It's begun

[Postal46]

Well my MEB has begun and I am extremely anxious to hear the results. I am scared because my MEB was initiated because of my OSA (38 AHI) and PTSD. Although my PTSD is not combat related. I have a few questions:

1. Will the C&P/PEB review my current mental health records and side with my current PTSD NARSUM? Or will they do their own review, with the possibility of finding it fit? Also, is constant medication for anxiety enough to find me unfit?

2. I have had blood pressure readings around 140/87 for the last year and I currently take blood pressure pills to control it. Is this enough to warrant a rating for anything?

3. I have current chronic pain due to back problems in my records. Does this warrant anything?

I truly want to be found unfit, as I am seriously in need of help and the service only seems to exasperate the issues. My commander has wrote a letter stating that I am in need of constant supervision and that I should be found unfit. Will this help?
I'm at the point where I'm williggtp pay someone to help me with this process

 

[chaplaincharlie]

Your command letter will help. Hypertension and OSA are often found fit. Fitness MH/anxiety/PTSD depends on the severity. It sounds like your commander clearly support that the severity is enough to significantly impact work performance. C&P exams are a breeze, just answer the questions.

 

[Postal46]

For the C&P do they generally use your current medical records for the PTSD or do I have to talk to a therapist all over and they rate me based off that conversation?

 

[Jason Perry]

Well my MEB has begun and I am extremely anxious to hear the results. I am scared because my MEB was initiated because of my OSA (38 AHI) and PTSD. Although my PTSD is not combat related. I have a few questions:

Why scared? What is your desired outcome?

1. Will the C&P/PEB review my current mental health records and side with my current PTSD NARSUM? Or will they do their own review, with the possibility of finding it fit? Also, is constant medication for anxiety enough to find me unfit?

Many IDES "C&P" (I put it in quotes because the military and VA are a bit "cute" about how they consider the exams) do not note that they consider all records. On the plus side, the forms generally list what records are considered. If you want them to look at additional records, you should push the issue.

2. I have had blood pressure readings around 140/87 for the last year and I currently take blood pressure pills to control it. Is this enough to warrant a rating for anything?

For VA or for DoD purposes?

3. I have current chronic pain due to back problems in my records. Does this warrant anything?

Depends on the degree of disability...also on how it is rated. There are mental health ratings for pain; there are ratings based on pain; there are ratings based on fibromyalgia. There are several "theories" that may apply to your case. Would need more info and/or details regarding your own situation to offer more guidance.

I truly want to be found unfit, as I am seriously in need of help and the service only seems to exasperate the issues. My commander has wrote a letter stating that I am in need of constant supervision and that I should be found unfit. Will this help?

I have written many posts about what is best in at commander's letter (search by name of the condition and the issue you have, as well as commander's letters generally). The general point I would make is that commander's letters are a piece of evidence. The medical evidence in your case (including provider's and examiner's opinions) are another source of evidence. It is always best when all of the evidence agrees with your position.

I'm at the point where I'm williggtp pay someone to help me with this process

There are military counsel available to folks going through the MEB/Process. In some cases that is a good choice. In other cases, civilian counsel can be of more effective assistance. Almost always, the facts of the particular case drive what is the best choice.

Hope all goes well for you!

 

[Postal46]

Thanks for the reply. My goal is to be found unfit. I am currently stationed overseas and my PEBLO told me that they only approve the serious cases for full MEB, due to the flight expenses (C&P in the states). My commander wrote that I should be found unfit, but did not go into specifics as to why my PTSD affects my job. Should I write my own letter to combat this?
As far as the blood pressure, I am asking for the DOD or VA side. I recently also began taking thyroid medication for hypothyroidism, should I add this to my MEB?
I do not know what to expect from my C&P and I hate having to talk about my PTSD all over again to someone new. I often get uncomfterable and clam up. I don't want to be misjudged due to feeling uncomfterable.

 

[Postal46]

Bump?

 

[chaplaincharlie]

For the C&P do they generally use your current medical records for the PTSD or do I have to talk to a therapist all over and they rate me based off that conversation?

C&P examiners function like an independent medical examiner. They consider your records, your answers... then make a diagnosis and an assessment of its severity. In the MH arena, diagnosis and severity determines compensation.

 

[Postal46]

Is getting MEB'd for PTSD enough to find you unfit?

 

[Warrior644]

Is getting MEB'd for PTSD enough to find you unfit?

In retrospect, since the DoD IDES is a performance-based process, the PEB makes the decision on fitness by balancing the extent of your medical condition(s), as shown through objective medical and performance evidence, against the requirements and duties that the military service member may reasonably be expected to perform in their assigned/respective military duties and grade.

To that extent, please note that the mere fact that one or more medical conditions exist does not constitute an unfit determination, and the inability to deploy to austere environments is only one factor in determining unfitness.

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

Best Wishes!

 

[chaplaincharlie]

Is getting MEB'd for PTSD enough to find you unfit?

It depends on the severity of symptoms.

 

[Jason Perry]

Thanks for the reply. My goal is to be found unfit. I am currently stationed overseas and my PEBLO told me that they only approve the serious cases for full MEB, due to the flight expenses (C&P in the states). My commander wrote that I should be found unfit, but did not go into specifics as to why my PTSD affects my job. Should I write my own letter to combat this?

It would be great if you could get the bolded portion in writing. That would be an explosive piece of evidence (overseas MEBs should not be any different than CONUS based MEBs).

Better if your commander would be willing to update his own letter providing more details.

That said, if the MEB does not find your PTSD to fail retention standards under the Medical Standards Directory and merit referral to the PEB, and you cannot get additional evidence, then, yes, write your own letter/rebuttal.

As far as the blood pressure, I am asking for the DOD or VA side. I recently also began taking thyroid medication for hypothyroidism, should I add this to my MEB?

Recall that DoD ratings are only given for unfitting conditions. You would need evidence showing significant impact/limitations on your duty performance to get an unfit findings. It is much easier to get a VA rating- all you need is service connection and a compensable disability for the VA ratings/findings.

I do not know what to expect from my C&P and I hate having to talk about my PTSD all over again to someone new. I often get uncomfterable and clam up. I don't want to be misjudged due to feeling uncomfterable.

This is understandable. Just also understand that if you don't present your case/testimony/statements to various folks, it is hard to get rated properly. Your best outcome would come from being frank and discussing all of your problems with the examiner.

Is getting MEB'd for PTSD enough to find you unfit?

Just getting "MEB'd" for a condition is not dispositive as getting found unfit. Much (if not all) depends on the impact of your ability to perform your duties. This will require evidence. It could be that the MEB/NARSUM/C&P exam provides that evidence. However, it is not a "sure thing."

Hope all goes well for you. Best of luck!

 

[cajual]

To alleviate your concerns;

The local medical facility will convene a small council that will review your information prior to placing you on a code 37. This is because they do not wish to submit individuals that are clearly fit, which will simply clog the MEB process and waste money. If you've made it past this stage, several medical professionals have agreed with your prognosis.

Secondly, your paperwork will need to be sent to the RILO at DPAMN/AFPC. This is a small committee that reviews every code 37 individual and initiates the actual MEB. You will receive one of three outcomes here: Return to Duty (RTD), Direct a full MEB, or RTD with a P1-4 profile (permanent profile).

If a full MEB is directed, you have reached the point where only 6% of members are returned to duty, and they are usually the ones fighting to stay in. At this point, you will perform your exams, your information will be reviewed locally and signed off by several members of your medical facility, and the information will be forwarded up to AFPC. AFPC will return a code on your unfitting condition that corresponds with the previous three values: Fit (RTD), Fit (RTD/PP), Unfit.

If you are found unfit, you will receive your ratings back from the VA, sign for them (if not appealing), and then your final package will be sent to the PEB. Finally, you will begin waiting for your orders to separate/retire.

Good luck.

 

[Postal46]

Just came back from my sleep doctor and he informed me that I have only been logging around 2.5 hours a night on my CPAP. This is mostly due to my nightmares and not sleeping. He stated that if I do not get my number up the VA will deny sleep apnea. Is this true? I am being MEB'd for PTSD and now Im being told that because I cant sleep im not going to get Sleep apnea!?!?

 

[cajual]

They can't provide a medical diagnosis without appropriate evaluation criteria being met. Unfortunately it is true that insomniacs are less plagued by sleep apnea -- because they don't sleep! It's absurd, but you need to go back to your PCM and demand some middle ground (medication, resources, etc) with which to adequately fulfill the diagnostic requirements of sleep apnea.

 

[Warrior644]

Just came back from my sleep doctor and he informed me that I have only been logging around 2.5 hours a night on my CPAP. This is mostly due to my nightmares and not sleeping. He stated that if I do not get my number up the VA will deny sleep apnea. Is this true? I am being MEB'd for PTSD and now Im being told that because I cant sleep im not going to get Sleep apnea!?!?

In retrospect, I have OSA w/ CPAP and have similar challenging experiences in the use of the CPAP machine unfortunately.

As such, I log anywhere between approximately 2.0 hours to 4.0 hours of CPAP machine time when I am capable of using the CPAP machine due to my lumbar spine, cervical spine, PTSD, sleep walking, migraine headaches, combat nightmares, etc medical conditions.

To that extent, I can't comprehend why the DoVA D-RAS would not military service connect your OSA w/ CPAP medical condition. As a worst case scenario, the D-RAS may adjudicate your disability evaluation percentage to a 30% rating instead of the 50% rating if your medical evidence/medical documentation doesn't show "why" the CPAP machine use doesn't conform to VA regulatory usage specifications.

With all of my other medical challenges in conjunction with the OSA w/ CPAP use, I received an official/final VA 50% rating due to the medically prescribed mandatory use of a CPAP machine.

Hmm, the MEB may not find that your OSA w/ CPAP machine medical condition is indeed "medically unacceptable" for continued military service; if so then you may have to submit a MEB appeal. Otherwise, if you have at least one "medically unacceptable" medical condition then your DoD IDES case file shall be forwarded to the PEB for adjudication.

Moreover, you shall have another opportunity during the PEB phase in their review of all medical conditions for any potential "unfit for duty" disposition. If you still believe that your OSA w/ CPAP medical condition warrants an "unfit for duty" disposition then you will need to request a Formal PEB hearing for any opportunity to potentially receive that type of an adjudication.

That all said, please take care and never default acceptance to any injustices while in the DoD IDES process!

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

Best Wishes!

 

[scoutCC]

I believe the requirement is something like 80% usage, with 6 hrs a night, for the CPAP for it to be considered a successful treatment. Don't quote me on that, but there is some threshold where they say, nope, CPAP isn't the right tool to use. If the CPAP doesn't help the condition, it won't be continued, they will have to look into other treatment options.

This isn't the same thing as denying sleep apnea. However the use of a CPAP is a really good thing due to the odd way the rating criteria is written.

If your sleep apnea is untreated it is likely to cause long term health problems, i.e. secondary conditions that can become secondary connected. In the mean time, you may be able to go about things in a fairly normal way. That means a 0% rating until those other conditions show up. If the sleep apnea makes you tired throughout the day, due to no good treatment or a less than perfect treatment, that's a 30% rating. The 50% rating requires you to need a machine to treat the apnea. The 50% rating is still there by use of the CPAP even if it leaves you with no residual symptoms. Even though a complicated jaw surgery might be far more significant and risky, if it leaves you with no residual symptoms, 0%.

As a note, the CPAP can't really tell too well if you're sleeping, just that its on and pushing out air. Continuing to wear it even if sleep is evading you is valid in my mind. For me the problem was I'd be ripping the mask off while in a mostly asleep state and wake up with it thrown across the room. It took some fine tuning of the CPAP settings by bringing it in every month, them looking at the data, and changing the settings. The machine wasn't responding fast enough to me wanting extra air or some such. Also, PTSD and the CPAP have well known poor interaction. They have masks with less face coverage that generally respond better. For me getting a prazosin prescription helped considerably to be less... feisty? in the middle of the night.

 

[Postal46]

Thanks everyone for all the replies! My supervisor wrote this witness letter to help with the unfit finding. What do you think?

 

[Warrior644]

Thanks everyone for all the replies! My supervisor wrote this witness letter to help with the unfit finding. What do you think?

Indeed, it seems that this medical evidence should be most beneficial and not detrimental to your overall DoD IDES case file in my opinion. Take care and never default acceptance to any injustices while in the DoD IDES process!

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

Best Wishes!

 

[Postal46]

one more thing:

I have been issued a Air Force lawyer from Texas but she seems to not be very interested in looking into my case until after the MEB. I would like your honest feedback on something. My current MEB for PTSD and OSA has me very anxious. On top of that I also suffer from chronic pain, social phobia, lower back pain and hypothyroidism. I know it is best to separate from the Air Force, do to my diminishing problems. I just have no familiarity with this process and want the best outcome for myself. With that being said, would it be in my best interest to contact a private lawyer who can look over my case from the very beginning and help me along each step? I know she's very busy and this process will be a life altering decision. I just want to make sure all my i's are dotted and t's crossed. Any advise will be MUCH appreciated.

 

[Warrior644]

one more thing:

I have been issued a Air Force lawyer from Texas but she seems to not be very interested in looking into my case until after the MEB. I would like your honest feedback on something. My current MEB for PTSD and OSA has me very anxious. On top of that I also suffer from chronic pain, social phobia, lower back pain and hypothyroidism. I know it is best to separate from the Air Force, do to my diminishing problems. I just have no familiarity with this process and want the best outcome for myself. With that being said, would it be in my best interest to contact a private lawyer who can look over my case from the very beginning and help me along each step? I know she's very busy and this process will be a life altering decision. I just want to make sure all my i's are dotted and t's crossed. Any advise will be MUCH appreciated.

Indeed, it's great that you have been assigned an "Air Force lawyer from Texas" at this particular point within the DoD IDES process! Hmm, from your feedback, will the aforementioned attorney represent you throughout the IDES process, or just within one particular phase (e.g., MEB or PEB)?

In my opinion and I concur, @JasonPerry previously stated that "civilian counsel can be of more effective assistance. Almost always, the facts of the particular case drive what is the best choice." Most participants within the DoD IDES process don't/won't have any familiarity until they are actually referred and accepted; therefore, it's to their benefit to comprehend the IDES immediately for best current & future success.

As such, please reference my specific URL for a detailed explanation about the DoD IDES MEB/PEB process:

http://www.pebforum.com/site/threads/a-detailed-explanation-of-the-dod-ides-meb-peb-process.22807/

Of most importance while in the DoD IDES, never default acceptance to any injustices; fight then continue to fight some more until receipt of all desired outcomes supportive via medical evidence and/or medical documentation! Take care!

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

Best Wishes!