Member Refused surgery now won't get PEB rather ADMIN Sep'd...........NEED HELP!!!

trav2210

PEB Forum Regular Member
PEB Forum Veteran
I had previously posted here http://www.pebforum.com/f32/questions-about-how-meb-initiated-27733/ about my situation.

Now after being told by numerous doctors including UCLA, not to have surgery, My Navy ORTHO doc said that since I won't take his offer of surgery, I will be admin seperated without benifits.

My MEBR shows a diagnosis of the following:
Spondylolisthesis
Degenerative Disc Disease
Radiculopothy
Osteoarthritis of the Left and Right Hip
Femoracitabular Hip Impingements in both

Once I was told this I asked "How can I be admin sep'd if the reason I'm not able to work is due to my medical problems?"

So I'm at a loss. I've looked at the Manual of the Medical Department, and in Chapter 18, Articale 18-11, Paragraph 7 it states that

(7) Determining Which Cases Merit Referral to the PEB for Disability Evaluation.

MANMED article 18-4 provides guidance on determining those patients for whom referral to the PEB may be appropriate.

Moreover, dilemmas at the MTF level over whether a disabling condition exists that renders a member unfit for continued naval service will be

resolved by referral of the case to the PEB.


Anyone who may know what to do in this situation please help me out with some guidance.
 
Member Refused surgery now won't get PEB rather ADMIN Sep'd...........NEED HELP!!

SECNAVINST 1850.4E:

"3413 Unreasonable Refusal Of Medical, Dental, Or Surgical Treatment
a. If a member unreasonably refuses to submit to medical, dental, or surgical
treatment, any Unfitting disability that proximately results from such refusal is incurred as
a result of the member's willful neglect. However, unreasonable refusal under this section
only may equate to willful neglect when the member most likely would be Fit had he or she
submitted to or complied (see paragraph 3802(c) failure to comply with prescribed
treatment) with the treatment regimen. Additionally, a member who refuses medical
treatment on a bona fide religious basis is eligible for disability benefits; refusal shall not be
considered willful neglect.
b. The PEB must determine whether refusal of treatment was or was not, in fact,
reasonable regardless of any opinion expressed in a medical board report. The medical
board report also shall contain the following:
(1) written comments by the member regarding the member’s refusal;
(2) written comments by the physician explaining why the refusal is
unreasonable, supported by specific medical references. If the PEB finds that the refusal of
treatment was unreasonable, the member shall, unless a MEDICAL BOARD
CERTIFICATE RELATIVE TO COUNSELING ON REFUSAL OF SURGERY AND/OR
TREATMENT (NAVMED 6100/4) already is contained in the record, be notified before a
finding of willful neglect may be made, and advised that continued refusal will result in a
finding of willful neglect and loss of disability benefits."

Looks pretty clear to me that the MEB has to occur and the PEB is the decision-maker, not your ortho doctor. The above regulation aside, I can't think of any MILPERSMAN separation section that would allow what he is suggesting.
 
Member Refused surgery now won't get PEB rather ADMIN Sep'd...........NEED HELP!!

Trying to figure out how to present all this info to my doctor. I'm planning on scheduling an appt to show her everything I've found, but I have no clue where I am in the process. I believe that my MEB is done and I'm on my second limdu but have a lot of confusion with my mtf and my ortho. If I have complaints about the process, where should I direct those issues. To the IG, my computer or where?
 
Member Refused surgery now won't get PEB rather ADMIN Sep'd...........NEED HELP!!

ok, well I just dropped off the info with my MTF so that they can see what they are supposed to be enforcing. It seems to me quite clear that their job and dicision making tasks are laid out quite well in the two medical manuals. I can only hope that from here my doctors follow the "rules". If not, Im not sure what I'm going to do from here.
 
Member Refused surgery now won't get PEB rather ADMIN Sep'd...........NEED HELP!!

My experience is that there is only two things the Navy will do: What they want to do and what you make them do. Making them do what they don't want to do often requires press, IG, or Congressional influence.

Mike
 
Member Refused surgery now won't get PEB rather ADMIN Sep'd...........NEED HELP!!

Thanks, that's great advice and its true.
 
found out that the above reference will work...when your doctor will submit a peb on its behalf.

My primary care doc (helpful one) said that she could push the issue with my ortho doc to "make" him submit the peb, but most likely an undesirable outcome will be the result. Rather than do that, she told me she will send me to another doc, possibly at camp pendalton that might help. eitherway, i'm feeling like this ortho doc in san diego is getting away with discrimination of a sort. I'm not sure his exact feelings on the matter, but when someone is diagosed with problems that are un-curable at the present time, or is more risk than the patient wants to go through, I think he should be obligated to tell someone..."hey, we cant do anymore in this situation"

to me that sounds like a PEB, but i guess this guy gets a bonus for every PEB he doesn't submit.

I'm getting to the point where this whole situation is creating a breaking point in me.

I'm in limbo right now with seperating, getting another job, finding healthcare for my family and schools for the kids. Its begining to get too much with no help or direction from the navy. I've not met with a peblo, or anyone directing me what to do with the situation. I've asked my chiefs and LPO and all i get is that medical will direct. I need to plan, but with this jackass doctor above, its creating a timeline that is unmanagable.

My EAOS is 01/28/2013 My second LIMDU ends August 2012. Once that is up, I'm 100% sure they will put me on my third, but what then.

I'm upset that one day I will get a phone call saying, ok you've been submitted to the PEB....and all of a sudden I have a month to figure everything out!!!!!


Someone HELP
 
ok, some more fuel to the fire. Like i said above, my EAOS is 1/28/2013. I just got back my 2nd pts denial. What is going to happen if I do not get PTS approved, and my PEB doesn't get started soon. Please respond with any guidance here.
 
Did they deny PTS because of Limdu? Contact your Limdu coordinator and PEBLO and find out if your MEB has been initiated. Is your command willing to request an MEB if it's not been started?

Options.......sick or hurt go to sick call. Go everyday you need to. I would assume being at sick call many days (everyday) would stop them from dragging there feet. You could always request mast, contact IG and Congressmen. If the hospital is not following procedure, you can direct your complaints at the MTF. Look through the JAGMAN, "Complaint of Wrongs." It can be painful to draft, but it's more painful for them to respond to. It gets a lot eyes on it.

If they take you off Limdu and don't initiate an MEB then you could try and reenlist. They can't deny reenlistment based on your medical conditions if they say you don't have any. Keep in mind the reason a separation physical exists is to make sure they don't separate someone who is sick/hurt and rates a medical board. That would be another level you could fight at if nothing else was working.

If they initiate MEB/PEB your EOAS is no longer a factor. You would ride the process out however long it takes.
 
well, from what i hear, no doctor wants to touch my case because I haven't had surgery. I'm starting a 3rd limdu soon, so I am meeting with another doctor here at my MTF who is supposed to subbmit a package to bupers supposidly. We'll see the outcome, but I'm not sure what to expect anymore.

Oh, Ive also been denied again a couple of times for PTS so thats great too (sarcasm)
 
Ok, push came to shove and I had to raise the red flag. Now Ive got a doctor at my mtf submitting a Narsum I believe. He said that We will have an 1 hour appotintment to "narrirate" what exactly has happend. He is an awsome doctor and is telling me he will put every little diagnosis Ive ever had. None the less everything is falling into place.

Main question now. What happens next. I know he wants to subbmit this NARSUM, but then what. I'm very familar with the whole process, but nothing is happening the way the manual dictates.

Other thing I think is funny is that this new doctor is only doing this because of all the problems I've had with people not submitting this case. He said that san diego is so horrible at this that he just does it as a favor.


I find that rediculous that he has to do that
 
Secondly,

I know that extremely sumerized It goes
MEB
NARSUM
PEB

At what point does a PEBLO come in. I have never had any type of counseling on whats happening other than the docotor that i see that day tells me what he is doing. Who assigns the PEBLO and what do I do if I never get one. Is it my doctor that is submitting my NARSUM. I wouldn't think so because he is a full time doc at the MTF.

Also Do I have the order right, or is the NARSUM start the MEB.

My timeline so far

24MAR2011 Hurt back went to doc
14AUG2011 1st Limdu
14JAN2012 2nd Limdu (expires 14JUL2012)

Ive been dealing with this since 2011 and Have no idea what stage of the process I'm in other than someone submitting a possible NARSUM for me on 4JUN2012
 
Not just any doctor can write the NARSUM. You would need to be referred to IDES and would be assigned a PEBLO who would be coordinating your appointments and ensuring all documents are correct and sent off. If I remember correctly, the NARSUM would be completed after all your evaluations to include VA evals are complete. Then the MEB doctor would write your NARSUM. The local MEB would determine if you meet or fail retention standards, and if so, your case would then go to the PEB to determine if you are fit or unfit for military service. From what you have explained above, it doesn't sound like you have officially began the MEB process. I could be wrong, but it just doesn't sound like it based on your comments.
 
I think there is something shady going on here, because I know that my MTF doesn't have CA, yet this new doctor that's doing me a "favor" is able to submit all this info on my behalf to start the process. Any ideas?
 
trav2210,

Do you have a permanent P3 profile? I see you are NAVY so I am not sure how the different services initiate the MEB process. If your doctor has given you a P3 and recommends MEB, I would believe that would be the first step at initiating a possible MEB. Maybe someone on the NAVY side can explain how the MEB process begins for your service. I would hate to give you any more information based off of my ARMY experience and it end up being different than how the NAVY handles the beginning phases of an MEB.

One shot note I forgot to add... before I officially began my MEB, I sat down with my Brigade Flight Surgeon who I have known for almost 10 years. She wrote a very in depth review of my medical history, listing every ache, pain, medical issue I have experienced since I joined the Army. When I finally met with my MEB doctor, he was able to use a lot of that information when determining if I needed any additional consults and also made a nice list for me to take to the VA when I had my initial sit down with the VA rep to go over what I intended to claim. This was a huge favor and I wonder if that is what your doctor is doing prior to your MEB officially beginning. Either way, let us know some more details and hopefully a NAVY board member can chime in.
 
I'm not sure exactly what a peemenant p3 profile is so no. We may not have that in the navy. I know that officially I've been put on limdu, not light duty, for my problems and was told I'm waiting for someone to submit a package for disability processing. Other than that not much official things have happened for over a year. We'll see how June 5th goes.
 
Pretty sure I just worked with my doctor to write up a narsum. We described everything that was wrong and did a quick exam. He said to com back in the morning to finish the process by filling out paperwork to start a Med board. He said the next step was to wait for a response from the peb. Very unofficial but stuff is actually happening now.

Anyone have any input here on what I should be concerned with. I still don't know if i have a peblo or not.

Help please!!
 
ok, well as it seems to me now, I think i just started the MEB process. I'm not 100 percent sure but from what i'm hearing is next, it sounds as if im in it. I received another statement saying that i am still on Limdu but this time for a PEB referal. Technically this ist the 3rd limdu, but once i am forwarded to the peb i assume time frame no longer matters.

What i was told today is that the main medical of my region (camp pendalton) will be requesting my visit to fill out paperwork and for a VA evaluation. I was also told that i will be given a POC for the person submitting my PEB to Washington. Is this my PEBLO?? It sounds like it, and i will treat it that way. Also, anyone know what to look for or what to prep for in this section of the med board.

Lastly I was told that from hear I'm looking at a 6-8 month timeline until i recieve a response with my findings.

anyone?
 
From my understanding, the procedure actually starts (after meeting with a MEB doctor and discussing your conditions) by meeting with a PEBLO who will give you a MEB brief. You will sign papers, including a list of your conditions to be considered by the board. Then, he /she will contact a VA rep to schedule your C&P appointments. When you are complete with your VA appointments, the doc finishes up his/her NARSUM, which you will have the chance to review and sign or request an independent medical review (IMR) if you disagree with the NARSUM or if it contains errors. The doc/PEBLO then send the complete package up to the PEB for fit/unfit decision. At the same time, the VA is reviewing your records and the C&P exams and building your rating. If the board finds you unfit, they will contact the VA and get the ratings for the conditions which they found you unfit for. They will then compile the ratings and package them up with their recommendations (retention, retirement, severance, etc.) and send it to your PEBLO to relay to you.
 
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