Confused/overwhelmed...NARSUM rcvd...IMR Request?

ides2017

Registered Member
#1
Currently undergoing MEB for Mental Health issues and I find the entire process very confusing and overwhelming. I don't feel like I have enough information to really understand the process, make informed decisions, and preserve any rights I may or may not have in the process.

I disagree with so much in NARSUM and the way this entire process ensued. However, based upon the way I am being treated by my command and mental health throughout this process I'm leaning towards wanting to get the entire thing over as quickly as possible so I can get out of this negative environment and move forward with my life.

So my decision at this point is whether to request an IMR...since I disagree with the NARSUM this seems like the right this to do. However, my PEBLO wants me to write an MFR with questions I'd like answered by the IMR. Is this standard? Any recommendations on the best approach for this MFR?

Since I no longer want to argue my case for being retained in the military based upon my treatment through this process, does it make since to delay it with IMR requests, rebuttals, etc. or should I just let the chips fall where they may and be grateful that my situation isn't worse than it could be? It seems there are many stories out there of people in a similar situation being shafted with an admin separation.

Appreciate any tips or advice on the way ahead.
 

gsfowler

Staff Member
PEB Forum Veteran
#2
Currently undergoing MEB for Mental Health issues and I find the entire process very confusing and overwhelming. I don't feel like I have enough information to really understand the process, make informed decisions, and preserve any rights I may or may not have in the process.
The process can definitely be overwhelming at times, have you had a briefing from the office of soldiers counsel (or equivalent) from your branch? This will be the lawyers that the military has to advise your throughout the process to ensure you make informed decisions.

I disagree with so much in NARSUM and the way this entire process ensued. However, based upon the way I am being treated by my command and mental health throughout this process I'm leaning towards wanting to get the entire thing over as quickly as possible so I can get out of this negative environment and move forward with my life.
Your best bet is to go through the NARSUM and highlight the areas that you believe are incorrect, then find evidence from your medical records that supports why you think it is incorrect. Opinion or your feelings do not count, you need medical evidence to support your decision.

So my decision at this point is whether to request an IMR...since I disagree with the NARSUM this seems like the right this to do. However, my PEBLO wants me to write an MFR with questions I'd like answered by the IMR. Is this standard? Any recommendations on the best approach for this MFR?
You would not be the person writing the MFR, this is the job of the MEB lawyer assigned to your case. You should be ready to help them write the memo by presenting to them the areas that you want to rebut, and the evidence you have (as described in the paragraph above)

Since I no longer want to argue my case for being retained in the military based upon my treatment through this process, does it make since to delay it with IMR requests, rebuttals, etc. or should I just let the chips fall where they may and be grateful that my situation isn't worse than it could be? It seems there are many stories out there of people in a similar situation being shafted with an admin separation.

Appreciate any tips or advice on the way ahead.
I do not recommend that you just "let the chips fall where they lie" but rather present the evidence that supports the correct outcome of your MEB, to ensure your receive a decision that is fair and just.

It does not matter what anyone else has received, the only thing that matters are the facts that are unique to your situation and that the decision(s) made are based upon those facts.
 

Chaps_Z

PEB Forum Veteran
Registered Member
#3
The NARSUM rebuttal process is a drop in the bucket compared to the big picture. You have a long wait after that so sit back and relax, its gonna be a while.
 

Jason Perry

Benevolent Leader
Site Founder
Staff Member
PEB Forum Veteran
Registered Member
#4
Welcome! I hope the information you get here helps you.

Currently undergoing MEB for Mental Health issues and I find the entire process very confusing and overwhelming. I don't feel like I have enough information to really understand the process, make informed decisions, and preserve any rights I may or may not have in the process.
Yeah, your concerns are common. I wish the system were better, but it's not. That is the reason I set up this forum, to help folks have a better understanding of the issues that they face and to try to equip folks with information to set them up for success. Also, the purpose is to provide a community for folks to share their frustrations and any info to help others.

So my decision at this point is whether to request an IMR...since I disagree with the NARSUM this seems like the right this to do. However, my PEBLO wants me to write an MFR with questions I'd like answered by the IMR. Is this standard? Any recommendations on the best approach for this MFR?
First, if you disagree with the MEB/NARSUM, then the best vehicle to get a good outcome is to first request an IMR and then to provide a rebuttal to the MEB.

There is no other requirement past requesting the IMR to get it. I have seen this many times, where PEBLOs sometimes suggest or state that the member must provide a memo/justification, etc. in order to get the IMR. That is pure bullshit. The law and regulations only require you to request it in order to get the IMR. That said, it can be helpful to provide what your concerns are so that the IMR provider can focus on your concerns. Normally, at the MEB level, this will be a request for consideration of additional conditions that should be found to fail retentions standards.

Since I no longer want to argue my case for being retained in the military based upon my treatment through this process, does it make since to delay it with IMR requests, rebuttals, etc. or should I just let the chips fall where they may and be grateful that my situation isn't worse than it could be? It seems there are many stories out there of people in a similar situation being shafted with an admin separation.
If you disagree with the MEB and/or the NARSUM, I would think it makes sense to request the IMR and then rebut the MEB unless the MEB Convening Authority changes your board report such that it addresses your concerns.

Not sure why or how you should have concerns with an ADSEP. I don't think this should be a factor in your consideration of the way ahead, absent other information.
Appreciate any tips or advice on the way ahead.
Nothing more, unless you have additional questions.

I hope all goes well for you. Best of luck in getting your desired outcome!
 

jahlon

PEB Forum Veteran
Registered Member
#5
As a person who suffers from a great many mental issues, I will share this.

When I first saw my NARSUM I disagreed with a lot of what was written about me. When I say disagreed, what I mean to say was I saw red and wanted to just go into full fight-back mode.

Instead of doing that, what I did was copy and paste out all the lines I disagreed with, and then asked my very close friends to take a look at it. I basically said to them "Does this really describe me?"

The hard truth was this: What my therapist said about me, my friends all agreed with.

That hurt, but it was the hurt that started the therapeutic process.

Mental health issues are ugly, the ugliest of injuries you can have. We (those who suffer from them) are always going to think the best of ourselves when stuff is written on paper. Sometimes we have to hear the ugly truth in order to get past it.
 

ides2017

Registered Member
#6
The process can definitely be overwhelming at times, have you had a briefing from the office of soldiers counsel (or equivalent) from your branch? This will be the lawyers that the military has to advise your throughout the process to ensure you make informed decisions.



Your best bet is to go through the NARSUM and highlight the areas that you believe are incorrect, then find evidence from your medical records that supports why you think it is incorrect. Opinion or your feelings do not count, you need medical evidence to support your decision.



You would not be the person writing the MFR, this is the job of the MEB lawyer assigned to your case. You should be ready to help them write the memo by presenting to them the areas that you want to rebut, and the evidence you have (as described in the paragraph above)



I do not recommend that you just "let the chips fall where they lie" but rather present the evidence that supports the correct outcome of your MEB, to ensure your receive a decision that is fair and just.

It does not matter what anyone else has received, the only thing that matters are the facts that are unique to your situation and that the decision(s) made are based upon those facts.
Thank you for your sound advice on how to address my concerns. I have contacted the Office of Airmen's Council (OAC) for advice. At the stage I'm at now, they generally just answer questions. Without the background on the case, I think it's difficult for them make any strong recommendations. I have been told that once I receive the results of the IFEB, I will have the option to elect counsel from the OAC.
 

ides2017

Registered Member
#7
The NARSUM rebuttal process is a drop in the bucket compared to the big picture. You have a long wait after that so sit back and relax, its gonna be a while.
Ha thanks! Definitely easier said than done...really antsy and ready to get out of dodge.
 

ides2017

Registered Member
#8
Welcome! I hope the information you get here helps you.



Yeah, your concerns are common. I wish the system were better, but it's not. That is the reason I set up this forum, to help folks have a better understanding of the issues that they face and to try to equip folks with information to set them up for success. Also, the purpose is to provide a community for folks to share their frustrations and any info to help others.



First, if you disagree with the MEB/NARSUM, then the best vehicle to get a good outcome is to first request an IMR and then to provide a rebuttal to the MEB.

There is no other requirement past requesting the IMR to get it. I have seen this many times, where PEBLOs sometimes suggest or state that the member must provide a memo/justification, etc. in order to get the IMR. That is pure bullshit. The law and regulations only require you to request it in order to get the IMR. That said, it can be helpful to provide what your concerns are so that the IMR provider can focus on your concerns. Normally, at the MEB level, this will be a request for consideration of additional conditions that should be found to fail retentions standards.


If you disagree with the MEB and/or the NARSUM, I would think it makes sense to request the IMR and then rebut the MEB unless the MEB Convening Authority changes your board report such that it addresses your concerns.

Not sure why or how you should have concerns with an ADSEP. I don't think this should be a factor in your consideration of the way ahead, absent other information.


Nothing more, unless you have additional questions.

I hope all goes well for you. Best of luck in getting your desired outcome!
Thank you so much for setting up this site!!! It's definitely needed. There's so little information out there, and they really don't make it a transparent process at all. It's good to be able to hear about people who have gone through what you're going through. it's also good to know I can share my frustrations since they aren't many avenues to do that where people actually understand the process that is frustrating me.

I requested the IMR yesterday. My PEBLO has encouraged me to also write a letter of exception to the board as she says this is my only opportunity to essentially speak to the board prior to the formal board. Trying to wrap my head around what I would possibly include in that letter and it's difficult to know where to begin.

Depending on what comes back from the IMR, I will likely submit an LOR too.

My concerns with the ADSEP are because I wouldn't have access to care after discharge.
 

jahlon

PEB Forum Veteran
Registered Member
#9
Don't be too concerned without having access to care after discharge.

If you get a VA rating for the condition, even if you don't have TRICARE you will still have access to VA health care.
 

ides2017

Registered Member
#10
Don't be too concerned without having access to care after discharge.

If you get a VA rating for the condition, even if you don't have TRICARE you will still have access to VA health care.
Thank you for this. I just remembered this earlier today. I suppose it's the stigma associated with it....especially after so many years of service.
 

ides2017

Registered Member
#11
Still really struggling with how to respond/approach this.....just feel like I'm in a damned if I do, damned if I don't scenario....here's some of the things I think are key from the NARSUM although I have no idea how to translate/interpret a lot of these docs/statements.

Original NARSUM initiating I-RILO

DSM-5 Diagnosis

Adjustment Disorder with Anxiety and Depressed Mood (309.28/F43.21)-resolved but likely to reoccur as evidenced by emotional symptoms in response to identifiable stressor occurring within 3 months of the onset of the stressor. SM noted marked distress out of proportion to severity/intensity of the stressor and caused significant impairment and social and occupational functioning. The symptoms have resolved as the stressor has resolved.

Social/Industrial Impairment: mild currently; definite with stressors
Military Impairment: moderate

Other Specified Eating Disorder-bulimia nervosa of low frequency as evidenced by meeting criteria for bulimia nervosa (eating, in a discrete period of time, an amount food greater than most in similar circumstances, a lack of control over eating, recurrent inappropriate compensatory behaviors in order to avoid weight gain, and self-evaluation influenced by body shape/weight though not meeting the full criteria for frequency.

Social/Industrial Impairment: mild
Military: moderate

Other Specified Personality Disorder (301.89/F60.89) as evidenced by having a pervasive pattern of unstable realtionships marked by idealization followed by devaluation, significant struggles with self-esteem, impulsivity with sex and food, and struggled with openness/trust resulting in being guarded in sessions and with command structure. She additionally noted struggling with fears of abandonment and needing the positive regard of others to maintain her own self-image.

Social/Industrial Impairment: Considerable
Military Impairment: Moderate

Note added following C&P exams
The patient has remained stable with no significant changes since the date of the initial NARSUM. VA C and P data was reviewed and the information within the NARSUM is current and complete. This date now becomes the new date for NARSUM currency. Symptom reports and some aspects of history in VA C and P differ from those pt has previously presented in this clinic. These symptoms reports which led to VA C and P diagnosis are not congruent with pets report of activities and are not congruent with behavioral observations from this clinic. For this reason, the initial diagnosis in the NARSUM are felt to be most accurate at this time.
 

ides2017

Registered Member
#12
And from my C&P exams...

5. Diagnosis: -------------

#1. Claimed condition: PTSD/MST, Adjustment Disorder with Anxiety and Depressed Mood

Diagnosis/Rationale: Posttraumatic Stress Disorder (with depressed mood, anxiety, and sleep impairment). Veteran reported that she was sexually assaulted by a peer while in the Air Force Academy in 2006. She reported that she was sexually assaulted again in 2016, while stationed in Germany. Please see examination report for additional details.

#2. Claimed condition: Other Specified Eating Disorder Diagnosis/Rationale: Unspecified Feeding or Eating Disorder.

Veteran reported disordered eating in 2004, again in 2011/2012 (related to issues with her ex- husband), and in 2017 (related to second sexual assault). Please see examination report for additional details.

1. Diagnostic Summary

---------------------
Does the Veteran have a diagnosis of PTSD that conforms to DSM-5 criteria based on today's evaluation?
[X] Yes [ ] No

ICD code: 309.81(F43.10)

2. Current Diagnoses
--------------------
a. Mental Disorder Diagnosis #1: Posttraumatic Stress Disorder

ICD code: 309.81(F43.10) Comments, if any:

with depressed mood, anxiety, and sleep impairment

4. Occupational and social impairment
-------------------------------------
a. Which of the following best summarizes the Veteran's level of occupational and social impairment with regards to all mental diagnoses? (Check only one)

[X] Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with normal routine behavior, self-care and conversation
 

SeniorMech

Registered Member
#14
And from my C&P exams...

5. Diagnosis: -------------

#1. Claimed condition: PTSD/MST, Adjustment Disorder with Anxiety and Depressed Mood

Diagnosis/Rationale: Posttraumatic Stress Disorder (with depressed mood, anxiety, and sleep impairment). Veteran reported that she was sexually assaulted by a peer while in the Air Force Academy in 2006. She reported that she was sexually assaulted again in 2016, while stationed in Germany. Please see examination report for additional details.

#2. Claimed condition: Other Specified Eating Disorder Diagnosis/Rationale: Unspecified Feeding or Eating Disorder.

Veteran reported disordered eating in 2004, again in 2011/2012 (related to issues with her ex- husband), and in 2017 (related to second sexual assault). Please see examination report for additional details.

1. Diagnostic Summary

---------------------
Does the Veteran have a diagnosis of PTSD that conforms to DSM-5 criteria based on today's evaluation?
[X] Yes [ ] No

ICD code: 309.81(F43.10)

2. Current Diagnoses
--------------------
a. Mental Disorder Diagnosis #1: Posttraumatic Stress Disorder

ICD code: 309.81(F43.10) Comments, if any:

with depressed mood, anxiety, and sleep impairment

4. Occupational and social impairment
-------------------------------------
a. Which of the following best summarizes the Veteran's level of occupational and social impairment with regards to all mental diagnoses? (Check only one)

[X] Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with normal routine behavior, self-care and conversation
What ultimately ended up happening with your PTSD claim and finding? The definition from the doc suggests 30% so I was curious about the final outcome since my current situation is very similar...
 

Bcollins49

Registered Member
#15
Welcome! I hope the information you get here helps you.



Yeah, your concerns are common. I wish the system were better, but it's not. That is the reason I set up this forum, to help folks have a better understanding of the issues that they face and to try to equip folks with information to set them up for success. Also, the purpose is to provide a community for folks to share their frustrations and any info to help others.



First, if you disagree with the MEB/NARSUM, then the best vehicle to get a good outcome is to first request an IMR and then to provide a rebuttal to the MEB.

There is no other requirement past requesting the IMR to get it. I have seen this many times, where PEBLOs sometimes suggest or state that the member must provide a memo/justification, etc. in order to get the IMR. That is pure bullshit. The law and regulations only require you to request it in order to get the IMR. That said, it can be helpful to provide what your concerns are so that the IMR provider can focus on your concerns. Normally, at the MEB level, this will be a request for consideration of additional conditions that should be found to fail retentions standards.


If you disagree with the MEB and/or the NARSUM, I would think it makes sense to request the IMR and then rebut the MEB unless the MEB Convening Authority changes your board report such that it addresses your concerns.

Not sure why or how you should have concerns with an ADSEP. I don't think this should be a factor in your consideration of the way ahead, absent other information.


Nothing more, unless you have additional questions.

I hope all goes well for you. Best of luck in getting your desired outcome!
What's a NARSUM? I'm in MEB and I haven't seen or heard of that.
 

Jason Perry

Benevolent Leader
Site Founder
Staff Member
PEB Forum Veteran
Registered Member
#16
What's a NARSUM? I'm in MEB and I haven't seen or heard of that.
Narrative Summary. It is the document that the MEB produces covering the member's conditions, their impact on duty performance, prognosis, and any relevant administrative matters.
 
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