DES Outrage of the Week #2 - DoD Continues to Low Ball Migraine Conditions

maparker

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#1
The key issues in this week’s Outrage are:

1. The DES, and in particular the Army DES, are continuing to lowball disability ratings for migraines, a disabilities common with PTSD and traumatic brain injuries.

2. PEBs and DES review authorities are still refusing to address key issues raised by service members in their disability evaluation boards and in their appeals as required by 10 USC 1222a.

3. DoD is not proactively identifying service members affected by erroneous migraine disability ratings so that they can request a review by the DoD’s Physical Disability Board of Review.

In last week’s Outrage, I wrote about how the Physical Disability Board of Review (PDBR) is continuing the denial of DoD disability benefits for service members with PTSD. In this week’s Outrage, I will be discussing how the DoD’s DES (Disability Evaluation System) is continuing to improperly assess and rate migraine and other headache conditions which are often associated with PTSD and traumatic brain injuries. As in the past, DoD continues to find ways not to rate conditions thus keeping disability ratings and benefits low.

For the past several months I have been assisting an Army soldier, SPC Postell, with her disability evaluation case. Her DES experience continues to demonstrate that serious problems remain in how DoD adjudicates disability cases. Medical and physical evaluation boards (MEBs and PEBs) are the core of the DES and they continue to be wrought with errors and outright avoidance of information critical for the well being and benefits of wounded warriors. While DoD and the Services have established several recent policies to ensure the proper adjudication of disability cases, MEB and PEB officials are failing to follow the policies. Worse, DoD and Service leadership are failing to monitor and enforce these policies. SPC Postell’s case further illuminates how DoD and the Services are simply bending over backwards to do the least possible for our wounded warriors.

SPC Postell’s disability case illuminates just how arbitrary and capricious the DES remains. SPC Postell suffers from numerous service connected medical conditions. The VA ratings for these conditions will undoubtedly exceed 100% additively and around 70% under VA ratings combination procedures. However, the Army Disability Evaluation System is limiting her rating to a mere 10%, well below the 30% required for the benefits of military disability retirement. By cherry picking which conditions to rate, the Army will be able to eliminate her from service without having to give her disability retirement. It is true that VA and military ratings will often differ because the VA rates all service connected conditions while the military limits their ratings to disabilities that they deem unfitting for military systems. While one can debate the appropriateness of limiting DoD ratings to a subset of the service connected disabilities, it is obvious that DoD often uses disingenuous practices to avoid finding conditions unfitting. By arbitrarily finding conditions not to be unfitting, DoD keeps disability ratings artificially low and that cheats our wounded warrior out of proper disability benefits.

While there are several areas in which SPC Postell’s disability evaluation was improperly adjudicated, the adjudication of her migraine condition was particularly egregious. To appreciate these concerns, it is important to understand DoD’s troubled history of rating migraines. The law requires DoD to rate conditions per the Veterans Administrations Schedule for Rating Disabilities (VASRD). One of the many ways DoD kept ratings low was by replacing or modifying VASRD rating criteria. For migraines ratings, the VASRD requires the attacks to be “prostrating”, a term the VA has never specifically defined. DoD’s rating policy defined prostrating as a headache severe enough to require one to stop activities and seek medical attention. The Army further stated in their migraine rating policy that, for a migraine to be deemed prostrating, seven steps had to be met. These steps included a headache journal, a treatment plan written and updated by a doctor, and an impact statement written by the commander. If all of the seven steps were not completed in full, the PEB would not deem the migraines prostrating no matter the true impact of the attacks. This limited the DoD rating for unfitting migraines to 0% regardless of their true severity and duty impact. Many soldiers were given 0% ratings purely because soldiers, doctors and commanders were not aware of the requirements of the policy. The Army migraine rating policy, which was kept close hold, was extremely effective in low balling migraine disability ratings.

The true impact of the DoD and Army migraine rating policies became evident in 2007 when the Veterans Disability Benefit Commission (VDBC) released the results of a study that compared DoD and VA ratings from the 2001 through the 2005 timeframe. For migraines, the study identified 442 cases where the service member received a DoD rating for migraines of less than 30% and then subsequently rated by the VA for the same migraine condition. Since both the DOD and the VA are required to rate conditions per the same VASRD standards, the individual should receive the same migraine rating from both departments. However, of the 432 cases identified in the VDBC study with DoD ratings of less than 30%, 319 of them (72%) received ratings of 30% of more from the VA. This means 319 wounded warriors found unfit by DoD should have been medically retired vice separated without disability retirement. There are countless other service members over the years that were not covered in the study that should have also received retirement level disability ratings from DoD. A recent lawsuit forced DoD to identify over 4,300 service members improperly rated for PTSD. Unfortunately, it appears wounded warriors will require similar legal action before DoD will identify the service members improperly rated for migraines. I have seen no evidence of DoD efforts to identify and notify service members who were separated for migraines so that they can have their DoD ratings reviewed by DoD’s Physical Disability Board of Review.

The Walter Reed media exposure and legislative action has forced DoD to be compliant with the requirement to rate unfitting conditions in strict compliance with the VASRD. In 2008, DoD rescinded their non-VASRD rating policies, to include their migraine rating policy. In 2009, the Army rescinded their migraine rating policy. Revised MEB guidance from the United States Army’s Physical Disability Agency generally deems migraines that are unfitting for military service to be prostrating as well. Per the VASRD, prostrating migraines that occur at a rate of once a month or more garners a 30% disability rating. Prostrating migraines that occur at a rate of once every two months garners a 10% rating. A lesser frequency garners a 0% rating. Now that DoD has been forced to follow the law and rate in strict compliance with the VASRD, the vast majority of unfitting migraine cases will be rated at 30% or more, something it appears DOD does not want to do.

DoD and the Services are now avoiding migraine ratings and compensation altogether when PEBs deem the condition not to be unfitting or when MEBs deem that migraines meet retention standards. The change in migraine retention and fitness standards to avoid paying compensation is more than obvious. The 442 migraine cases identified in the VDBC study mentioned above all received DoD disability ratings, indicating the service member suffered prostrating migraines at a frequency of one every two months or less. All 442 service members were found not to meet retention standards by their MEBs and then found unfit by their PEBs because of these low frequency migraine attacks. SPC Postell has 4-8 prostrating migraines a month but was not found unfit for this condition by her PEB.

Except in very rare exceptions, PEBs will not declare a condition unfitting if the MEB did not first declare that it failed to meet retention standards. This is an important fact that illuminates how the Army’s disability evaluation process is again bastardizing the system to continue to deny proper disability compensation for migraines. SPC Postell’s case is a prime example of this scheme of lowering retention and fitness standards which keeps the Army from awarding retirement level disability ratings.

SPC Postell’s migraine rating problem centers on her MEB’s nonsensical position that her headaches meet retention standards. Army Regulation 40-501 states that migraines fail to meet retention standards if they are frequent and incapacitating. Frequent and incapacitating are subjective terms that DoD and the Army have refused to further define. Such subjective terms lead to different DES results and ratings for similar situations. Whether a service member becomes eligible for benefits becomes a matter of their doctor’s personal attitude and standards, rather than on the nature and impact of the condition. And, while DoDD 1332.18 requires uniformity in the DES, DoD leadership has done little to established, monitor or enforce DES uniformity.

SPC Postell suffers from four to eight debilitating migraines every month. However, her neurologist, Dr. La Mancusa, stated he will not find migraines to fail retention standards unless the frequency is two to three migraines a week. (Remember, there were 442 cases indentified in the VDBC study found that service members failed retention standards and were found unfit with migraines that occurred at a frequency of once every two months or less.) Apparently Dr. La Mancusa’s retention standard for migraines is driven by the amount of work it would require of him. When SPC Postell asked Dr. La Mancusa why he felt her migraines met retention standards, he wrote in her medical records the following:
"If I boarded every SM [Service Member] at Fort Hood who claimed to have chronic daily headaches I would be boarding - 9 soldiers per day (or 2,400 SMs per year); therefore, MEDICALLY ACCETABLE!

It appears Dr. La Mancusa has raised the frequency standard to one which met his comfort level in terms of the amount of work required. However, Dr. La Mancusa’s rationale is also faulty as SPC Postell is well beyond merely claiming to have headaches. She has a diagnosis of migraines and her attacks have been severe enough to require emergency room treatment and they have caused a significant amount of lost duty time. Her migraines require the use of strong prescription medicines and her attacks accompanied with vomiting, severe fatigue and visionary impairments.

At her formal board, SPC Postell testified that heat, lack of sleep, hunger and dehydration trigger her migraine attacks. These conditions are common in military environments, especially in her primary duties as a chemical decontamination specialist which requires the wear of encapsulating protective equipment for hours on end. Her PEB stated that her testimony was truthful and accurate but then completely ignored it when they deemed her migraines not to be unfitting. Her PEB mysteriously stated her migraines did not prevent her from performing the duties of a chemical decontamination specialist despite evidence to the contrary and the fact she has not performed these duties since 2005.
Her commander stated in his impact assessment that SPC Postell’s medical conditions and physical limitations prevent her from performing her primary military duties and they impair the accomplishment of the unit’s mission. Her commander specifically mentioned only two of her conditions in his assessment; her migraines and her back condition. Despite being the only two conditions specifically mentioned in her commander’s impact assessment, her PEB refused to find her back or migraine conditions as contributors to her unfitness. Doing so would have led to a DoD disability retirement level rating. Instead, her PEB arbitrarily declared these conditions not to be unfitting. In the PEB’s rationale for finding her migraines not to be unfitting, they cite her MEB’s finding that her migraines met retention standards; bogus PEB rationale based on a bogus MEB determination.

Dr. La Mancusa’s retention standard is particularly troubling given he is at Fort Hood. Fort Hood is home to the III Corps and two combat divisions and undoubtedly has a large number of soldiers impacted by PTSD and traumatic brain Injuries. Migraines and other headache conditions are highly correlated with both PTSD and traumatic brain Injuries. Soldiers stationed at Fort Hood with PTSD and traumatic brain Injuries will undoubtedly be cheated out of proper disability benefits if they also become victims of Dr. La Mancusa’s two to three migraines a week retention standard.

The United States Army Physical Disability Agency (USAPDA) is ultimately responsible for the quality and integrity of SPC Postell’s MEB, which they use to determine her fitness and disability rating. They accepted a substandard MEB and that led to erroneous PEB determinations. The USAPDA and its PEBs are empowered to send MEBs back to the medical treatment facilities if they are incomplete or lack the required quality. To their credit, the USAPDA has established very good standards and policies to ensure the content and quality of MEBs. Unfortunately, as demonstrated in SPC Postell’s and numerous other disability cases, the USAPDA has done nothing to enforce these standards at the expense of wounded warriors and their families. It appears these policies are for show only.

More troubling, the USAPDA and her PEB have completely ignored issues raised by SPC Postell in her formal board and in her subsequent appeals that demonstrated her MEB and PEB were improperly adjudicated. 10 USC 1222a requires PEBs and other review authorities to specifically address the issues she has raised in her board and in her appeals. The USAPDA and her PEB are simply refusing to follow the legal requirement to specifically address the issues she has raised. If they did address her issues, their answers would tend to expose their continuing deceitful practices that cheat wounded warriors out of disability benefits. To date, the USAPDA and her PEB have refused to specifically address the key issues raised in her appeal. This not only keeps her in the dark on the details of their rationale, but it will impair her ability to get the issues properly addressed in court.

Three years after the Walter Reed press coverage, DoD and the Services continue to bend over backwards to do the least possible when it comes to the payment of disability compensation and benefits. They talk a good talk for public consumption but their actions continue to demonstrate that they really don’t have the backs of our wounded warriors.
In next week’s Outrage, I will be writing about a despicable practice used primary by the Department of the Navy to deny disability benefits. The PEBs simply declare the condition fitting and then the Service administratively discharges the member for “unsuitability” because of the same condition. The Services use this practice to kick wounded warriors to the curb without having to pay them disability benefits. Truly Shameful!


Michael A. Parker
LTC, US Army (Retired)
Wounded Warrior Advocate
 

Jason Perry

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#2
Jason - February 24th, 2010

Apparently Dr. La Mancusa’s retention standard for migraines is driven by the amount of work it would require of him. When SPC Postell asked Dr. La Mancusa why he felt her migraines met retention standards, he wrote in her medical records the following:
"If I boarded every SM [Service Member] at Fort Hood who claimed to have chronic daily headaches I would be boarding - 9 soldiers per day (or 2,400 SMs per year); therefore, MEDICALLY ACCETABLE!

It appears Dr. La Mancusa has raised the frequency standard to one which met his comfort level in terms of the amount of work required
Aside from the error in the definition used for failing retention standards, I want to point out something about this apparent issue with workload.

The 2008 NDAA, in section 1612, required the Secretary of Defense to establish "(F) Standards for the maximum number of medical evaluation cases of recovering service members that are pending before a medical evaluation board at any one time, and requirements for the establishment of additional medical evaluation boards in the event such number is exceeded."

The DoD Policy Memorandum on Implementing Disability-Related Provisions of the
National Defense Authorization Act of2008 (Pub L. 110-181), , dated October 14, 2008 states, "E3.P1.6.9. Case Backlog.
E3.P1.6.9.1. MEB. The Secretaries of the Military Departments should direct an additional MEB consistent with DoD policy and Departmental instructions when the
median quarterly processing time for cases assigned to a particular MEB exceeds 50 calendar days and the backlog of cases exceeds 50 percent of cases being reviewed or when the MTF commander of the MEB deems appropriate for proper and expeditious review of case load.
A MEB backlogged case is defined as a case with a completed narrative summary/clinical summary pending submission to the MEB. Time attributed to rebuttals, or pending consultation with an impartial physician will not be considered as backlog time. In this regard, 50 calendar days is defined as the time between when a Service member is referred into the MEB and the point at which the MEB case file is accepted by the PEB (excluding any time attributed to appeals)."

If workload is driving the medical evaluation of members, this is supposed to be remedied by seating more boards. It is simply not up to individual doctors to ignore Congress and the Secretary of Defense by artificially holding the workload down by not properly evaluating cases. (Note that there is a similar law and regulation almost mirroring the above language that applies to PEBs, too).

I am unaware of a single additional board being seated and am curious as to the DoD response to whether or not, aside from promulgating the regulation, they have actually implemented the requirement to seat additional boards. I can say with confidence, both based on my caseload as an attorney and from hearing from people on this site, that by and large the timelines are not being met.​
 

nwlivewire

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#3
Dear maparker:

Another great article highlighting the need to fix this area of the DES system.

Faxing this to Thom Hartmann. Will fax your weekly issues every week to him. I sure hope Thom devotes some airtime to this and other DES issues you will be shining the light of day on.

Clearly, the impact of these type of decisions, and the "rationale" utilized to arrive at these decisions, have lifelong, adverse impacts to all Wounded Warriors - and across all branches of service.

What is so horrible about these types of decisions resulting from these "courts of flaw", is that there appears to be a serious problem at almost every gateway of entry - no matter which gate the Wounded Warrior enters into - and, at no matter what level of entry. The sad part is that the Servicemember - our Nation's Wounded Warrior - oftentimes has to enter multiple gateways along their journey, in order to complete the navigation process through the DES system.

Whether singly or in combination, these errors of judgement and intrepretations throughout these various levels and stages of the DES process continue to compound false outcomes, layering injustice after injustice in decisions rendered. The individual Wounded Warrior is left "on the hook" to deal with the fallout and gets "ground up" in the process - morally, financially, and psychologically ground up. And when there is a right and proper outcome through budget-busting extended litigation and class-action lawsuits, there never seems to be a penalty exacted upon the DoD to at least repay the errors with interest to the litigants. Instead, after years of delay and denial to the Wounded Warrior, the DoD merely receives a legalistic slap on the hand, a finger-wagging, "Naughty-Naughty" - and then it reverts back to the old business as usual - delay - deny - dilute. Until the next class-action comes along. It's the old "catch-me-if-you-can-afford-to-ligtigate-me" tactic. How corporate can you get? I thought we were better than this!

Dear maparker:

Let's remember to include the Wounded Warrior's adult family members and their children, and the adverse impacts this process has on them as well. Can anyone say bankrupt, destitute, creditless, broke, homeless, and/or divorced? The needless social costs to our great Nation and to our taxpayers are becoming a greater and greater unnecessary burden to carry. These secondary impacts to our Wounded Warriors and to their families, and to their children, do not build up our people, our future generation, or our Nation. These type of repeated results (assaults) tear our people and our families apart, and rip more hemorrhagic tears into our social fabric. These types of decisions do not lend themselves to nation healing, but rather, more likely lend themselves to nation bleeding.

One Wounded Warrior - bleeding out. One Wounded Warrior - one at a time. Over and over and over again.

And haven't these Wounded Warriors bled enough? What more of a cost must be extracted? What more can they give that is left to give that they have not already given?

And the band plays on.

Writing this as a Wounded Warrior, I can hardly wait until its my turn to hit my gates.

When will these people ever wake up and see the damage this process is doing to our Great Nation?
 

maparker

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#4
Below are some comments from the Veterans Benefit Network website.

usmc7319105 02/25/10 12:32:03

I am permanent retired for seizure disorder. I received 0% for migraines from my PEB. I received 30% from the VA for migraines on my first claim I submitted to the VA. Same medical records and same VASRD rating guidelines.

I am a good example of what you posted.

maparker - 02/26/10 16:16:23

You should file with the Board for the Correction of Naval Records to get the 0% changed to 30% which may increase your overall benefits. When were you retired?

Mike


usmc7319105 - 02/27/10 19:58:14

I was retired 11/01/2009 at 40% for seizure disorder. The PEB said my migraines was a condition caused by my seizure disorder. No other Dr or the VA has ever made such a claim. The VA awarded me 30% for migraines right away. I didn't fight it in service b/c I knew 40% would gurantee me retirement, which was important for me b/c of tricare. I got three kids I need to take care of. My PEBLO scared the heck out of me by saying "if you appeal they can always lower your seizure rating". I spent 2005 to 2009 on TDRL. I had a total of 5 TDRL appointments and finaly got permanent retirment. That was a long almost 5 years. The VA has been real good to me for the migraine condition. Your article was very interesting to me b/c I know two other Marines that have in service documentation of Migraines and they were not rated anything from active duty, however, they also are awarded 30% from the VA for migraines. Seems your article hits the nail on the head. I never thought about Board corrections Naval Records. Would that be worth a shot? I'm now permanent and would not want to risk losing it. Is there a chance of that happening if I appeal to them?
Thanks for your help.


ADNick - 02/28/10 15:56:58

My PEB gave me 10% for Migraines, listed them as "Post Concussive Headaches"

VA listed them as "Post Traumatic Migranes" and gave me 50%

VA also gave me 50% SC for TBI (from post concussive and organic brain findings)

PEB did not even list TBI

Thanks for your efforts,


usmc7319105 - 02/28/10 17:13:25

NickAD nick you are another fine example of how they "low-ball" people. There are so many examples of the same injustice happening time and time again. I am happy to see the VA is supporting you with the proper rating. If it ever gets worse, get it documented and file a NOD for an increase in rating.

Good Luck to You
J


From ADNick - 03/02/10 10:44:23
Thanks for the comments J,

The VA did treat me better than DoD... DoD gave me 90% (all combat related) and the VA gave me 100% for loss of use, and another 100% combined, plus more that resulted in an SMC of M

However the VA did not find me SC for PTSD, even though "Mild PTSD" was part of my Neuro Phsy dx--they stated that my PTSD type events were covered by the dx of TBI, and the related mental problems associated with the TBI....

I admit my case is complicated, 16 SC conditions out of 19 claimed, and all but three happened in one event. Plus my medical records are well over 2,000 pages! Moreover I never felt like fighting, still don't, and I know that the system takes advantage of that...

Glad there are people like "maparker" that take up the fight for our service members. You should take his advice and see if you can get your PEB % corrected to 30% at min.....

Regards,
Nick
 

hangingon

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Jason,
I know this thread is old. It's funny through, I seem to be having similar problems. I was referred to an MED for PTSD, and depression. However, I also have Chrons, migraines, fibromyalgia, arthritis. When I initially went to FT. Knox, I explained that I know I was referred for mental health, but I wanted to be evaluated for all of my illnesses. They said everything would automatically be evaluated. I went through my C&P, and the findings came back that I did in fact have everything I was claiming, as well as the severity to make me unfit for duty ( I knew that) but the only thing that rendered me unfit was behavioral health? I have looked at information on your site. I see that my symptoms for each illness meets the criteria of a discharge, however in my notes, beneath each illness there was a comment that said "did not interfere with duties". I have a stream of letters, evaluations from physicians and coworkers that site my consistent missing of work due to flare ups, doctors appointments, and being ill. I am still in, I still have to come on post, which is a big trigger for me. After being assured by my PEBLO that my PTSD, and depression would never drop below 30%, and that the VA would rate my other conditions, that I have "nothing to worry about". Obviously, by reading this post you can tell I am worried. My MEB packet was sent to Washington for PEB board.

My story, I am a survivor of multiple sexual assaults, harassment. I am a Guard member, but have been AGR for over 10 years. I have been deployed. I have done my best to be the best soldier I could. But I'm tired. Tired of fighting. I want to be free of this environment. My impulse to run is far greater than understanding this mess. However, I have four children that are depending on me to fight for what I can.

Did I make a mistake signing my paperwork for only PTSD and depression?
Can they ever take away, or make my PTSD ratings so low that I will lose my military benefits?

I just want to get out, and heal.
 

hangingon

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#6
Jason - February 24th, 2010


Apparently Dr. La Mancusa’s retention standard for migraines is driven by the amount of work it would require of him. When SPC Postell asked Dr. La Mancusa why he felt her migraines met retention standards, he wrote in her medical records the following:

"If I boarded every SM [Service Member] at Fort Hood who claimed to have chronic daily headaches I would be boarding - 9 soldiers per day (or 2,400 SMs per year); therefore, MEDICALLY ACCETABLE!


It appears Dr. La Mancusa has raised the frequency standard to one which met his comfort level in terms of the amount of work required

Aside from the error in the definition used for failing retention standards, I want to point out something about this apparent issue with workload.


The 2008 NDAA, in section 1612, required the Secretary of Defense to establish "(F) Standards for the maximum number of medical evaluation cases of recovering service members that are pending before a medical evaluation board at any one time, and requirements for the establishment of additional medical evaluation boards in the event such number is exceeded."


The DoD Policy Memorandum on Implementing Disability-Related Provisions of the

National Defense Authorization Act of2008 (Pub L. 110-181), , dated October 14, 2008 states, "E3.P1.6.9. Case Backlog.

E3.P1.6.9.1. MEB. The Secretaries of the Military Departments should direct an additional MEB consistent with DoD policy and Departmental instructions when the

median quarterly processing time for cases assigned to a particular MEB exceeds 50 calendar days and the backlog of cases exceeds 50 percent of cases being reviewed or when the MTF commander of the MEB deems appropriate for proper and expeditious review of case load. A MEB backlogged case is defined as a case with a completed narrative summary/clinical summary pending submission to the MEB. Time attributed to rebuttals, or pending consultation with an impartial physician will not be considered as backlog time. In this regard, 50 calendar days is defined as the time between when a Service member is referred into the MEB and the point at which the MEB case file is accepted by the PEB (excluding any time attributed to appeals)."


If workload is driving the medical evaluation of members, this is supposed to be remedied by seating more boards. It is simply not up to individual doctors to ignore Congress and the Secretary of Defense by artificially holding the workload down by not properly evaluating cases. (Note that there is a similar law and regulation almost mirroring the above language that applies to PEBs, too).


I am unaware of a single additional board being seated and am curious as to the DoD response to whether or not, aside from promulgating the regulation, they have actually implemented the requirement to seat additional boards. I can say with confidence, both based on my caseload as an attorney and from hearing from people on this site, that by and large the timelines are not being met.


Jason,
I know this thread is old. It's funny through, I seem to be having similar problems. I was referred to an MED for PTSD, and depression. However, I also have Chrons, migraines, fibromyalgia, arthritis. When I initially went to FT. Knox, I explained that I know I was referred for mental health, but I wanted to be evaluated for all of my illnesses. They said everything would automatically be evaluated. I went through my C&P, and the findings came back that I did in fact have everything I was claiming, as well as the severity to make me unfit for duty ( I knew that) but the only thing that rendered me unfit was behavioral health? I have looked at information on your site. I see that my symptoms for each illness meets the criteria of a discharge, however in my notes, beneath each illness there was a comment that said "did not interfere with duties". I have a stream of letters, evaluations from physicians and coworkers that site my consistent missing of work due to flare ups, doctors appointments, and being ill. I am still in, I still have to come on post, which is a big trigger for me. After being assured by my PEBLO that my PTSD, and depression would never drop below 30%, and that the VA would rate my other conditions, that I have "nothing to worry about". Obviously, by reading this post you can tell I am worried. My MEB packet was sent to Washington for PEB board.

My story, I am a survivor of multiple sexual assaults, harassment. I am a Guard member, but have been AGR for over 10 years. I have been deployed. I have done my best to be the best soldier I could. But I'm tired. Tired of fighting. I want to be free of this environment. My impulse to run is far greater than understanding this mess. However, I have four children that are depending on me to fight for what I can.

Did I make a mistake signing my paperwork for only PTSD and depression?
Can they ever take away, or make my PTSD ratings so low that I will lose my military benefits?

I just want to get out, and heal.