4th Period of Limdu STS1(SS)

B

batcheej

PEB Forum Regular Member
PEB Forum Veteran
Just wanted to know if someone has had a similiar experience. I am on my 4th period of Limdu for the same condition Lumbar back problems (original MRI showed L4-L5 heriniation and L5-S1 herniation with nerve root compression). Have had a discectomy of L5-S1 and more recently a L4-S1 lumbar fusion. Was found fit after discectomy until I did PHA (as ordered by UMO to return to Sub duty) then had fusion because of reoccurence of symptoms L4-L5 herniation became more severe. Just had left knee surgery plica removal which ortho says was partially due to my back because I was walking messed up for over 2 years. My LIMDU re-eval is next month. I thought I was going to go to PEB after 3rd period Limdu but was granted a 4th. Now I am again thinking PEB but is it possilbe I could get a 5th period of Limdu? I have 13 and half years of service and am really tired of the LIMDU limbo.
 
batcheej,

Welcome! A third LIMDU is rare. I have not seen a 4th LIMDU, so that indicates that a 5th LIMDU, while probably possible (like most things, if someone high enough grants a waiver or exception to policy, then I suppose it is possible), is extremely unlikely to occur.

Hope all goes well for you.
 
I made it through 4 periods of limdu before I got fed up with the system and inquired about a meb/peb.
I've got a co-worker that just started her 5th period of limdu.

Have you talked with your PEBLO about requesting a MEB/PEB?
 
Jeffb,

Interesting! Was the LIMDU for the same condition? I probably should have added that it is possible if the MTF/physician doesn't follow through with what the regulations require. That said, if it works in the members favor, then fine. If not, then I think inquiring/complaining is the first step.
 
batcheej said:
. My question is since the doctor is saying I am fit with limitations can the Navy just ADMIN SEP me without a PEB? Thank you for your responses.
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They may think they can. I disagree. I am currently suing the US Government for this practice of finding Sailors fit but unsuitable. We will have to see what the court has to say about this, but I believe that they cannot.
 
batcheej,

You have probably already heard this, but I'm going to press on with this advice. You need a laywer. Based on what you have said, someone in the MTF is not following proceedure. There should be a patient advocate located in the same MTF/Hospital as your doctor. You should also request a formal Admin SEP board with legal representation. Good luck
 
batcheej said:
Jason,
Thank you for your response. After reading other posts here, I realized that the doctor I saw at least thinks that I will just be admin separated without a PEB. I will not allow that to happen. I will continue to post updates and hopefully my experience will help others. Fortunately I am pretty sure my command will support me. I talked to my C.O. briefly yesterday, and he said he would push for the resolution that I want. Also I am now seeing a social worker from mental health at my mtf who has helping me deal with my stress and anxiety while I have been going through this process and she thinks that the Navy would be making a big mistake by just throwing me out. I also talked to my ortho and neurosurgeon yesterday and they both said they will go to bat for me. I am not really scared of being out the Navy, I just do not want to throw away almost 14 years of my life where up to this point I have always been a superior performer and have always done what has been asked of me.
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Batch,
Hey got a question cause it seems like we at least have been in the same amount of time. Did your command try to screw you on the Non Medical Assessment? Mine is and i am wondering what if anything there is i can do. Here is my situation and maybe you can help maybe not. I joined the volunteer fire dept when i came back stateside, my injury has been going on for over 9 years, i put in for the MOVSM in october before my 2nd LIMDU. Now due to the fact my XO forgot that i was awarded it, he pulled me in his offfice and asked how can i say that you are unfit if you can do this. I tried to explain to him i hadn't done that in almost 6 months. But he didn't listen. Do you know if they can put adverse stuff in your NMA? just curious
Grant
 
Gunmate1,

As far as I know the NMA is pretty straight forward. Your C.O. needs to basically say if he thinks you can remain in the military or not. He could I guess put in adverse remarks that you are on LIMDU but still manage to be a volunteer firefighter. If I was in your shoes my biggest concern would be if any of your doctors put any type of restrictions on you such as no heavy lifting, bending, etc. and you were working as a firefighter while having those restrictions that would be bad. As far your X.O. you need to prove to him that you were not doing anything in violation of your doctor's orders or LIMDU restrictions maybe getting a statement from the chief of your fire house would help with that. I wish you the best of luck.
 
Update on my status is there is no update. I am still waiting for the MED boards people to call me to sign the paperwork to clear me off of LIMDU and TRY to give me the the title of "Fit but unsuitable" I was seen by the Navy doctor on the 12th of April. This LIMDU period officially ends in May and I know the Med Board findings are supposed to be submitted 15 days prior to the end of the LIMDU period. Does anyone know if the Med Board can submit their findings without allowing the service member to review and sign the paperwork?
One good thing is my C.O. is actively involved and appears to be on my side were my case should be referred to a P.E.B.
 
Just giving an update that may help some other individuals the Navy doctor is telling me that I can be returned to duty despite my medical condition and stating that my civilian neurosurgeon has cleared me although my neurosurgeon explicitly denies this. I tried to get an informal resolution of this with the navy doctor who actually lifted a restriction that I can not lift more then 30 pounds and continues to state that my forward flexion (bending over at the waist and attempting to touch my toes) is 35 degrees while my neurosurgeon's notes specifically state that my forward flexion is limited to 15 degrees. I was told by the med boards personnel that I can not receive a copy of the NAVMED 6100/6 the form stating that I can return to duty until sign it which I refused to sign. So I am know appealing that I am fit to return to duty in writing, appealing to the department head of the Navy doctor who is saying that I can return to duty. I am doing this IAW the Navy Manual of the Medical Department Article 18-10. I am using my neurosurgeon's notes as evidence that I can not perform the duties of my rate and rank. As well I am submitting certificates of service to who I am addressing my written appeal to and am respectfully asking for a response by 27 May 2010. So I will post again after that. If anyone needs assistance on how to do this I would be more then glad to help. Also this is not an appeal to a PEB as the Navy doctor states my case does not require referral to an Informal PEB which I do not agree with. The Navy doctor actually told me that "if I deploy and have to wear body armor I need to be careful and not jump out of any HUMVEE's" I just said O.K. sir and thought to myself does guy have no idea what he is doing? Another thing I suggest anyone who is going to an MEB read the the Navy Manual of the Medical Department.
 
Bat,

Your case is a classic example of "useful idiots" not knowing their jobs. I think it's way time you started to "Lawyer up". You need to start bringing heat on these people to "motivate" them into learning their responsibilities. In my opinion, since you already know your Sub career is already over and the DES awaits you, I think you have good cause to get your Congressman involved. You need to draft a well pled one to two page document stating your concerns. At the minimum, the Command will have to respond to a Congressional inquiry and it will serve the purpose of letting them ALL know you are serious about you case.

The next step is to retain Jason Perry...
 
So yesterday I was told that I had to sign my Navy doctor's dictation for the MEBR that is going to the PEB and of course it was not completely accurate and I was told that if I was going to submit a rebuttal to it I would have less then 24 hours to do so. So I signed it and chose not to submit a rebuttal because the dictation contradicted itself with statements such as "The patient claims that he has absolutely no back pain" then a couple of paragraphs later it stated "the patient regularly states that his lower back pain is a 2-3 out of 10 on the pain scale. It also stated that my neurosurgeon has cleared me (not true). I also believe that my neurosurgeon and ortho's notes stand up on their own so I have those up my sleeve. What has been the kicker right now is the Med boards office did not offer me a copy of this document that I signed and agreed to which is in contradiction to Navy medical instruction. So I was advised to ask the PEBLO what authority do they have to with hold giving me a copy of the document. I was told by the PEBLO that they didn't have the dictation, the convening authority had it because they may want changes to be made to it. I said o.k. and then thought how will the CA recommend changes to the dictation without the complete MEBR. So I started the paper trail by writing the PEBLO an e-mail that I do not understand why I can not get a copy of this dictation and that I would like a copy of all the documentation that gets submitted with my MEBR. The next thing to force their hand even more will be when I ask to speak to all of the members of the MEB which I have the right to IAW their instruction.
 
Consider requesting an impartial medical review of your MEB. This triggers a requirement for them to respond in writing to your concerns. Sounds like they are trying to pull a fast one.
 
Jason,
Thank you for your response. I will definitely consider this. I will have to research who the appropriate party is to address this request to.
 
So after starting the paper trail of e-mails. I get one today from the Patient Administration Program Advisor (not sure what that title means) stating that I again can not have a copy of this doctor's dictation that I agreed to and signed because my MEBR has not been signed by the CA. The e-mail also stated that once my MEBR was completed and signed by the CA I could review it and have a copy of it before it went to the PEB as well as stating that I can have an impartial medical review if I so wish. So my response to the e-mail was yes of course I would like an impartial review IAW NAVMED Policy 09-017 and thank you for bringing it to my attention as I have never heard of this procedure before. I also noted how the PEBLO had told me that I would have had less then 24 hours to submit a rebuttal to the dictation and how if I am going to submit any further rebuttal to the MEBR I again respectfully request a copy of dictation and that if it is a working copy that it should be marked as such so I would not be confused as a final copy. I closed my response with "Additionally, in exercising my rights contained within NAVMED Policy 09-017, I request a copy of the dictation so that I may prepare a proper rebuttal. Any sur-rebuttal will be made with the aid of the original dictation; fairness dictates my right to do the same. Thank you again."
 
To everyone I need help in answering a question is there a requirement that actual range of motion measurements must be taken with a an actual measurement device as part of the MEBR submission to the PEB. SECNAV INSTRUCTION 1850.4E does not specifcally state how to measure range of motion for my medical condition (lumbar back problem) from what I have read. I have heard that the military is required to use the VA examination criteria and I asked the MTF doctor who did my physical examination for the PEB yesterday if actual measurements of my ROM needed to be taken and he said that he did not know but he would note that I had significant decreased ROM. No military medical provider has actually taken a ROM measurement with an actual measurement device for my condition is this right / acceptable? Thank you for you responses.

Also I am getting my impartial medical review but it is being done before the MEBR is complete does this make sense? Thanks again for responding.
 
This is from the Navy Manual for the Medical Department, Chapter 18 Medical Evaluation Boards, Article 18-12, "(5) Orthopaedics
(a) Range of motion (ROM) measurements must be documented for injuries to the extremities. The results of the measurement should be validated and the method of measurement and validation
should be stated."

The goniometer requirement comes from VA regulations (both the VASRD, which mentions it, here) and by reference, the DoD Policy Memo Implementing the 2008 NDAA, which mandates use of VA rating worksheets, which do require measurement with a goniometer.

No, I don't see how you can have your findings "reviewed" if they are not complete. Sounds fishy to me.
 
Jason,

Thank you so much for your response. I am a little concerned about having the impartial review before the MEBR is complete. From what the PEBLO has told me the only thing missing from the MEBR an addendum from another MTF provider which I am not to worried about because this addendum is for my mental status for which my diagnosis is "workplace stress". Thanks again for your response and I will continue to provide updates so that they may help someone else.
 
So I had my impartial review done and the Doctor I saw stated that the dictation of the doctor who was originally trying to tell me that I was fit for duty was inaccurate and it will be re-written, as well I will have the opportunity to review it again and if it is still not correct they will fix it again. Needless to say I was very pleased with this outcome. This doctor could not believe that the other "Doctor" was not following the recommendations and diagnoses of the my civilian specialists. Her exact words were "They are the experts and we are going to follow what they have written". Also Happy Father's Day to all of the Dads out there.
 
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