Help...Should all conditions be listed on VA form 21-0819?

Gomez

PEB Forum Regular Member
PEB Forum Veteran
[FONT=&quot]I just received initial notification from my newly assigned PEBLO. I’m an M-Day Army National Guard soldier in the new pilot program. The PEBLO sent me a partially completed VA/DOD Joint Disability Evaluation Board Claim, VA form 21-0819 for my signature. Under section 1, MTF Provider Referral, the doctor annotated only my diagnosis of PTSD. However, I have multiple other conditions for which the VA has previously rated me as service-connected but that the doctor omitted from the form. Is this the point where I should ensure that these conditions are listed before I sign the form? The form states that “I further understand that I will be provided an opportunity to claim other medical conditions before my case is referred to the VA Rating Board.” So, should I just go ahead and sign the form without all my conditions being listed or require [/FONT][FONT=&quot]all of the other conditions to be listed on the form?
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Gomez,

That form is used to start the IDES process. It will only contain the disease/disorder that disqualifies you from service. After you sign that, you will meet with your VA rep and list all the individual issues you wish to claim. If you want, you can list further conditions in section 11.

11. ADDITIONAL CONDITIONS - (Do you have any disabling conditions, other than those referred for the fitness for duty determination, that you feel were incurred in or aggravated by, your active military service? Please list those disabilities below.) (If you need additional space, please use VA Form 21-4138, Statement in Support of Claim available at VA Forms)
 
Are you saying that this physician gets to make the determination on which of my conditions are service disqualifying? I thought the physician’s job, for the MEB’s purposes, was to list all of my conditions that are listed in AR-40-501 and that it’s the PEB’s job to determine which of them are service disqualifying/unfitting.

I understand that there are two areas on the VA Form 21-0819 where medical/mental conditions can be listed. The first is the block titled “Medical Conditions To Be Considered As The Basis of Fitness (List Only Conditons Referred by Physician).” This is the block that the physician uses to refer conditions. The second is the block where the soldier can enter their conditions that the physician didn’t refer. I am not concerned with this second block at this point.

I am concerned with the first block on the form 21-0819, where the doctor referred only one of the three Permanent 3 conditions that were on my profile. I’m hoping for an unfit condition, so I feel that the physician should have referred all of my P3 conditions from my profile and that are listed as referable conditions in AR 40-501, not just cherry pick one of the conditions.

Once the PEB stage is reached, does the PEB only use this single condition referred by the physician when determining the conditions that are physically unfitting? This would allow the PEB to give me a rating for only this one condition. If this is the case, can I protest for a change to the form 21-0819 to get the additional P3 boardable conditions included in the physician’s referral block prior to it being processed through the VA Military Service Coordinator (MSC) and the MEB/PEB?

I feel that I may be getting shortchanged on a PDES rating/compensation from DFAS (I'm not talking about the VA's separate rating for all conditons) because the physician referred only one of the conditions that should have been listed on the form 21-0819. I suspect that this process of intentionally reducing the number of referred conditions is commonly happening to other service members as a way to reduce the military’s compensation liabilities.
 
First off a couple of questions. How much time do you have in, and what is your rank? Most time the VA pay is significantly higher then what you will get from the military anyway. Also you are only rated by the military on the reffered disqualifiying condition, so yes if it's not on there, the PEB will not rate it. That doesn'e mean the VA won't. Example, in my case I'm being rated by the VA for sleep aphnea, MS, Degenerative disk disease, and high frequency hearing loss. The PEB however will only rate the MS, because that is what was reffered. Understand you can do a rebuttal for the what the doctor wrote, but unless a doctor has given you a confirmed diagnosis (documented), it probably wont makeit to the PEB.
 
Your PCM does not write up the actual VA 21-0819. That is done by your PEBLO. If your PCM has noted 3 conditions that meet your regulations disqualifying standard, check with the PCM and make sure each are clearly labeled in the system and contact your PEBLO. Tell him your PCM listed 3 conditions that are disqualifying and have him update the form.
 
Thanks. To answer your questions, I have 22 “good years,” so I have my 20 year letter and about 4700 points. E-7.


I was led to believe, by my PEBLO, that the PEB’s military/DOD rating (not the separate VA rating) would be based on both the physician’s referred condition as well as conditions that I added on the VA form 21-0819 (provided the PEB determines my added conditions from the form 21-0819 to be unfitting) . Seems this is wrong and that the PEB only considers the physician’s referred condition for the military/DOD rating.


Is it usually the case that the physician only refers one condition even though a service member may have another well-documented condition that has been diagnosed and treated by multiple doctors and that is clearly listed in chapter 3 of AR 40-501? Has anybody else out there been referred for more than one condition?


You mentioned that I can do a rebuttal for what the doctor wrote. Would I do that now, at the point where the VA MSC is getting ready to process my VA form 21-0819, or later when I review my NARSUM?


Also, I understand that the VA compensation is usually higher than the military/DOD compensation, but it appears I am eligible for CRSC and CRDP, so this could be a significant issue in my case.
 
Also you are only rated by the military on the reffered disqualifiying condition, so yes if it's not on there, the PEB will not rate it. That doesn'e mean the VA won't. .

Thanks. To answer your questions, I have 22 “good years,” so I have my 20 year letter and about 4700 points. E-7.


I was led to believe, by my PEBLO, that the PEB’s military/DOD rating (not the separate VA rating) would be based on both the physician’s referred condition as well as conditions that I added on the VA form 21-0819 (provided the PEB determines my added conditions from the form 21-0819 to be unfitting) . Seems this is wrong and that the PEB only considers the physician’s referred condition for the military/DOD rating.


Is it usually the case that the physician only refers one condition even though a service member may have another well-documented condition that has been diagnosed and treated by multiple doctors and that is clearly listed in chapter 3 of AR 40-501? Has anybody else out there been referred for more than one condition?

Seems like there is some confusion on what can be rated by the PEB. It is true that if a condition is not noted by the MEB (and preferably stating that it fails retention standards), it is unlikely that the PEB will find the condition unfitting and rate it. However, the MEB is required to evaluate ALL conditions. And the PEB can and does (though it is somewhat unusual) rate a condition that is not noted by the MEB. The PEB must rate all unfitting conditions.

At Army PEB's you will see the rationale state something like, "The PEB acknowledges the Soldiers contention that he suffers from XYZ Syndrome and should be rated at xx%. This condition was not noted by the MEB as failing retention standards, is not listed on the physical profile and does not appear to significantly limit Soldier's ability to perform his duties. Not unfitting." I see many erroneous PEBs fail to demand the MEB to document the condition and the impact on duty performance and then ignore or discredit the Soldier's testimony at the PEB hearing. Every once in a while, though, the condition is so clearly unfitting, the PEB will rate it even though the condition was not documented by the MEB.
 
So, it seems that it really doesn’t matter whether a condition is listed as a physician referral or as a condition annotated by the soldier on the VA Form 21-0819. It looks like the important thing for purposes of the possible PEB military/DOD rating toward the end of the PDES process is that at the beginning of the MEB process: (1) The soldier ensures that all conditions he or she has are annotated on the VA Form 21-0819 either as a physician referral or as a soldier self-annotated condition and (2) The soldier ensures that the MEB’s NARSUM includes all conditions that fail Army retention standards in AR 40-501 since these are the ones that the PEB considers for an unfitting finding and possible military/DOD rating.
 
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