CONUS Timeline (MH)

Z

zazoo

Active Member
PEB Forum Veteran
Registered Member
Here is my little timeline. Perhaps someone will find it useful.

Condition: Chronic Adjustment Disorder (9440)

PRE-IDES:
  • 16 Jul 25 – Referred to AMRO
  • Early Aug 25 – First contact with PEBLO; NARSUM received
  • 8 Aug 25 – CIS signed (Retain); submitted to DPMNR for IRILO; 37 applied (Day 0)
  • End of Sep 25 – Inpatient admission
  • 26 Sep 25 – DPMNR requested additional documentation (Day 49)
  • 29 Sep 25 – DPMNR results: RTD ALC-2; 37 to be removed (Day 52)
  • 2 Oct 25 – Case resubmitted to IRILO for re-consideration (Day 55)
 
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Did you push for a reconsideration? Were you able to appeal your initial IRILO?
 
DEADEYE said:
Did you push for a reconsideration? Were you able to appeal your initial IRILO?
Click to expand...
It was my MH provider's initiative. She's amazing.
It's all still "fresh." (happened literally last week)
 
An update - got an official notification about being referred to MEB.

Condition: Chronic Adjustment Disorder (9440)

PRE-IDES:
  • 16 Jul 25 – Referred to AMRO
  • Early Aug 25 – First contact with PEBLO; NARSUM received
  • 8 Aug 25 – CIS signed (Retain); submitted to DPMNR for IRILO; 37 applied (Day 0)
  • End of Sep 25 – Inpatient admission
  • 26 Sep 25 – DPMNR requested additional documentation (Day 49)
  • 29 Sep 25 – DPMNR results: RTD ALC-2; 37 to be removed (Day 52)
  • 2 Oct 25 – Case resubmitted to IRILO for re-consideration (Day 55)
  • 6 Oct 25 - DPMNR results: Full MEB requested (Day 59)
IDES:
 
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Oh wow! Is that what you were hoping for? Did your PCM or team say anything about how the IDES process will or be delayed with the Shutdown? Or are they going to begin processing your MEB as normal?
 
DEADEYE said:
Oh wow! Is that what you were hoping for? Did your PCM or team say anything about how the IDES process will or be delayed with the Shutdown? Or are they going to begin processing your MEB as normal?
Click to expand...
Yes. Work and health just became too heavy to handle. Don't want to disclose recent details.
And they didn’t say anything about the shutdown, and how the processing will go.
 
@zazoo before your narsum is compiled id recommend doing a lot of thinking about fighting the referred unfitting condition, from your post history you say you also have diagnosed MDD/GAD/PTSD. of course i dont know your clinical notes/details but if you let the narsum go off to ipeb with only adjustment disorder as unfitting you run a very high risk of the IPEB finding fit, or unfit at only 10%. then your only option is a full FPEB, but even then you already have the CIS retain working against you.

of course no need to divulge anything youre uncomfortable with, but a few questions that may help you as you progress:
1. you noted that you had some injury / neglect issues by a supervisor, how long ago? was it your current, or a prior command? did you pursue an inspector general (or branch equivalent) inquiry for abuse of authority/improper command pressure? if the results of a finding are substantiated, it could do a lot of work to mitigate the impact of the CIS retain.
2. as i said earlier, i'd think long and hard about the adjustment disorder referral. since most of your unfitting conditions seem to be mental health (me too), if you get a generous narsum/IPEB it may lump your AD/MDD/PTSD/GAD into one condition, where the sum of effects are deemed to be inextricably linked and self reinforcing, it could turn out fine. if you not, expect a long and hard battle to be even found unfit. it also seems the pressures you've faced so far are heavily leaning towards retention.
3. im not a psych, nor do i know much about your case, but an inpatient stay is generally a one track ride to IDES referral, but the previously mentioned confusion on referred unfitting conditions throws a wrench into this narsum writing. do the discharge notes from the inpatient stay reference AD or MDD/PTSD? if primarily MDD then getting an narsum rebuttal to add MDD as unfitting could be strong. also, AD (again not a psych) seems to never rise to the level of SI/HI or inpatient.
4. you say youve already received a narsum, and im not sure exactly about this process, but since you had the inpatient post narsum, theres a strong argument it should be updated. also, the verbiage of your existing narsum could answer a lot of these questions. does it focus exclusively on AD? or does it lump in the impairments you experience from all your MH conditions? the fact that your 37 was removed leads me to believe it excluded other MH issues.


again no need to answer anything, just some stuff for you to consider/think about going forward
 
Hi, DNIF,
To answer your questions:
  1. A few years ago, different MAJCOM. I was brand new to the Air Force and didn’t have a mentor willing to give any real guidance. I just tried to keep my head down, do my job, and not complain. Things happened — some people have since retired, others got promoted.
  2. The NARSUM lists all the conditions as they were diagnosed over time, finally settling on Adjustment Disorder. BTW: The "MDD/GAD/PTSD Triad" is apparently a hospital thing and in that particular order it was given to me.
    The CC who wrote the CIS is no longer my CC.
  3. Not sure yet — I haven’t seen the discharge papers. The doctor read the diagnoses from his papers during one of the daily check-ins.
  4. The NARSUM was written before the AMRO, and the CIS before the IRILO. Things were super dynamic here while I was hospitalized. I still have "Y C2" on my CDB from previous DPMNR results.
I hope that is a sufficient clarification.

As far as moving forward - I have no energy to go forward. I am drained. Exhausted.
First need to get back on my feet and will try to take care of the IDES. I think I will try to trust the PEBLO.
 
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i totally understand and can sympathize with the exhaustion, however id strongly caution against trusting the PEBLO mil psych combo as the sole source of information for the IPEB. if you think that AD is a good comprehensive narrative for your problems, and separation would result in significant or complete remission in symptom presentation/functional impairment, then letting the system send you down that track may be justified.

again havent seen your clinical notes but if you think thats maybe not the best summary of your problems, and your functional impairment you believe would persist largely even in a civilian environment, then maybe one thing id recommend that would be most impactful would be having a civilian psychiatrist who specializes in disability or legal cases do a full review of your records to include an inperson (or tele) evaluation. since youre at the beginning of the MEB referral maybe you can trust the C&P exams and further appts with mil psych to tease out the nuance of your case, but thats a lot of trust to place in the system thats already seemed to have failed you

such evaluations can be expensive, but if its the difference between an improper med separation vs justified retirement, it pays itself back in a month, and should only take a few hours of your time to coordinate. if the civilian provider has a better narrative or diagnosis that explains your issues (possibly without AD), that can be attached with a narsum rebuttal when the package is sent to the IPEB, giving you at least a shot they consider an outside perspective, and certainly cant hurt your chances of a more appropriate IPEB offer.

and one final thing to consider, is that i believe while all of your conditions are listed on the narsum, the ipeb will only rate on the conditions that are deemed unfitting for DOD ratings, which is why it matters so much whether AD is the only unfitting, or if all the MH are lumped together. if AD was the unfitting condition, and MDD was the result of the inpatient stay, a less than generous IPEB could result in a 10% DOD rating for AD as the sole unfitting condition.

10% for MH ratings: "Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or symptoms controlled by continuous medication."

you can maybe kind of see how an IPEB could argue that if AD is the only DOD ratable condition, then depending on your notes and how the narsum is written 10% could be a plausible response. of course, the VA would likely come back higher with the SI/inpatient stay, since the VA rates all your service related conditions, but you would then be reliant on VA healthcare, not tricare for you and your family, for whatever thats worth.

i know this is a lot, believe me im going through the gauntlet as we speak, but a day or two of work now for the independent eval may prevent the entire many, many months of FPEB process being required to fight against the 10% IPEB possibility.
 
OT:

I have been wondering if the shutdown affects PEBLOs too?
 
zazoo said:
OT:

I have been wondering if the shutdown affects PEBLOs too?
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Well, most PEBLOS are active duty, so no. However, if your PEBLO office has civilians though, those are furloughed.
 
justgoingthroughit said:
Well, most PEBLOS are active duty, so no. However, if your PEBLO office has civilians though, those are furloughed.
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My PEBLO is a civilian and is not furloughed along with some other folks in the forum!
 
CrohnieOstomate said:
My PEBLO is a civilian and is not furloughed along with some other folks in the forum!
Click to expand...
interesting. Our Peblo office is active duty, with one civilian who is furloughed. Also my PEBLO is currently getting everything ready for IPEB, and says if there are any delays it would happen up there for my case.
 
Just found out our PEBLO office (civillians) are working.
 
Update:

PRE-IDES:
  • 16 Jul 25 – Referred to AMRO
  • Early Aug 25 – First contact with PEBLO; NARSUM received
  • 8 Aug 25 – CIS signed (Retain); submitted to DPMNR for IRILO; 37 applied (Day 0)
  • End of Sep 25 – Inpatient admission
  • 26 Sep 25 – DPMNR requested additional documentation (Day 49)
  • 29 Sep 25 – DPMNR results: RTD ALC-2; 37 to be removed (Day 52)
  • 2 Oct 25 – Case resubmitted to IRILO for re-consideration (Day 55)
  • 6 Oct 25 - DPMNR results: Full MEB requested (Day 59)
IDES:
  • 20 Oct 25 - Case submitted to VA (Day 0)
  • 22 Oct 25 - First contact w/ MSC; VA claim appointment scheduled (Day 2)
 
Update:

PRE-IDES:
  • 16 Jul 25 – Referred to AMRO
  • Early Aug 25 – First contact with PEBLO; NARSUM received
  • 8 Aug 25 – CIS signed (Retain); submitted to DPMNR for IRILO; 37 applied (Day 0)
  • End of Sep 25 – Inpatient admission
  • 26 Sep 25 – DPMNR requested additional documentation (Day 49)
  • 29 Sep 25 – DPMNR results: RTD ALC-2; 37 to be removed (Day 52)
  • 2 Oct 25 – Case resubmitted to IRILO for re-consideration (Day 55)
  • 6 Oct 25 - DPMNR results: Full MEB requested (Day 59)
IDES:
  • 20 Oct 25 - Case submitted to VA (Day 0)
  • 22 Oct 25 - First contact w/ MSC; VA claim appointment scheduled (Day 2)
  • 24 Oct 25 - MSC Appointment, form signed, sent back (Day 4)
 
Got a text from Optum Serve today. Registered on-line filled out their stuff, and they started scheduling appointments.
Now waiting for DBQs to arrive soon.
 
Update:

PRE-IDES:
  • 16 Jul 25 – Referred to AMRO
  • Early Aug 25 – First contact with PEBLO; NARSUM received
  • 8 Aug 25 – CIS signed (Retain); submitted to DPMNR for IRILO; 37 applied (Day 0)
  • End of Sep 25 – Inpatient admission (MH)
  • 26 Sep 25 – DPMNR requested additional documentation (Day 49)
  • 29 Sep 25 – DPMNR results: RTD ALC-2; 37 to be removed (Day 52)
  • 2 Oct 25 – Case resubmitted to IRILO for re-consideration (Day 55)
  • 6 Oct 25 - DPMNR results: Full MEB requested (Day 59)
IDES:
  • 20 Oct 25 - Case submitted to VA (Day 0)
  • 22 Oct 25 - First contact w/ MSC; VA claim appointment scheduled (Day 2)
  • 24 Oct 25 - MSC Appointment, form signed, sent back (Day 4)
  • 5-8 Nov 25 - Calls from the contractor before "head-to-toe" exam (Day 17-19)
  • 6 Nov 25 - C&P #1 (hearing) (Day 18)
 
Weekly update 15 Nov 2025:

PRE-IDES:
  • 16 Jul 25 – Referred to AMRO
  • Early Aug 25 – First contact with PEBLO; NARSUM received
  • 8 Aug 25 – CIS signed (Retain); submitted to DPMNR for IRILO; 37 applied (Day 0)
  • End of Sep 25 – Inpatient admission (MH)
  • 26 Sep 25 – DPMNR requested additional documentation (Day 49)
  • 29 Sep 25 – DPMNR results: RTD ALC-2; 37 to be removed (Day 52)
  • 2 Oct 25 – Case resubmitted to IRILO for re-consideration (Day 55)
  • 6 Oct 25 - DPMNR results: Full MEB requested (Day 59)
IDES:
  • 20 Oct 25 - Case submitted to VA (Day 0)
  • 22 Oct 25 - First contact w/ MSC; VA claim appointment scheduled (Day 2)
  • 24 Oct 25 - MSC Appointment, form signed, sent back (Day 4)
  • 5-8 Nov 25 - Calls from the contractor before "head-to-toe" exam (Day 17-19)
  • 6 Nov 25 - C&P #1 (hearing) (Day 18)
  • 10 Nov 25 - C&P #2 (general) (Day 21)
  • 13 Nov 25 - C&P #3 (vision) (Day 24)
 
Weekly update 20 Nov 2025:

PRE-IDES:
  • 16 Jul 25 – Referred to AMRO
  • Early Aug 25 – First contact with PEBLO; NARSUM received
  • 8 Aug 25 – CIS signed (Retain); submitted to DPMNR for IRILO; 37 applied (Day 0)
  • End of Sep 25 – Inpatient admission (MH)
  • 26 Sep 25 – DPMNR requested additional documentation (Day 49)
  • 29 Sep 25 – DPMNR results: RTD ALC-2; 37 to be removed (Day 52)
  • 2 Oct 25 – Case resubmitted to IRILO for re-consideration (Day 55)
  • 6 Oct 25 - DPMNR results: Full MEB requested (Day 59)
IDES:
  • 20 Oct 25 - Case submitted to VA (Day 0)
  • 22 Oct 25 - First contact w/ MSC; VA claim appointment scheduled (Day 2)
  • 24 Oct 25 - MSC Appointment, form signed, sent back (Day 4)
  • 5-8 Nov 25 - Calls from the contractor before "head-to-toe" exam (Day 17-19)
  • 6 Nov 25 - C&P #1 (hearing) (Day 18)
  • 10 Nov 25 - C&P #2 (general) (Day 21)
  • 13 Nov 25 - C&P #3 (vision) (Day 24)
  • 17 Nov 25 - C&P #4 (TBI) (Day 28) (virtual)
  • 20 Nov 25 - C&P #5 (PTSD/MH) (Day 31) (virtual)
  • 20 Nov 25 - Sleep Study at a clinic (Day 31)

Last C&P exam today (PTSD/MH). It was virtual. About 50 minutes. I’m giving it a 6/10.
Examiner told me they’d “read my record later” and match it to today’s notes.
Is that a red flag?
 
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