Thank you all.
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_______________________________***:D*** Happy New Year! ***:D***________________________________

Welcome to the PEB Forum! :)

Indeed, I have in-depth bad experiences with DoVA C&P Examination clinicians not performing their assigned duties in a professional manner albeit I shall not re-live those unfortunate experiences at this point.

Instead, I shall offer positive information to potentially assist with obtaining a favorable resolution. To that extent, please thoroughly review the NARSUM with the assistance of the MEB Legal office as previously mentioned.

Hmm, if you truly believe as based upon medical evidence that "the doctor that examined me at the QTC fudged my whole summary" is a valid assessment then it seems that a MEB appeal is definitely warranted.

In addition, please don't view your assessment as something too lightly dismissible since it's vital to have your issues formally documented at the appropriate phases within the DoD IDES process.

If not documented at the appropriate phases within the DoD IDES process, you can be very certain that the IPEB/PEB/FPEB shall make mention to your potential non-assertion to challenge the MEB's determination for sure in my opinion.

As such, your opportunities within the DoD IDES process shall continue if the PEB determines one or more medical conditions to be "unfit for duty" for physical continuation of military service. Please remain positively proactive and establish your rebuttal foundation now while in the DoD IDES MEB phase since there exist at least one "medically unacceptable" condition.

Nonetheless, please continue to do what you think is right for your particular medical situation; it's extremely easy to admit defeat albeit it's extremely hard to weather the battle in my opinion. Take care! ;)

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

Best Wishes!
 
Well there is a chance that since there is two compartments, those ratings will be separate, but you may have to fight for it. there is a few cases out there that explain it on the board of veterans appeals. The DoD and the VA may only count it as one condition, BUT if two distinct muscle groups are affected than it is two ratings, if both meet the moderate category then that is potentially a 40% rating. or as Warrior above notes, proving via your doctors that one of your other conditions would fail to meet retention standards. all though I will not sugar coat it if the following are the only other claimed conditions it may prove difficult.
Left Ankle Sprain
Right Ankle Sprain
Essential Benign Hypertension
Bilateral Hallux Valgus
Bilateral Foot Degenerative Joint Disease w/Calcaneal Spurs

The reason why i say it may be difficult is, the 2 ankles likely will be a zero% rating, the hypertension if you are on a medication daily for its control will be 10%, but in all my research has never shown to be unfitting, and your last 2 with evidence present MAY receive a total of 10% combined. Do some research on previous cases of lower extremity compartment syndrome and see what key words they used in order to raise the ratings up.
http://www.index.va.gov/search/va/b...=1997&DB=1996&DB=1995&DB=1994&DB=1993&DB=1992
 
Sorry for the late response, but I was found unfit 20JAN14. Now waiting for the ratings :(

Also, I have to attend a Vocational Rehab. Want to know what to expect from this...can anyone shed any light on this? Thanks in advance.
 
Ratings came in and no bueno!
 
TSgt Twitch said:
care to go into detail on that?
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I received 0% - Army, 20% VA. I'm a combat veteran who suffered an injury which resulted in a surgery. My battle buddies received 80-90% and never deployed, just tried to milk the system and get paid for the rest of their lives. Of course every case is different, but why did I get screwed over. Not trying to be greedy or anything, but when I heard the 20% from the VA my heart dropped. I was speechless to think what I would do to take care of myself and my family. I immediately asked for an appeal and waiting for a response for further investigation.
 
I meant detail on what was rated what, from reading your other posts I see that it was your ankles rated 10% each, and your other conditions rated zero. What I really am curious about is the rating decision wording for the fasciotomies for my own information, and possibly help you since I am up to speed on that particular listing of your claimed conditions. I am guessing in regards to your feet they say something like "evidence exists of this condition but bu there is no loss of rom or evidence of pain on motion" in regards to your heart I am guessing that you are on medication, but they state you do not have an average of 160/100 etc.

I am also guessing that in regards to your fasciotomies that they coded it as a vascular condition and not a muscular one. but with you going on and insulting other soldiers your loosing focus and being a tad bit dismissive, so either kick the attitude and regain your focus or bugger off, those of us trying to help have little time for folks playing the blame game.
 
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