Jason Perry

Mr. Perry,

I am going through an MEB for Ankoloysing Spondylitis, and most of my joints are affected. I also have gastritis and esophagitis. I am only being MEB'd for the AS and am currently on Humira. I have been told that my ratings will be dictated by my ROM using DC 5240 but doing research, this is an active disease and should be rated under DC 5002. What can I use to ensure that I am rated under DC 5002 when I go to my VA exams? Any help would be greatly appreciated.

V/r

James Bolton

Mr. Perry,

Recently I just got my C and P exams back from QTC for my MEB and he seems to not only contradict himself, but he also states things that are not accurate. I have a condition called POTS and it seems as though the examiner rated it analogously under the METs scale. Even though I told the examiner at the appointment that my condition is exacerbated by exertion he wrote that I do not suffer symptoms from exertion. In my medical records there is proof of this as well since I am prescribed an exercise program that emphasizes recumbent exercises. The biggest concern is that in another DBQ for Neurological conditions, he makes notes that I have to avoid triggers of exertion. Also, my POTS causes Tremors and he wrote that he acknowledged seeing a video I showed him of severe tremors, but at the end in the remarks he claims that there is no diagnosis of tremors because it is a symptom of my POTS. From my understanding Tremors is a symptom that has to be considered separately because the METS scale doesn't cover the symptom of tremors. I attached a rebuttal using VA Form 21-4138 and I pointed out every section where there were discrepancies and then I attached medical records and highlighted the sections that debunked his inaccurate claims. Ultimately, how effective have you seen this to be as I seem to have found mixed opinions from people when it comes to submitting Statements in Support of a Claim. My goal is to try and bring these issues to the adjudicator before the IPEB applies ratings so that I can maybe avoid a VARR/FPEB. I attached pictures so you could see how bad the contradictions are. The first one is from DBQ Heart Conditions and the others are from DBQ for Neurological Conditions.

Hello Mr perry. Greatly appreciate what you have been doing after reading through. I have a case and i require some advice from you or anyone.

Been having knee issues for 7 months now been to physical therapy for 4 months and then discharged, went to orthopedic after MRI and got diagnosed with chondromalacia in both knees however the left knee is worst showing much degeneration. I got injections prp which didn’t help then orthopedic told me to make a decisions with my career goals and go speak with my wife/family because my diagnosis is a condition that will separate me also being on a profile longer that 180 days will trigger one. I went home and made the decision that I’ll take the MEB option the orthopedic then schedule me to a FIT for DUTY and then told me and also put in her notes that I’d rather to exit the army via MEB and I should go back to PA.

I went to My PA who now states that he has seen guys with this diagnosis still jump out of planes and keep doing airborne things. I am 3 months away from being 31 years old and have a kid on the way. My PA states that he sees that I just want to get out the ARMY and that’s okay to him but my right knee isn’t that bad opposed to the left. Also he told me I have to get my FIT for DUTY appointment fulfilled which is on Friday before he can do anything but therapy again. Is it that my PA is disregarding my diagnosis of my knees because I am in so much pain from this injury I received and it’s been since last year June. I joined late because I am in a little over a year. What are the odds at FIT for DUTY exam this Friday. Sorry for the long post.

Hello, Mr. Perry

THANK YOU so much for this site and all the advice you provide!

Allow me to introduce myself: AD USN LDO with 24 yrs.
Here is my situation
1) My mandatory retirement date is 01 Mar 2022.
2) I was MEDEVACed from my previous duty station in Mar 2021
3) 1st (and last) LIMDU expired in Sep 2021
4) I was referred to PEB for 6 disabling conditions and got the "docket" number on 06 Oct 2010
5) ALL of the QTC/VA claim medical evals were complete in Nov 2021
6) from MILPERSMAN 1830-030: Involuntary/Mandatory Retirement or Fleet Reserve Transfer. Members pending a mandatory retirement ... will not be delayed unless member is either hospitalized or a medical board report has been accepted by the PEB for disability evaluation processing prior to the mandatory retirement date. If a medical board is referred to the PEB for review as a result of the member’s retirement physical, the medical board’s narrative summary should include a statement that the medical board is the result of the member’s involuntary/mandatory retirement physical (reference (a)). If delay of retirement is required based on the above, the commanding officer (CO) will advise NAVPERSCOM (PERS-482) of member’s situation and request modification of retirement date.
7) PERS-482 is NOT supportive

What are my options? Course of action?
ANY advice is highly apprecieted
Thank you.

Mr. Perry,
Thank you for all of your work on this site. Those of us who have spent our careers in the Guard or Reserves have very little information on processes, rules, and rights. I have seen so many members just booted out of the door for medical issues that would have resulted in a medical retirement or high VA ratings simply because the member was a part timer and leadership thought it was easier to just move on. I have become a locker room lawyer for my flying squadron since being informed of an MEB after 25 years of Guard service. (yet I still don't know anything about anything) Your website and other contributors have made the process much easier. Is there a section related only to ARC members? Which kind of points are used for final determination of pay versus % DoD disability, etc? There is so much misinformation out there, and our Guard brethren are not subject matter experts...

Thank You.

Mr Perry, are you able to tell me what the rule is on “intent to file”? If say intent to file was submitted June of 2020 and documents not supplied by June 2021 what happens? Does it expire, do you have to refile, it’s not renewed yearly is it? Also, if you receive a military reserve pension will it be offset if you get VA benefits? I know there is a difference between VA pension and VA benefits can you choose which one to receive? And will receiving a VA pension wipe out the military reserve pension? I appreciate your knowledge and time!! All my best.

Hello Mr Perry, l was injured at Annual training last july 2020. I underwent physical therapy, injections etc. Medcon kept saying l was a tier 2 not 1. In Jan 2021 l had decomp back surgery, they paid me tier 1 for 2 months. I went thru ldes, the findings has me rated unfit for my back, and specifies initial injury july 2020. I haven't went back to work as a title 32 miltech, still under care,and just received my retirement order for November 2021. I should have been paid tier 1 correct.thanks

Hello Mr. Perry,

I have a question, based on VASRD FEV-1 of 56- to 70-percent predicted, or; FEV-1/FVC of 56 to 70 percent, or; daily inhalational or oral bronchodilator therapy, or; inhalational anti-inflammatory medication. 30%

Does Singulair (Montelukast) qualify if its prescribed daily for Asthma?

Jason

Have you heard from your son? What a difficult time to have a loved one in theater.

Mike

Hello Mr Perry, I so look forward to a response from you!
I’ll keep this short as possible. What are the chances of the VA giving a favorable rating to any ailments being presented “NOW” after retirement from civil service and the reserves of 38 years. No prior medical documentation in service records. Only claims went to civilian doctors. I guess working on collecting medical now to present to VA for delayed submission. Claims: ptsd, hearing, shoulder impingement, wearing leg braces due to drop foot (lower back issue). Thank you!!

Hello Mr Perry,

Can a Formal board be approved one week and denied the next? im HYT (Navy ) my eaos was 15 mar 2020 and im still in waiting for results from my FPEB. would they not grant my unfit after 17 years cause im HYT? my IPEB was fit for ptsd, anxiety , my back and knees .

Hey man, I was digging through some of the decade old stuff just now and am very impressed with the professional quality of your posts. I recently applied to the NDRB and was granted partial relief (OTH upgraded to General); however, the narrative reason remained misconduct. I petitioned in Feb of 2020 and received my decision last week.

While this is an incredible accomplishment, I feel as if reapplying for further relief is warranted. Hopefully you wouldn't mind to weigh in?

I served in USMC Infantry from 2008-2012 and deployed to Afghanistan twice. I sustained a TBI that is documented in my Admin Sep paperwork. I never received any negative counselings or page 11 entrys. I was discharged due to possession of spice. Nothing else or additional to that. Simple possession of spice. During the required screening (simple yes/no questionnaire performed by a Physician Assistant) for mitigating PTSD/TBI, I only answered yes to having headaches. At the time of my petition, I had been service connected by the VA for Combat PTSD at the 50% rate.

My argument was that the discharge was inequitable because drug seeking behavior is a symptom of PTSD in the DSM-IV under the avoidance category. Additionally, the no answers were actually also evidence of my PTSD because they are also avoidant symptoms. This, in addition to the VA rating, is evidence that I did have a condition that mitigated the misconduct.

The board gave their decision and stated that full relief is not warranted because they do not feel as if the severity of my symptoms completely mitigated the misconduct.

During the time that I was waiting for their decision, I was reevaluated by the VA and my service connected issues now are:
Combat PTSD 70%
Traumatic Brain Injury 40%
Migraine Headaches 50%
Ulcerative Colitis Secondary to PTSD 30%
Degenerative Lumbat Arthritis 20%
Tinnitus 10%
Left ear hearing loss 0%
Bilateral Bunions 0%

Considering all of the above do you think that I have a shot at making a compelling argument for full relief? I would think that this qualifies as new evidence that hasn't been previously considered.

I also found that the USMC updated their Admin Sep order to state that those being discharged while having PTSD/TBI are supposed to have a mental health evaluation done by a qualifying provider. I obviously did not have this done. Would this stand to offer any sort of credible argument for upgrade? Perhaps an actual Psychiatrist might have been able to spot the signs of PTSD in me better than a PA who asked a short yes/no questionnaire.

Thank you for your time.

Hello Mr. Perry,
I am currently being medically retired with no service connection. I was on Title 10 orders for more than 30 days and was deployed to Kuwait. I am a Guardsman and Civil Technician at my unit. I am being denied service connection based on EPTS. I am looking into 1207a "eight year rule" and everything I find on it says that i have 8 years active service. But there is so much room for interpretation. I can't find any case law aside from i case that was denied because the eight year rule didn't exist at the time of the SM's injury. Basically, what counts and what doesn't and how do I prove that the days count to my FSS office and my Lawyer? Thanks for your Time!

Good Day Mr. Jason Perry,
I have over 20 years in the National Guard and am a Title 32 Technician for 13 years. I like many other have sucked up the pain but it's at a point now that I had to report it. I am currently marked as MND and am going through the Med Board process. I have been told this can take a very long time. Is it possible to continue the MED Board and get out of the guard but stay in the Technician side until the Med process is completed? I have arthritis, Degenerative disease, Nerve damage, blown disk, bad knees, temporary paralysis, and hip issues. I believe they think I may have MS as they are requesting me to be seen by a neurologist because of some of the symptoms I have. I don't want to have to go to drills anymore as the 2 hour drive is painful for me and I have to make this same drive for my medical appointments. If I have to stay in do I have any options for not attending drill, as I don't get paid because I receive 90% from the VA?
Thank you in advance for any assistance you can give to me, I'll be looking forward to your reply.

You seem very knowledgeable. I wanted to see if you could maybe answer a question for me. I got injured March of 2020 doing the deadline during a diagnostic ACFT. They never did imaging but I did do 4 months of physical therapy. After months of PT didn’t help I finally asked for the third time if they could do imaging. They did in Sept and found a wedge deformity with fragmentation and Schmorl nodes and I got sent for a MRI. It showed the “chronic” appearing wedge deformity, bulging disc with annular tear etc., and intervertebral discogenic disease. I tried a few other things that my PCM wanted and then was sent to pain management. The doctor there basically said my diagnosis was early age appropriate splondylosis. My PCM is discussing med board. If it’s considered age appropriate would I even get a DOD rating and do you think the wedge deformity went undetected due to them not doing images and now they are sweeping it under the rug?

Dear Sir,

I have a question on my case. May you give me an advice?

I have joined Army for a year and 3 months, and got out on August 2014 under medically separation on DD214. I have gone through MEB process under VARR and got 10% DOD and 100% VA on Combined Medical Symptoms since September 2014. However, at that moment, I was under medical treatment and got serious medical conditions, so I did not know that DOD rating is too far different from VA rating. The end of this year 2020, I have discovered that I could get other unfitting symptoms to my DOD rating based on VARR during MEB process.

Therefore, do I still have a chance to increase my DOD rating to get Medical Retirement?
Please, give me an advice or instruction. I am looking forward to hearing from you. Thank you.

Sincerely,
Thai

Sir,

Can you explain the financial statement you made in my thread? Thank you!

Jeff

Good morning, Mr. Perry. Any chance i could share my NMA with you to get your thoughts on it? ( will discuss in more details when in a more private setting). Thank you.

Have a question for you. I am at the PEB stage and have199 but I have not signed and returned it yet. The PEB rated me at 50% but soon after that the VA raised my percent to 100% for my main cause of medical retirement. Being in the nation guard and have served 21 years should I do the VARR to get the 100%?