Last April I gave birth to my son at a MTF and nearly died when my nurse administered a large dose of the wrong drug. When I returned to work following my maternity leave I experienced many PTSD symptoms, high anxiety, emotional outbursts, etc. related to this near death experience. My commander stated that I was clearly in no state to be at work, so I made an appointment with my PCM who immediately referred me to neuropsychology. A staff psychologist was soon seeing me and diagnosed me with PTSD. She put me on convalescent leave on an as needed basis (renewing my convalescent leave every 30 days). My continued inability to return to work prompted a medical review, including sessions with a senior psychiatrist, and triggered a med board that has led to a formal PEB.
While on signed convalescent leave my commander ordered me to work on more than one occasion to sign paperwork despite the fact that my PTSD symptoms were triggered by being on base, as noted by my psychologist. I was also told to complete my ancillary training while on convalescent leave, which I managed to do mostly by borrowing my husband’s work laptop, but was unable to complete due to access issues I was unable to resolve despite tech support help [at my recent meeting with the commander he said usually he would just cancel a members convalescent leave and have them come in to complete training, this was not the first time my convalescent leave was brought up in a threatening manner]. I was then asked to schedule myself for a PT test, which I told the unit I felt fit enough to do, but my PTSD symptoms made it impossible for me to take the test at the base I’d been stationed. [During my later recent meeting with my CC he said this was “crazy”). I asked if I could take the PT test at any nearby base, but was told no, so I said I would schedule an appointment with my PCM to see if my PTSD symptoms warranted a PT profile.
At a recent meeting, my commander said I needed to report to work to sign a Referral to Healthcare Counseling, he explained by phone that he wanted me to be seen by an AF psychologist because of my long absence from work.
My husband had to take off time from his work in order to drive me to base as my anxiety gets so bad it’s unsafe for me to drive on my own. When we met with the CC he presented the letter referring me to a new doctor, the letter accused me of missing medical appointments, refusal to complete training, refusal to PT test, and refusal to come into work. These accusations are all false, or at least highly misleading. Any and all work that I have missed has been while I was on convalescent leave. My attending psychologist records that I have been cooperative and working on my recovery in every way.
The referral letter listed many references; I read them all. (DoD Directive 6490.1, DoD Instruction 6490.4, Section 546 of Public Law 102-484, AFI 44-109) There is not a single reference to referring a member under the current care of a military health provider. In fact, all the regulations were written in such a way that clearly communicates that a commander is to use the referrel in order for the member to be evaluated, diagnosed, and given treatment. My psychologist, has not only evaluated me, diagnosed me, but has as written my NARSUM for my med board which has been underway for some months. I think it will be clearly seen that my commander is taking great liberties with the regulations he has cited, and is manipulating the evaluations process.
I expressed to my commander that forcing of me to see a new psychologist was effectively “Dr. Shopping,” considering that my case has been through my PCM, a psychologist, a psychiatrist, an AF psychologist, and an informal PEB, which initiated a formal PEB. By that count my case has been through five separate levels. After explaining this to my commander he expressed that he did not think I needed to be out on convalescent leave, and that had talked to another doctor (the one I have been referred to see) who believed if I was seen by them they could return me to work. I again expressed to CC that this was clear interference in my medical care based on his personal doubts regarding my current doctor’s prognosis, and it frightened me immensely that my command had so much control over my healthcare. I explained how many sessions and how much time I had spent on my recovery with my doctor that had led to her assessment that I continued to need convalescent leave, and how very traumatic it would be for me to rehash all the details once again with a new doctor. My commander informed me that the new doctor I would be assigned to had mentioned that it would not be necessary for me to go through the same sessions, but rather an assessment could be made to return me to work just by reading my records. My husband and I again explained that picking a doctor that had already agreed that I can be returned to work prior to even seeing me was clearly undue influence on my medical care. My commander reiterated that I had been out for a long time, and said this was not normal for PTSD. He said he did not agree with the way my current doctor was handling my care.
Additional info:
-One of the main points being made for this referral is the fact that my current doctor is not “Air Force.” However, she is DOD working IN my assigned MTF. This hospital is joint military, even if not solely AF, and treats the bulk of the military’s returning vets many of whom suffer from PTSD. Also, My doctor has already coordinated with an AF psychologist at the base I am assigned. She told My doctor that based on my records it was clear I was doing everything I could to recover.
-Another point being made is that my current Dr has not been able to “fix me” and return me to work. However, my doctor did speak to my commander, about the possibility of my returning to work, on more than one occasion. She told the CC I would most likely return to the work environment but be unable to perform any duties for some time and would need time to just overcome intense anxiety. The CC said that would not be possible (something I reminded him of at our recent meeting, and he again agreed that that was not a possibility).
-A major limiting factor in my recovery has been my inability to take medications, this is due to the fact that I am nursing my very young infant, and then just recently, became pregnant again.
-CC said he had spoken to my PEBLO about referring me to an AF mental health provider, my PEBLO said this was permissible based on an inaccurate reading of AFI 10-203. She said that AF Providers have “final authority.” However, My PEBLO was unaware that my case had already been signed off on by the AF side, when the AF psych reviewed my doctor’s recommendations and signed off on them. [AFI: 10-203 2.12.4. AF providers will only consider recommendations from civilian (non-MTF) clinical consultants that are related to, or describe, functional limitations. AF providers retain the final authority on deployment, medical retainability, and physical limitation recommendations 3.7. External duty limitations (civilian or sister service). All AF personnel must report
changes in physical status to their AF military medical unit. Duty limitations from a non-AF provider are a recommendation and must be entered on an AF Form 469 by an AF provider to be valid. AF providers retain final mobility recommendation authority.]
This is not a situation I ever anticipated I would be in, I am used to being the top ranked CGO in my unit receiving kudos for a job well done. In fact I was CGO of the year, at this very unit, shortly before I left to have my baby. I suffered a medical mistake that nearly cost my life and has had very terrible consequences, which have resulted in a med board and likely means the end of my military career. If this were not bad enough, now my unit is harassing me while on convalescent leave and infringing on my rights to unbiased medical treatment, and is overtly seeking new care for me that will prove to offer a diagnosis/prognosis that better fulfills the commander’s desires.
The PEB reg clearly state: AFI 36-3212 1.13. “Unlawful influence. No one may attempt to coerce or, by any unauthorized means, influence the PEB or the outcome of any disability case. “ Referral after already being treated is clearly unauthorized coercion/influence.
I'm very interested in your advice and or experience in similar situations!!
While on signed convalescent leave my commander ordered me to work on more than one occasion to sign paperwork despite the fact that my PTSD symptoms were triggered by being on base, as noted by my psychologist. I was also told to complete my ancillary training while on convalescent leave, which I managed to do mostly by borrowing my husband’s work laptop, but was unable to complete due to access issues I was unable to resolve despite tech support help [at my recent meeting with the commander he said usually he would just cancel a members convalescent leave and have them come in to complete training, this was not the first time my convalescent leave was brought up in a threatening manner]. I was then asked to schedule myself for a PT test, which I told the unit I felt fit enough to do, but my PTSD symptoms made it impossible for me to take the test at the base I’d been stationed. [During my later recent meeting with my CC he said this was “crazy”). I asked if I could take the PT test at any nearby base, but was told no, so I said I would schedule an appointment with my PCM to see if my PTSD symptoms warranted a PT profile.
At a recent meeting, my commander said I needed to report to work to sign a Referral to Healthcare Counseling, he explained by phone that he wanted me to be seen by an AF psychologist because of my long absence from work.
My husband had to take off time from his work in order to drive me to base as my anxiety gets so bad it’s unsafe for me to drive on my own. When we met with the CC he presented the letter referring me to a new doctor, the letter accused me of missing medical appointments, refusal to complete training, refusal to PT test, and refusal to come into work. These accusations are all false, or at least highly misleading. Any and all work that I have missed has been while I was on convalescent leave. My attending psychologist records that I have been cooperative and working on my recovery in every way.
The referral letter listed many references; I read them all. (DoD Directive 6490.1, DoD Instruction 6490.4, Section 546 of Public Law 102-484, AFI 44-109) There is not a single reference to referring a member under the current care of a military health provider. In fact, all the regulations were written in such a way that clearly communicates that a commander is to use the referrel in order for the member to be evaluated, diagnosed, and given treatment. My psychologist, has not only evaluated me, diagnosed me, but has as written my NARSUM for my med board which has been underway for some months. I think it will be clearly seen that my commander is taking great liberties with the regulations he has cited, and is manipulating the evaluations process.
I expressed to my commander that forcing of me to see a new psychologist was effectively “Dr. Shopping,” considering that my case has been through my PCM, a psychologist, a psychiatrist, an AF psychologist, and an informal PEB, which initiated a formal PEB. By that count my case has been through five separate levels. After explaining this to my commander he expressed that he did not think I needed to be out on convalescent leave, and that had talked to another doctor (the one I have been referred to see) who believed if I was seen by them they could return me to work. I again expressed to CC that this was clear interference in my medical care based on his personal doubts regarding my current doctor’s prognosis, and it frightened me immensely that my command had so much control over my healthcare. I explained how many sessions and how much time I had spent on my recovery with my doctor that had led to her assessment that I continued to need convalescent leave, and how very traumatic it would be for me to rehash all the details once again with a new doctor. My commander informed me that the new doctor I would be assigned to had mentioned that it would not be necessary for me to go through the same sessions, but rather an assessment could be made to return me to work just by reading my records. My husband and I again explained that picking a doctor that had already agreed that I can be returned to work prior to even seeing me was clearly undue influence on my medical care. My commander reiterated that I had been out for a long time, and said this was not normal for PTSD. He said he did not agree with the way my current doctor was handling my care.
Additional info:
-One of the main points being made for this referral is the fact that my current doctor is not “Air Force.” However, she is DOD working IN my assigned MTF. This hospital is joint military, even if not solely AF, and treats the bulk of the military’s returning vets many of whom suffer from PTSD. Also, My doctor has already coordinated with an AF psychologist at the base I am assigned. She told My doctor that based on my records it was clear I was doing everything I could to recover.
-Another point being made is that my current Dr has not been able to “fix me” and return me to work. However, my doctor did speak to my commander, about the possibility of my returning to work, on more than one occasion. She told the CC I would most likely return to the work environment but be unable to perform any duties for some time and would need time to just overcome intense anxiety. The CC said that would not be possible (something I reminded him of at our recent meeting, and he again agreed that that was not a possibility).
-A major limiting factor in my recovery has been my inability to take medications, this is due to the fact that I am nursing my very young infant, and then just recently, became pregnant again.
-CC said he had spoken to my PEBLO about referring me to an AF mental health provider, my PEBLO said this was permissible based on an inaccurate reading of AFI 10-203. She said that AF Providers have “final authority.” However, My PEBLO was unaware that my case had already been signed off on by the AF side, when the AF psych reviewed my doctor’s recommendations and signed off on them. [AFI: 10-203 2.12.4. AF providers will only consider recommendations from civilian (non-MTF) clinical consultants that are related to, or describe, functional limitations. AF providers retain the final authority on deployment, medical retainability, and physical limitation recommendations 3.7. External duty limitations (civilian or sister service). All AF personnel must report
changes in physical status to their AF military medical unit. Duty limitations from a non-AF provider are a recommendation and must be entered on an AF Form 469 by an AF provider to be valid. AF providers retain final mobility recommendation authority.]
This is not a situation I ever anticipated I would be in, I am used to being the top ranked CGO in my unit receiving kudos for a job well done. In fact I was CGO of the year, at this very unit, shortly before I left to have my baby. I suffered a medical mistake that nearly cost my life and has had very terrible consequences, which have resulted in a med board and likely means the end of my military career. If this were not bad enough, now my unit is harassing me while on convalescent leave and infringing on my rights to unbiased medical treatment, and is overtly seeking new care for me that will prove to offer a diagnosis/prognosis that better fulfills the commander’s desires.
The PEB reg clearly state: AFI 36-3212 1.13. “Unlawful influence. No one may attempt to coerce or, by any unauthorized means, influence the PEB or the outcome of any disability case. “ Referral after already being treated is clearly unauthorized coercion/influence.
I'm very interested in your advice and or experience in similar situations!!