NARSUM...how many will I get?

peasoup

PEB Forum Veteran
#1
So after reading through these posts, I see now that I should have made sure all of my diagnosis were included in the running tally of my mil med rcds. Unfortunately that did not happen. That means that my PCM is writing my NARSUM today (literally) and it will be done tomorrow. He is only using the running talley of conditions. (is this 'Ahlta' list ppl mention?) I know this because I mentioned another diagnosed (rateable) condition to him on the phone today and it was not included. I explained why it was important to me that ALL diagnosed conditions be included on the NARSUM (because if I am not RTD the NARSUM will be evaluated for my compensation) and told him that I was compiling a list to bring to my NARSUM review. He said there was no review, and got bent out of shape. Also, I am still in the process of diagnosis for an ankle problem (not the MEB reason, but could end up being unfitting). He is starting the MEB before that is done. I asked about that and he said it "will resolve during the process". My PCM is new, and I am worried I will get hosed. I have not even been briefed by Peblo yet. Can anyone tell me if this NARSUM from PCM is "all important", or will another NARSUM be created down the road? If this is IT, when do I get to have items included on it that he left off? I am really confused!! BTW...he does not want to review it with me or have my input before he turns it in (I asked).
 

TSgt Twitch

PEB Forum Veteran
#2
IF you have not met a single peblo yet, or been to any VA appointments, then this is not yuor NARSUM, this is your reffered conditions. YES it is important that any potentially unfit conditions be on this paperwork, but its not the end all of it. once you meet the PEBLO you will be given a VA MSC appointment, this is where you list every condition not on your referred paperwork. the VA MSC will setup all appts. for claimed/reffered conditions and your NARSUM is produced from those C/P exams. THEN you get a copy and can request IMR/stuff be added etc. IF they push it on and there are conditions you have medical evidence supporting as unfitting but they (PEB) label them as cat 2/3 unratable by DOD then you can go to Formal and try to get them added, IF you agree with every conditions and its category but not th epercentages assigned you can request a 1 time va recon, or take what they give you if its "sufficient" and fight for percentages increases on the outside through the va which is a long and lengthy process.

If your comand is supportive and your not in dire straits/issues with still showing up to work etc. I recommend exhausting every appeal option you have up to and including the secretary of your branch, if you do not get what you think is appropriate. YOU are your only true advocate in this entire process.
 

peasoup

PEB Forum Veteran
#3
IF you have not met a single peblo yet, or been to any VA appointments, then this is not yuor NARSUM, this is your reffered conditions. YES it is important that any potentially unfit conditions be on this paperwork, but its not the end all of it. once you meet the PEBLO you will be given a VA MSC appointment, this is where you list every condition not on your referred paperwork. the VA MSC will setup all appts. for claimed/reffered conditions and your NARSUM is produced from those C/P exams. THEN you get a copy and can request IMR/stuff be added etc. IF they push it on and there are conditions you have medical evidence supporting as unfitting but they (PEB) label them as cat 2/3 unratable by DOD then you can go to Formal and try to get them added, IF you agree with every conditions and its category but not th epercentages assigned you can request a 1 time va recon, or take what they give you if its "sufficient" and fight for percentages increases on the outside through the va which is a long and lengthy process.

If your comand is supportive and your not in dire straits/issues with still showing up to work etc. I recommend exhausting every appeal option you have up to and including the secretary of your branch, if you do not get what you think is appropriate. YOU are your only true advocate in this entire process.
Sgt Twitch, thank you!!! The PCM called it NARSUM (but he also called my condition by the wrong name too). I have a friend here going through the process and did not have the PEBLO meeting (or sign the statement of understanding...MEB) until many months after the package went to DPAMM. (we only have 1 PEBLO here). It seems because of that, my friend missed some decision point timelines (?). I have asked the peblo at what point in the process to expect my MEB info brief and he has not given me a solid answer. I see in the guidance that they are supposed to brief me, but I don't see it in writing as far as WHEN that is supposed to happen. I do not want to miss any deadlines or windows, but the terminology is a little confusing and I am not getting guidance here. I apologize for my continued confusion on this sight, and I really do appreciate everyones help.
 

peasoup

PEB Forum Veteran
#6
I have seen the IDES process flowchart and the MEB process flow chart on this site, but I would love to see something all inclusive that shows every step from the SM point of view (not the clinic). Starting with when the SM is notified (verbally or in writing) of the MEB. This would help me make sure I take care of things by all the different timelines I have (even if DOD can bust theirs, I know I am bound by mine). Then I don't have to rely on others telling me the info. Does anyone here have something like this? flowchart, checklist, etc?
 

Sascha Roberson

PEB Forum Veteran
Registered Member
#7
They are having you go through an MEB OS? How is that possible? With the new iDES process, individuals going through a MEB are required to meet with a VA MSC and have the VA do all the exams. If I were you I would really make sure that they are starting a MEB on you, because you will have to come stateside to complete.
 

peasoup

PEB Forum Veteran
#8
They are having you go through an MEB OS? How is that possible? With the new iDES process, individuals going through a MEB are required to meet with a VA MSC and have the VA do all the exams. If I were you I would really make sure that they are starting a MEB on you, because you will have to come stateside to complete.
The MSC meeting will be done over the phone in the PEBLOs office (crappy, because my morning is their end of day), and we are sent TDY CONUS for the C&P. I am not happy about not having a face to face with the MSC.
 

peasoup

PEB Forum Veteran
#10
No VTC...only the phone. And in the PEBLOs office. Plus, my copy of med records is sorted by year, and also by condition....so it would be much easier to point out the many missing conditions buried in my specialist notes, and then they can locate it in their copy, etc. My records are 2 volumes, so this MSC meeting will be very long. I dread I will get the brush off bc they want to go home for the night (with time difference)! I am open to suggestions~~
 

Sascha Roberson

PEB Forum Veteran
Registered Member
#11
First, they should have already recieved a copy of your military medical records ahead of time. Before you sign off on the VA Form 21-0819 and 4138 (these forms are used to list your claimed conditions) be 100% sure that everything that you talked about is listed on those forms somewhere. It's sort of tricky to give you real good advise, but if it were me this is what I would do. and I would try and push for a VTC.
 

peasoup

PEB Forum Veteran
#12
Does anyone know if the MSCs are contactable after the meeting? As in, I remember something or find a ref later, can I just call them? Or are they "untouchable"?
 

Sascha Roberson

PEB Forum Veteran
Registered Member
#13
Usually once you have completed your initial meeting with them and listed all conditions, it has been my experience that you can not go back and add something later
 

TSgt Twitch

PEB Forum Veteran
#14
The MSC assigned to your case will review your records before your telephone call and allready have a "good" list of conditions they think you will be/need to be claiming. you can also add any at that time.

As to your friend, keep in mind the AF has started a process in the last few months (dec 2012) that they do the initial packet with or without the commanders NMA and send that to DPAMM to do what is similar to a RILO (review in lieu of meb) they can actually say you do or do not need a full PEB and can bless permanent profiles, assignment eligibility coding etc.

I know at tinker and supposedly a few others, everything has gone digital finally, everything in my records has gone to digital, all old records are scanned and emailed and a packet of PDF's is sent. My records BEFORE going digital in 2011 were 8 volumes, and my MSC caught all but 2 things I wanted to claim.
 

peasoup

PEB Forum Veteran
#15
First, they should have already recieved a copy of your military medical records ahead of time. Before you sign off on the VA Form 21-0819 and 4138 (these forms are used to list your claimed conditions) be 100% sure that everything that you talked about is listed on those forms somewhere. It's sort of tricky to give you real good advise, but if it were me this is what I would do. and I would try and push for a VTC.
So when do I see these forms? Is this what the PCM is prepping now, or will the MCS complete these forms and review them with me? Also, if I review these forms and conditions are not listed, then I bring it up with the MSC (I assume they verify my records), and they have it included on these forms? Then I sign them? (thanks for the help BTW)
 

TSgt Twitch

PEB Forum Veteran
#16
You can contact them at anytime, but keep in mind they can do nothing in RE to your case until you get to the point of were you want to submit for a VA recon, or VA voc rehab programs.
 

peasoup

PEB Forum Veteran
#17
The MSC assigned to your case will review your records before your telephone call and allready have a "good" list of conditions they think you will be/need to be claiming. you can also add any at that time.

As to your friend, keep in mind the AF has started a process in the last few months (dec 2012) that they do the initial packet with or without the commanders NMA and send that to DPAMM to do what is similar to a RILO (review in lieu of meb) they can actually say you do or do not need a full PEB and can bless permanent profiles, assignment eligibility coding etc.

I know at tinker and supposedly a few others, everything has gone digital finally, everything in my records has gone to digital, all old records are scanned and emailed and a packet of PDF's is sent. My records BEFORE going digital in 2011 were 8 volumes, and my MSC caught all but 2 things I wanted to claim.
8 volumes?? I hope you are doing ok now. WOW...that MSC is very impressive! I have no idea what state mine will be from. Also, I did not know about the new AF process you mentioned. Is their guidance on that?
The PCM did say that when my package goes to DPAMM they will either RTD with assignment limitation code, or direct the full MEB. The PCM said he was not going to include all of my conditions on his document....from what can can gather on this site, it will only be the unfitting ones. That was one of my main questions....when are all of my "other" conditions listed. I think I have that answer now: the "other" conditions will be listed with the MSC consult. Is that correct?
 

Sascha Roberson

PEB Forum Veteran
Registered Member
#18
8 volumes?? I hope you are doing ok now. WOW...that MSC is very impressive! I have no idea what state mine will be from. Also, I did not know about the new AF process you mentioned. Is their guidance on that?
The PCM did say that when my package goes to DPAMM they will either RTD with assignment limitation code, or direct the full MEB. The PCM said he was not going to include all of my conditions on his document....from what can can gather on this site, it will only be the unfitting ones. That was one of my main questions....when are all of my "other" conditions listed. I think I have that answer now: the "other" conditions will be listed with the MSC consult.


Is that correct? correct
 

maparker

Staff Member
PEB Forum Veteran
Registered Member
#19
Per DoDI 1332.38, the MEB is required to cover all medical conditions with full clinical data. Make sure they do this. If they don't, request an impartial medical review and appeal.

Mike
 

Oojutiku

Registered Member
#20
I have a quick question concerning some issues going on with me. I was on 2 periods of limdu. My first period was for depression and PTSD. My doc wanted to return me to full duty but I didn't feel capable so she wanted me to do a member initiated admin separation which I refused to do (I have over 10 years of continuous active service). She then wanted to do an admin sep for failure to adjust but I pointed out I've had nothing but great evaluations and I've been in for 10 years. She then downgraded my diagnosis to personality disorder and sent that info to the PEB board as my referred condition (personality disorder unspecified, depression, and eating disorder not otherwise specified). The PEB returned my determination as fit and I requested an appeal. I added documentation from a second oppinion from a Military doctor who said I didn't have a personality disorder and stated that in his professional opinion I was not fit for continued naval service (not sure if my congressional complaint motivated that or not). I also included paperwork from my GI doctor concerning my Irritable Bowel Syndrome. Even with all the added information the PEB denied my appeal and reiterated their finding of fit. In order to make myself available for Naval assignment I had to do a Medical assignment screening. The screening came back that I was not worldwide assignable and that I would require ongoing care for my conditions. The screening also referenced my doctor's recommendation that I was unfit for duty/ naval service.

My concern is that the system is trying to set me up for an administrative discharge with no severance or medical retirement. So pretty much the Navy is telling me that I'm unfit for continued service for the same thing the PEB board said I was fit for. I'm not sure where to go from here. I'm pretty frustrated with the whole process and being treated like a business commodity, where the Navy wants to save money at all costs. I was hoping that maybe you could point me in the direction of someone who could help. Any assistance is appreciated.

Also in response to the congressional inquiry the Navy said that all instances of PTSD and ADHD were self reported though I have documentation from several civillian doctors of a PTSD and ADHD diagnosis- to include the civillian psychiatrist that treated me while I was seeing my current military doctors, because I attempted suicide while in their care.
 
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