Something seems fishy here..

JohnViro

PEB Forum Veteran
Registered Member
#1
I received a revision of my NARSUM today. I noticed that for the referring condition, my provider only listed chronic lower back pain, but nothing about my diagnosis of Lumbar spondylolisthesis, lumbar spondylolysis, or lumbar radiculopathy. Along with this, in the amendment, it states that she reviewed all C&P and concurred with it but says that my extreme radicular pain was relieved post operation (L4-S1 fusion and dual discetomy) which, in fact is false, and my C&P shows this, and I even have had an appointment with my doctor about still having sciatica, which x-rays were taken! What do I do? I'm submitting a rebuttal for her NARSUM but what will that result in? Will she fix what she has clearly messed up, or did she not mess up?
 

3529USMC

Registered Member
#2
I received a revision of my NARSUM today. I noticed that for the referring condition, my provider only listed chronic lower back pain, but nothing about my diagnosis of Lumbar spondylolisthesis, lumbar spondylolysis, or lumbar radiculopathy. Along with this, in the amendment, it states that she reviewed all C&P and concurred with it but says that my extreme radicular pain was relieved post operation (L4-S1 fusion and dual discetomy) which, in fact is false, and my C&P shows this, and I even have had an appointment with my doctor about still having sciatica, which x-rays were taken! What do I do? I'm submitting a rebuttal for her NARSUM but what will that result in? Will she fix what she has clearly messed up, or did she not mess up?
JohnViro,

I am on my 2nd PEB for the same conditions as you. My 1st PEB was a total cluster. Ended up requesting a formal board because, just like you, my radiculopathy was not in my NARSUM and was not caught until after being submitted. The FPEB decided to terminate my case with instructions to re-submit. Fast forward 6 months and the new doctor not only left the same things out but concurred with the PA who did my C&P exams. Long story short, the PA either fat fingered the numbers for my ROM or just decided he wasn't going accurately measure and document. So I had to request a rebuttal of the NARSUM. When you do this, you will be seen by a different doctor. You will have to explain to them what you want added and why. My 2nd doctor was very helpful with this. Once the rebuttal is completed and submitted, the VA will no longer take into consideration what is on your C&P exams for that certain diagnosis but will use the new doctors rebuttal. This rebuttal will also take the place of your NARSUM so be very specific when talking to the new doctor. I hope this helps.
 

concernedwife

PEB Forum Veteran
Registered Member
#5
ahhhhh, gotcha! thank you so much. best of luck to you both. my husband feels for the both of you - he's going through it as well :/
 

JohnViro

PEB Forum Veteran
Registered Member
#8
I didn't submit my NARSUM and am rebutting it to have it added because I don't want this sent off and have to start appealing stuff. Luckily this should be sorted out before the ball gets rolling. I looked through my C&P and everything was right, ROM was 0 to 10 for my extension, and I know I'll get all the right percentages, I just don't want to risk DOD just giving me a rating for "Lower back pain" when there's 3 conditions attached to it, and talking with the lawyer he said I won't need to do another C&P or see another doctor, it's already noted in my C&P for radiculopathy, with EMG findings (or whatever that test is when they read your nerve signals)
 

chaplaincharlie

PEB Forum Veteran
Registered Member
#9
I'd would ask the provider to fix the errors. I was fortunate during my first Board; the provider wrote the NARSUM, but waiting until we consulted to send it. He gladly fixed the minor errors because he wanted to do a great job.
 

JohnViro

PEB Forum Veteran
Registered Member
#10
I'd would ask the provider to fix the errors. I was fortunate during my first Board; the provider wrote the NARSUM, but waiting until we consulted to send it. He gladly fixed the minor errors because he wanted to do a great job.
That's actually a real good idea. My PCM is an extremely nice lady and I am almost certain this is her first time doing NARSUM, I will be in contact with her! Thank you!!
 

MaxMillion

Registered Member
#14
JohnViro,

I am on my 2nd PEB for the same conditions as you. My 1st PEB was a total cluster. Ended up requesting a formal board because, just like you, my radiculopathy was not in my NARSUM and was not caught until after being submitted. The FPEB decided to terminate my case with instructions to re-submit. Fast forward 6 months and the new doctor not only left the same things out but concurred with the PA who did my C&P exams. Long story short, the PA either fat fingered the numbers for my ROM or just decided he wasn't going accurately measure and document. So I had to request a rebuttal of the NARSUM. When you do this, you will be seen by a different doctor. You will have to explain to them what you want added and why. My 2nd doctor was very helpful with this. Once the rebuttal is completed and submitted, the VA will no longer take into consideration what is on your C&P exams for that certain diagnosis but will use the new doctors rebuttal. This rebuttal will also take the place of your NARSUM so be very specific when talking to the new doctor. I hope this helps.
Hello,
How can I get the peb to order a new C&P? Many issues were left out.
 
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