Admin Discharge?

CarlB

PEB Forum Veteran
Fellow forum warriors, I need some advice for a Soldier of mine.

1. Soldier suffers from chronic pain, diagnosed by mental health military doctor with no identified cause.

2. Physician at the troop clinic can't pin down a cause, but determines that Soldier is not fit for duty due to limitations caused by the above chronic pain. Physician recommends to commander to administratively discharge Soldier.

My question: Is the Soldier entitled to or required to undergo a MEB/PEB? Both the Soldier and the CO are pushing for a MEB, but the physician is saying that without a diagnosable condition he cannot proceed with the medical board.

Not being a medical professional its hard for me to put in my .02, but I observe the Soldier having pain under classroom conditions, ie sitting at a desk and studying. I agree that the Soldier's future is probably not in the military, but what is the right way to go about discharging this individual?

Any advice or help would be appreciated. I'm sitting down with this Soldier on Monday after I spend the weekend diving through regulations to better advise him, but I'm fairly certain there's some better qualified individuals here on the boards that can point me in the right direction.
 

Sullivan1

Registered Member
From experience, I know chronic and severe pain can be linked to trauma. Has the soldier been evaluated for PTSD or other trauma-related condition? Is there any injury or strain (even an over-use injury) that could have caused a chain-reaction in the body to cause the pain? Sometimes the pain is not where the initial injury occurred. If you can give me a brief idea of this person's time in service and deployment/training experience, I could take some guesses.

Also from experience, I know that acupuncture and other energy-based modalities such as Emotional Freedom Technique can help. Chiropractic may be another helpful option. I'm hoping to get the GI Bill to become a practitioner to address this type of issue! Sounds like something similar to what I went through (although I had injuries as well). I'm happy to help however I can.
 

maparker

Staff Member
PEB Forum Veteran
Registered Member
See chapter 3 of AR 40-501. It lists conditions that are cause for a MEB. There is at least one catch all for any condition that interfers with the performance of duty.

Mike
 

maparker

Staff Member
PEB Forum Veteran
Registered Member
From 3-41 of AR 40-501:
e. Miscellaneous conditions and defects.
Conditions and defects not mentioned elsewhere in this chapter are causes
for referral to an MEB, if—
(1) The conditions (individually or in combination) result in interference with satisfactory performance of duty as substantiated by the individual’s commander or supervisor. Any medical condition, injury or defect (individually or in combination) that prevents the Soldier from performing any of the functional activities listed under item number 5 on DA Form 3349 (Physical Profile).
(2) The individual’s health or well-being would be compromised if they were to remain in the military service.
(3) In view of the Soldier’s condition, their retention in the military service would prejudice the best interests of the Government (for example, a carrier of communicable disease who poses a health threat to others). Questionable cases, including those involving latent impairment, will be referred to PEBs.
 

Bananers

PEB Forum Veteran
Registered Member
Perhaps your soldier can be referred to a rheumatologist? Chronic pain with no etiology could be Fibromyalgia (of course, there are other causes of chronic pain as well).
 

grizz13

PEB Forum Veteran
Registered Member
Sounds to me like the doc doesn't want to refer them to MEB/PEB so they don't have to do the paperwork/and or save the military money...
 

CarlB

PEB Forum Veteran
Thanks guys for the regulatory help. Soldier is in AIT, is an initial entry student with roughly one year of service and has no idea how the military works. He's come to me for help as I've been going through the MEB/PEB process as well. I will contact the Soldier's commander and give her the regulatory guidance that she needs to approach the doctor with.

CarlB
 

CarlB

PEB Forum Veteran
From experience, I know chronic and severe pain can be linked to trauma. Has the soldier been evaluated for PTSD or other trauma-related condition? Is there any injury or strain (even an over-use injury) that could have caused a chain-reaction in the body to cause the pain? Sometimes the pain is not where the initial injury occurred. If you can give me a brief idea of this person's time in service and deployment/training experience, I could take some guesses.

Also from experience, I know that acupuncture and other energy-based modalities such as Emotional Freedom Technique can help. Chiropractic may be another helpful option. I'm hoping to get the GI Bill to become a practitioner to address this type of issue! Sounds like something similar to what I went through (although I had injuries as well). I'm happy to help however I can.
Soldier has an injury to the shoulder that may be instigating some of the radiating pain, but the doctor doesn't believe that it is the likely cause of the remaining chronic pain. No trauma that I know of aside from that (blasts, etc) as Soldier is in AIT status with roughly one year in service.
 

grizz13

PEB Forum Veteran
Registered Member
Soldier has an injury to the shoulder that may be instigating some of the radiating pain, but the doctor doesn't believe that it is the likely cause of the remaining chronic pain. No trauma that I know of aside from that (blasts, etc) as Soldier is in AIT status with roughly one year in service.
I had a similar fight with the oral surgery I had done back in 2007, had to go through 20 sick-calls at medical and dental until I found a doc that said "I know a guy." He sent me to a facial pain specialist, who didn't believe me either and had me do psycho babble breathing therapy... Finally about a year after my surgery the doc finally went a made some weird mixture and put it on a q-tip and put it on the affected area, waited 15 min with no improvment. He decided to wait an additional 15 min, and out of no where I actually had little/no pain and could feel my tongue and could actually taste again! The doc stated "huh... you do have nerve damage..." Go figure no one believed me, after a year long fight and everyone though I was stupid/crazy! I am in pain for the rest of my life and the treatements are not available to me anymore... :(
 

CarlB

PEB Forum Veteran
Update:

SM is visiting with legal assistance. Physician still insisting that without a diagnosable condition that they cannot initiate a med board. We are gathering the medical records from two visits to neurologists and have a sit-down consult with a family friend who specializes in treatment/diagnosis of chronic pain disorders. His initial assessment is that the physician needs to make a big-boy decision and make a differential diagnosis based upon available evidence.

According to this family friend, several medical conditions exist that don't show in common tests that can have this sort of effect, to include fibromyalgia, myofacial disorders, and rheumatoid arthritis.

Will update again after legal counsel is consulted. I've also shown the SM this website and he should be on to take over the discourse on his own if he has any further questions. Thanks again all for your contributions.
 

grizz13

PEB Forum Veteran
Registered Member
Good that you are looking out for him CarlB, if I may suggest getting a second opinion from another doc? I know PA's know-it-all's don't diagnose well and all they use is WebMD to try and diagnose something... Yes, I have caught them multiple times while they were trying to diagnose me on a few things.
 

Del

PEB Forum Regular Member
I can attest from personal experience that the doctor is full of BS. I spent over two years trying to get a diagnosis for my chronic chest pain and other symptoms after being told repeatedly that it was all in my head or other nonsense. After being on profile for over a year with no diagnosis, they started a MEB for 'non-ischemic chest pain' that ended up being found by the MEB to fail retention standards before I finally got my real diagnosis and had it changed.

It took a lot of fighting for me to keep from getting pushed out by doctors, mostly the know it all PAs others have described, to keep getting treatment and finally a real diagnosis. Don't be afraid to use the Patient Advocates. I had to file two complaints before I finally got a doctor who went the extra step to figure out what was really going on.

However, even if they can't find a diagnosis they can definitely start an MEB without a diagnosis.
 
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