Pending PEB

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immortalmusic

PEB Forum Regular Member
Registered Member
I am active duty USMC with 11 years in. I am pending a PEB starting in April. I am on my 3rd term of limited duty following my 3rd knee surgery (1 on left, 2 on right) in a year. My concerns are as follows:

My PCM said that if the PEB is only for my right knee, I would probably only get 10-20% and just a severance check. She said if both are considered for the PEB, I would probably get over the 30% threshold and get the retirement.
1 - Is that true?
2 - How do I make sure BOTH knees are considered for the PEB?

Once the PEB has started, how long does the entire process take? I am due to EAS February of 2018, so if it takes too long, would I be on Med Hold?

During the process, I know they evaluate you for both the PEB and your VA rating. What is the rating for knees? I keep seeing on here it is range of motion, but is that straight ROM or ROM without pain?

I am sure there will be more as the process flows, so I wanted to get something started that I can keep coming back to and getting good information from this group. Thanks in advance.
 
When you meet with the VA have a complete list of all your contentions - every medical issue. The PEB is required to consider all your conditions. If you don't believe the IPEB considered all your contentions appeal to a FPEB.

But you are getting way ahead of the process.
 
immortalmusic said:
My PCM said that if the PEB is only for my right knee, I would probably only get 10-20% and just a severance check. She said if both are considered for the PEB, I would probably get over the 30% threshold and get the retirement.
1 - Is that true?
2 - How do I make sure BOTH knees are considered for the PEB?
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I don't know how much a knee is rated at. But http://www.militarydisabilitymadeeasy.com/index.html is a great resource for looking up ratings and what all is involved.

Once a MEB is initiated it is up to the MEB to evaluate all of your claimed conditions and determine which ones are duty restricting for your career field specifically. However, that is in a perfect reality and it really doesn't work out that well a lot of the time. I was initially being boarded for only one condition and had to appeal twice in order to get my back added for the IPEB to evaluate. It took me two months but it was worth the effort.

If you end up under 30% total on the DOD side then yes it is severance. Over 30% is retirement, which is either permanent or temporary depending on the stability of your condition.

immortalmusic said:
Once the PEB has started, how long does the entire process take? I am due to EAS February of 2018, so if it takes too long, would I be on Med Hold?
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The entire MEB/PEB process can take a very long time. Up to 2 years for some cases, but more around 6 months to a year on most from what I have observed. Some people have even finished in just a few months, but that is rare. The timelines for each branch of service also vary to a degree. I didn't have enough retainability to do the MEB so I was medically extended several times. I would hope/believe the same would happen to you. But make sure you personally stay on top of this and not fall between the cracks.

immortalmusic said:
During the process, I know they evaluate you for both the PEB and your VA rating. What is the rating for knees? I keep seeing on here it is range of motion, but is that straight ROM or ROM without pain?
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Go to the website I linked above and read over knee conditions. The range of motion is an interesting discussion. When being measured for your range of motion at your C&P exams you are supposed to stop when you are in pain. So even if you can go further you really shouldn't if you are in pain. If you do then you will give them an inaccurate range of motion to base your claim on.

Welcome to the forum BTW. Ask away if you have any other questions or if you want me to elaborate any deeper on my answers. Take care!
 
To see if I have this correct. Limitation in flexion and extension for these degrees is movement without pain or just straight ROM? It seems like if it is without pain then I am going to have ridiculous numbers as I will (hopefully) have almost full range of motion, but there is pain in ANY use.

Limitation of Motion of the Knee
Code 5261: If the knee is not frozen, but is limited in extension and cannot straighten all the way, then it is rated under this code. If the leg can only straighten to within 45° of being completely straight, then it is rated 50%. If it can straighten to 30°, it is rated 40%. To 20°, it is rated 30%. To 15°, it is rated 20%, To 10°, it is rated 10%, and to 5°, it is rated 0%.
Code 5260: If the knee can straighten, but cannot bend all the way, then it is rated under this code. If the knee can only bend to 15°, then it is rated 30%. If it can bend to 30°, it is rated 20%. To 45°, it is rated 10%, and anything 60° or more is rated 0%.

Now if the knee can move, but cannot either bend all the way or straighten5261, and once under this code 5260.
 
immortalmusic said:
To see if I have this correct. Limitation in flexion and extension for these degrees is movement without pain or just straight ROM? It seems like if it is without pain then I am going to have ridiculous numbers as I will (hopefully) have almost full range of motion, but there is pain in ANY use.
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It is based off of range of motion without pain. I believe the knee measurements are inaccurate because they don't test the range of motion while weight bearing, rather you will be laying down on a table. As for pain they don't really mean as in a 1 out of 10 king of pain. I believe the intent is if you would continue the range of motion further you would be in a lot of pain.
 
Almost_Separated said:
It is based off of range of motion without pain. I believe the knee measurements are inaccurate because they don't test the range of motion while weight bearing, rather you will be laying down on a table. As for pain they don't really mean as in a 1 out of 10 king of pain. I believe the intent is if you would continue the range of motion further you would be in a lot of pain.
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If that is the case, where does the pain portion come in. Does the C&P not use the above scales for ROM? This is getting a little confusing for me.
 
immortalmusic said:
If that is the case, where does the pain portion come in. Does the C&P not use the above scales for ROM? This is getting a little confusing for me.
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They do use the scales above for rating the range of motion. I don't know where it is written about stopping the moment you feel pain, but I do know that that is the common practice advised to members.
 
That is true when i had my C&P my doctor told me to stop the moment i felt pain
 
SGTDja said:
That is true when i had my C&P my doctor told me to stop the moment i felt pain
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So if that is the case, and they use the above mentioned angles, I am good to go as far as retirement/severance goes. And from your signature, it looks like it took 2 months for the examination after your started the MEB? Just trying to figure out a rough timeline for myself.
 
So update time. My PCM suddenly went control freak and will not consider anything else for the PEB other than my knees, even though my Disability Attorney said my shoulder should be included as well. Is there any way to get other things included into the PEB portion of this? The way the C&P exam went (fighting that as well), I am going to be rated at 0% because he marked no pain noted on exam, even though I almost came out of the chair when he hit my knee with the reflex hammer....

I did have my physical therapist and surgeon both fill out the DBQ to refute the C&P. Not sure if this will help, but it cannot hurt.

Any help about options once the findings come back?
 
You should request an Impartial Medical Review of your case once your exam results come back. A medical professional not associated with your case will look through your documents and see if anything was inaccurate.
 
ruyehara47 said:
You should request an Impartial Medical Review of your case once your exam results come back. A medical professional not associated with your case will look through your documents and see if anything was inaccurate.
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The impartial review is overlooked by most people. It really helped me out in my case!
 
Almost_Separated said:
The impartial review is overlooked by most people. It really helped me out in my case!
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It's good in theory, but has flaws. Imagine asking you your opinion vs your colleagues in a medical practice? Do you go against your colleagues and add stuff during this look? The issue resides in all these physicians are in the same practice and basically made to think the same. I was told the doc barely has time to do his daily tasks and glanced mine over. Sounds like a great imr right.
 
Noobzor said:
It's good in theory, but has flaws. Imagine asking you your opinion vs your colleagues in a medical practice? Do you go against your colleagues and add stuff during this look? The issue resides in all these physicians are in the same practice and basically made to think the same. I was told the doc barely has time to do his daily tasks and glanced mine over. Sounds like a great imr right.
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Very good points. My initial impartial review was agreed upon by the first doctor. I then wrote a lengthy rebuttal and the second doctor agreed with me. The advantage of an impartial review is that it is essentially an appeal opportunity early on that most people never attempt. The only thing someone has to lose is about a month max of addition time onto the process. Better to try and possibly succeed than to never try at all.
 
Almost_Separated said:
Very good points. My initial impartial review was agreed upon by the first doctor. I then wrote a lengthy rebuttal and the second doctor agreed with me. The advantage of an impartial review is that it is essentially an appeal opportunity early on that most people never attempt. The only thing someone has to lose is about a month max of addition time onto the process. Better to try and possibly succeed than to never try at all.
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Same experience, my inexperienced peblo tried using the imr doc as my cma doc. After a lengthy discussion about why it couldn't be, I ended up having the cc do my cma response for my imr rebuttal. She didn't go as far as blatantly disagree, but she noted there is room for further diagnosis based of generic used terms on 618 and referral diagnosis. OAC just said submit your imr stuff in the stance you wish to have for outcome.

Overall, it bought me like 3 months of arguing with local med group here on how to do their job via afi and dod regulation.
 
Do I speak to my peblo about the impartial review? And does it go to a doctor of their choosing? Is it a military doc, VA doc or civilian doc?
 
Well. Got my findings from the Informal board. 20% DoD, 80% VA.......so close. I got 10% for each knee. Apparently the ROM that was noted by my Surgeon and PTA were not taken into consideration. I have my phone call with my lawyer in 8 days (cutting it close, I know). I am happy with the VA portion. I agree with all of those findings. Just don't like the DoD. Wanted to get to that magical 30%. Any suggestions?
 
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