Erroneous Diagnosis from AHRC Command Surgeon and Now PEB?

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dukboki

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I just got an email from the medical fitness team at HRC in Fort Knox. The Command Surgeon there just wrote me a P3 profile for Diabetes Mellitus based solely on me taking a blood sugar control med temporarily. This was despite my private physician saying that I have hypothyroidism, weight gain, and glucose intolerance - but not diabetes (and thus temporarily prescribed an oral diabetic medication to help bring down my weight). However, the profile also indicates no assignment restrictions and the only activity restriction is "no continuous consumption of combat rations." The PA who took a look at my case said that I will get an "option letter" which I'm guessing is where I can request a MEB/PEB, correct?

The history is that I came down with hyperthyroid symptoms in 2003 while on active duty and later was MEDEVACed out of Afghanistan for treatment. The condition went stable and I was later deployed again in 2005. I resigned from active duty in 2006 and went into the Reserves. The VA awarded me with a 30% rating for my thyroid symptoms. After seeing a private physician (while a Reservist) who did not listen to me and kept cutting my thyroid dosage, I eventually sought treatment from another physician (the current one) and have already started to lose the weight and am working toward reversing the glucose intolerance. The labs that triggered my current doc to prescribe the meds were a fasting glucose of 110 and an A1C of 6.0. I think she did me no favors in prescribing it and I guess I was too honest on my last PHA.

I am nervous of this MEB/PEB process and have no clue what to expect. I'm a Reserve logistician with 12 years of service (6.5 active, 5.5 Reserve) who is serving in a headquarters staff assignment and am wondering what my chances of being found "Fit for Duty" are. I see there are a lot of topics on this but it seems that either people are Type I or don't post their results. Any advice on this? Jason, any sage counsel? Do I need to retain a lawyer?
 
dukboki,

Welcome! A few questions, first. It sounds like you want to continue to serve. Is this correct? What is your grade? What are your profile limitations?

As a general comment, your first "formal" step to challenging the medical determinations will come after your NARSUM is complete. Though, you may be able to influence the actual write up depending on how open your MEB dictating physician is to input and what evidence you can gather.
 
Jason -

Thanks for the quick reply.

Yes, I would like to continue to serve. I think the Army has invested much into me as I have it and want to see it through to retirement rather than disability retirement/separation. I'm currently a Reserve O4 - as for the "limitations," while the profile says "DM, hypothyroidism, knee pain, and PTSD," the only limitation is no 2-mile APFT. Everything else is a "yes" to include deployability.

Since I didn't do an MEB, rather, the Reserves requires a PHA and the Command Surgeon is sending it forward to PEB, will I still be able to affect the NARSUM? It seems like this guy is shutting things out and I'm rather annoyed that he keeps on pushing DM even though the medication was used to help weight loss rather than treat DM (my labs don't cross the threshold).

Any thoughts?

dukboki
 
Seems like a big disconnect. They cannot skip doing an MEB. If they want to call the MEB a PHA, that is fine, but they must comply with all of the regulations regarding MEBs.

Your response raised another question for me. Do you have a LOD for diabetes (realizing that you disagree with the dx, but they still need to do a LOD)? It may be that they are thinking you are not in the line of duty and therefore they can skip to trying to separate you. Not really clear what they are doing/thinking, but I am suspicious about the process they appear to be using.
 
I haven't had to do an LOD on the diabetes diagnosis. I do know that the hypothyroidism that caused the weight gain (which tripped this whole debacle) did occur on duty and I have my active duty medical records to back that up. If they have to go through a MEB, then great - I can make my case there. But so far, they did the PHA, issued a directive for additional medical information, and then the command surgeon entered a permanent profile after he saw the additional information. Are you saying that I should get an opportunity to do a MEB before the informal PEB? I won't elect for separation and I'm prepared to fight this every step of the way. Just not sure what to expect or what actions to take just yet.

Thank you for your advice - please keep it coming!
 
Exactly...they cannot do a PEB without the information from the MEB. MEB is the first step in the disability evaluation system process. I can't know for sure, but it seems like they are thinking your condition is not in the line of duty, so they will just process you for separation.

If you have an LOD with a favorable determination, you will be entitled to benefits if you are unfit. Either way, you can fight for a fit determination.
 
Hey Jason and dukboki,
I hae a similar situation yet different. I am Type 2 Diabetic that was diagnosed whle serving on AGR tour, I was Med Boarded and found fit for duty. Upon initiating a reenlistment my security clearence expire which resulted in my being Honorably Discharged, I subsequently did a ante-dated reenlistment that ony garnered a reenlistment into AGR with subsequent tranfer to the IRR which also led to my being assigned to the same unit as a TPU. I was told that I needed to re-apply for AGR since I was discharged, which I did. Now they're saying that because of my P3 Profile I'm ineligible for AGR even though I received my P3 and Found fit for duty while on AGR. They are considering me as a new accession therefore I do not qualify for AGR. I personally believe this is erroneous and am inquiring as to how to go about getting back on tour. The option I was given by the 81st Surgeon General's Office is to get off my meds, regulate my A1C with diet and exercise to affect an upgrade to my P3 Profile to a P2. My sceurity clearence is now in good standing, I'm fully qualified by all standards and was found fit for duty. It seems as if there is an exception to policy or a reinstatement request that can be made, but I'm running into roadblocks at every turn. Please advise, Thanks.
 
sgtnbc,

Yours is a very complicated issue. Much depends on exactly what happened and your particular facts and circumstances. My instinct is that you have some remedies, but I would not have any insight without researching the issues. A related issue is whether or not you should have been found fit. Also, not sure why your SC expired. That would factor in as well.
 
My SC is now good to go. I am currently TPU attempting to get back on AGR tour. I still have a P3 and I am working with my personal Dr. to get my P3 upgraded to a P2. If you can email me at [email protected] I can give further details and/or documentation to get all relevent facts to better answer my questions. Thanks.
 
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