jason..or anyone with experience please help

hey guys ...my tdrl re eval isnt for a few months but i have been curious about something. ive talking to my psychiatrist and phycologist about writing recommendation letters for me when my eval comes around for generalized anxiety disorder..they have agreed and i do have a good relationship with them..but what i am curious is how i should tell them to write it..what should i have them write and what are some good things based on people with experience opinion. i was thinking of giving them both a copy of the VA rating schedule for mental health disorders and finding where my symptoms fall into most and in their letters write word for word what the rating schedule says ..so that there is no question to the PEB what percentage i should be at. since my doctors wrote word for word what symptoms i have from the rating schedule itself. also i figured i would have them include words such as "chronic" "stable" and words like that. any opinions..on what else i should have them say, add, and if you think im correct or not is greatly appreciated. thanks in advance guys...please help!
 

italianguy4

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thank you..so do you reccomend that i print this out and ask them to basically fill in the blanks for a recommendation letter?
 

Jason Perry

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It may just be semantics or word choice, but I would not think of this as a "Recommendation letter." If it comes off as something that is advocating an outcome, it may be rejected as not being objective. It is more a "clinical resume" or just an objective recounting of your current condition based on the worksheets linked above.

The important thing is that the information in the worksheet is covered. But, review it before you submit it...if it seems like it is not accurately covering the severity of your conditions it may end up causing you to get a low rating.
 

italianguy4

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thanks jason thats good to know...so do you recommend that i print out that worksheet and give it to my doctors to write it up and then submit it to the peb at my re eval? ...so not so much a letter but just ask my doctors to follow and answer the worksheet?
 

Jason Perry

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The important thing is that the information in the sheet is covered. Whether to submit it at the TDRL re-val will depend....some doctors that the re-eval would take it and use it as a basis for their findings. Others would not (and may not even look at it...though, if they don't it raises interesting legal questions). In that case, you would have to submit it directly to the PEBLO.
 

italianguy4

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oh wow so i think i havnt been understanding this whole tdrl re eval this entire time. i thought that all of my medical records from my private doctors and va findings etc was all directly submitted to the PEB by me myself. i didnt know i bring it to the examiner and he/she submits it at their own discretion....so when i go for the eval...my examiner is the one who will write up a narrative summary based on what i say, my medication list, etc. and then make a recommendation and send it up to the PEB? and also say he/she didnt accept my private medical records how would i go about submitting my evidence such as a VA award letter, copy of c&p exam, medical records, and all of that to the PEBLO. my anxiety is kind of up now..i thought i had this figured out but it looks like i was wrong
 

maparker

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Your Service will direct a TDRL exam but you always have the right to submit whatever you like directly to the PEB. You can read about TDRL requirements and processes in DoDI 1332.38 as well as in your Service's DES manual.

Mike
 

italianguy4

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thanks mike...i read over the tdrl section in the dodi...still a little confused on some things. so basically my tdrl examiner will be the one to write up the narrative summary? and then my other medical records will be submitted to the examiner to be submitted to PEB? also..in your opinion or anyones opinion who has already been through this...what do you recommend i bring to the tdrl examination and also what do you recommend my doctors write when they fill in the worksheet for me as a "clinical resume" as jason said. i am trying to get a PDRL finding so i figured the words stable and chronic are important. any input to help would be great...i want to be very prepared..thanks everyone
 

italianguy4

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anyone have any experience with tdrl re evals with the airforce? and if you did how did you go about turning in your records , letters, etc. just an overall explanation of how the examination works is greatly appreciated !
 

newpeblo1

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I'm not sure I understood all of what you were saying, but I'm an Army TDRL PEBLO, and this is how we do it at our facility: First, we talk to the service member (SM) to ask at what facilities you've been treated since being placed on the TDRL. We ask about any new medical conditions you feel need to be evaluated. I get a signed Release of Medical Information form, and get a copy of all your records. Then, I scour the records to make a list of medical conditions that need to be evaluated along with the ones listed on your DA 199, 3947 and w/in the NARSUM. I then talk w/the SM again about this list and make sure we're addressing everything that needs to be evaluated. I request referrals for the examinations, and send a packet of info. regarding each condition to send to the evaluating doctor. It includes a copy of the 199, 3947, NARSUM, and any medical notes relating to that condition for which the doctor is evaluating you. I also include the VA worksheet for that condition for the doctor to use as a template for the report. Generally, the closer they stick to the template, the better the report. Then, I spend the next few months waiting for/checking up on your appointments and chasing paper (i.e. getting copies of those reports). Depending on which facility we're dealing with, this can be the most challenging part...getting those reports! Once they're all in, I review them for completeness/accuracy and appropriate signatures and send them, along with some of your background info., radiology reports and medication profile to our MEB doctor. He writes a consolidated summary and we send that to the deputy commander for clinical services, who offers his opinion as to whether or not the SM's conditions are stable for rating purposes. We then send the whole thing to the SM for you to review and concur or nonconcur-rebutt. Once I get that back from you, it all goes down to the PEB. Right now, our PEB is taking aobut 90 days to adjudicate, and I wouldn't be surprised to see that time-frame increase based upon the backlog of cases and a physical relocation of the office. The whole process can take close to a year, but it really varies on a case by case basis. If I can get my SM's to our MTF for their appt's., we'd be ready to go in a month or two. Anyways, hope this was helpful, and good luck!
 

italianguy4

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wow so for army it has been taking 90 days after the tdrl re eval to get a new decision back?
 

carnelli53

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Very informative newpeblo1! Thanks for going in to such detail concerning the process. I'm sure it isn't always efficient to get the consolidated reports from the commander/doctor on the MEB side either.
 

newpeblo1

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Well, not exactly...90 days once the peb has the case.
Your evalutions could be complete, but we may not have the reports. Once we get them, we have to wait for a consolidated summary (depending on the caseload, this may take up to a month at our facility). Actually, our MEB doc is really quite good... But we don't like to rush him b/c he really does read EVERYTHING and writes a very thorough summary. The commander usually gets his part back to us w/in a day. When we get the OK from the SM back after you've read anything, then we send to the pen immediately and our 90 day timeline starts...this is our timeline, but I don't know if it's better or worse elsewhere...
 

italianguy4

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i see.. ok reading over that more...i dont know if air force does it the same way as army but probably similar...once the case goes to the commander and say he decides it isnt stable for rating purposes are you just kept on tdrl for another 18 months? also...the medication profile if i have been getting my scripts from private doctors im going to have to get a copy of that for you right?
 

Marine32

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I just had my TDRL eval and it was an effortless experience... a little to effortless to be honest with you, but I didn't care because I was hoping to be found fit.

Marine Corps/Navy 1st TDRL eval: In January, I received a letter in the mail notifying me that my TDRL eval was going to be scheduled by the end of April. Around March 15th I received a letter saying my 1st appointment was on March 30th at Camp Lejuene (about 40 miles from me). I called up the PEBLO to let them know that I may not be able to receive all of my medical records by then, and she told me just to bring what I have. Now, If I was wishing to be found unfit this would be a problem. I was surprised, but I told her ok. Basically, I had my first appointment on the 30th of March, and they recommended I be returned to duty, and I had my second and final appointment on April 7th, and they recommended I be returned to duty. I received the write-ups by both examining physicians, and now I'm just waiting. They didn't submit any medical records. I brought in some, but they didn't even look at them lol. They said they have never seen anybody who wanted to return to duty. Now, I am just waiting.

Italianguy4... for your eval just make sure you have all of your medical records since you went on tdrl, and just make sure any recommendations/write-ups you bring are tailered to your fitness, and the VASRD. And saying your condition is stable would definately help. Good luck!
 

italianguy4

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thanks marine..thats what i plan to do and hope it goes well...peblo if your on...where would i get my medication profile on and does that just show what medications im on and the dosage?
 

newpeblo1

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Hello again! You can get a copy of your medication profile from your doctor's office or, even better, your pharmacy. If you get this from your pharmacy, ask them to make sure it includes your fill/refill dates (which shows you comply with your treatment. W/regard to your other question...if the commander states that he/she feels your condition is not yet stable, your case will still go to the PEB for them to decide...they don't always agree. Bear in mind that if you disagree with the commanders opinion, you can say so (and should) in writing on your statement of election form. That's what we send to you for review with your packet before everything goes to the PEB.
 

newpeblo1

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And yes...the med profile should include everything...the med, dose, frequency, etc. and dates. If you fill your prescriptions at a VA or MTF, we should have that for you, otherwise, we can request it for you with a release of information, but it's quicker if you get that and send to us. Also, you may want to wait to get that until your evals are complete, otherwise we'll just need an updated one later on in the event your meds change.
...I've never seen anyone who wanted to return to duty, either :)
 

italianguy4

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PEB Forum Veteran
so if i get scripts from a private pharmacy i would get it from them? or i get it from my doctors?
 
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