NARSUM Review Strategy | Seeking Guidance

S

soonami

PEB Forum Regular Member
Registered Member
Hello,

I will be receiving my NARSUM any day and wanted to post a thread to begin a discussion regarding NARSUM Review Strategy. When in IDES, I know SMs have the ability to:

-Conduct NARSUM Review/Initial Signature (starts 5-day timer)
-Seek Legal Guidance
-Provide Personal Statements/Evidence
-Request an IMR
-Request a Rebuttal to the IMR

My inquiry here revolves around the best strategy for dissecting the NARSUM IOT posture for the best "defense" if/when an IMR/Rebuttal are requested.

Here is my understanding for what to look for when reviewing your NARSUM, regardless of whether you leverage gov provided legal counsel, have your own private lawyer, or plan to represent yourself with something as simple as creating/signing an MFR for items you disagree with:


1.) Check for any "Baseline Documentation" errors such as dates of service, misspellings, etc

2.) Dispute the UNFIT (Diagnoses NOT Meeting Medical Retention Standards) conditions listed on the NARSUM if necessary; the doctors are supposed to reference AR 40-501, para 3-31 (Army); if a SM feels like 1 or more of their other conditions are in fact UNFIT, this is something you want to fight for as it affects your future 199, DOD% (crucial especially if you have less than 20 years AFS), etc

3.) Review all FIT (Diagnoses Meeting Medical Retention Standards) conditions; compare this list with your initial VA claim that you submitted through your MSC; make sure no conditions are missing when compared to the conditions your claimed which then triggered C&P exams; also, see if any of these conditions were listed as "Claimed Condition: No VA Diagnosis" when in fact you know you have a diagnosis in your medical records; the VA examiner could have missed a diagnosis when reviewing your medical records and therefore provided an inaccurate DBQ which contributed to the NARSUM doctors (Psych & Gen Med) capturing inaccurate information on NARSUM; if you have a diagnosis for a condition where your NARSUM states you don't, fight this


From my understanding, the above content (1-3) seems to be the meat and potatoes to NARSUM review. That said, I wanted to post this in hopes of receiving feedback from personnel who have gone through this experience who want to rebut me, add additional items to be on the look out for, share strategy, share their experience and things they "wish they would have known", etc.

Any information regarding the above content will be appreciated. Thanks!
 
soonami said:
Hello,

I will be receiving my NARSUM any day and wanted to post a thread to begin a discussion regarding NARSUM Review Strategy. When in IDES, I know SMs have the ability to:

-Conduct NARSUM Review/Initial Signature (starts 5-day timer)
-Seek Legal Guidance
-Provide Personal Statements/Evidence
-Request an IMR
-Request a Rebuttal to the IMR

My inquiry here revolves around the best strategy for dissecting the NARSUM IOT posture for the best "defense" if/when an IMR/Rebuttal are requested.

Here is my understanding for what to look for when reviewing your NARSUM, regardless of whether you leverage gov provided legal counsel, have your own private lawyer, or plan to represent yourself with something as simple as creating/signing an MFR for items you disagree with:


1.) Check for any "Baseline Documentation" errors such as dates of service, misspellings, etc

2.) Dispute the UNFIT (Diagnoses NOT Meeting Medical Retention Standards) conditions listed on the NARSUM if necessary; the doctors are supposed to reference AR 40-501, para 3-31 (Army); if a SM feels like 1 or more of their other conditions are in fact UNFIT, this is something you want to fight for as it affects your future 199, DOD% (crucial especially if you have less than 20 years AFS), etc

3.) Review all FIT (Diagnoses Meeting Medical Retention Standards) conditions; compare this list with your initial VA claim that you submitted through your MSC; make sure no conditions are missing when compared to the conditions your claimed which then triggered C&P exams; also, see if any of these conditions were listed as "Claimed Condition: No VA Diagnosis" when in fact you know you have a diagnosis in your medical records; the VA examiner could have missed a diagnosis when reviewing your medical records and therefore provided an inaccurate DBQ which contributed to the NARSUM doctors (Psych & Gen Med) capturing inaccurate information on NARSUM; if you have a diagnosis for a condition where your NARSUM states you don't, fight this


From my understanding, the above content (1-3) seems to be the meat and potatoes to NARSUM review. That said, I wanted to post this in hopes of receiving feedback from personnel who have gone through this experience who want to rebut me, add additional items to be on the look out for, share strategy, share their experience and things they "wish they would have known", etc.

Any information regarding the above content will be appreciated. Thanks!
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You are definitely on track! Most times you won't get them to change anything but the key is to dispute anything you believe to be incorrect throughout the process. It will help you build your case for a FPEB later on. My wife challenged the combat related designation with a NARSUM rebuttal that her private dedicated attorney had written up. When it was time for a FPEB she felt she had the best chance possible to get a favorable FPEB designation due to preplanning and challenging anything incorrect throughout the process. She did get one condition changed to combat related by the FPEB so it was totally worth it to have her chapter 61 pension to be exempt from federal taxes!

Also, if you were to get denied from a FPEB there is 1 new last appeal you can do after the FPEB that most soldiers don't know about that is in the AR. You can appeal again if need be. The reason to fight for the right outcome even if you lose through the end is that you then can explore other options to remedy it after you are out such a a ABCMR etc!
 
Provis said:
You are definitely on track! Most times you won't get them to change anything but the key is to dispute anything you believe to be incorrect throughout the process. It will help you build your case for a FPEB later on. My wife challenged the combat related designation with a NARSUM rebuttal that her private dedicated attorney had written up. When it was time for a FPEB she felt she had the best chance possible to get a favorable FPEB designation due to preplanning and challenging anything incorrect throughout the process. She did get one condition changed to combat related by the FPEB so it was totally worth it to have her chapter 61 pension to be exempt from federal taxes!

Also, if you were to get denied from a FPEB there is 1 new last appeal you can do after the FPEB that most soldiers don't know about that is in the AR. You can appeal again if need be. The reason to fight for the right outcome even if you lose through the end is that you then can explore other options to remedy it after you are out such a a ABCMR etc!
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Awesome! Thank you for sharing this information! Much appreciated! I'll definitely document ALL ISSUES and as you say, even if nothing is changed during IMR/Rebuttal, at least my rebuttal is attached with my packet and continues onto the PEB.
 
soonami said:
Awesome! Thank you for sharing this information! Much appreciated! I'll definitely document ALL ISSUES and as you say, even if nothing is changed during IMR/Rebuttal, at least my rebuttal is attached with my packet and continues onto the PEB.
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Also, you can continue to build your case on the outside. For example, if you think another condition is unfitting but don't have a profile for it that is a red flag! The AR is one thing but the PEB rules based on what actually prevents you to do your job so if you are thinking of challenging another condition to be changed from fitting to unfitting make sure to have a profile for it that later on you can submit to the PEB showing actual limitations documented:). You can do the same things with private docs. If you have a private doc that will attest that a certain condition would prevent you from doing certain activities that you know are needed to do you job then it can be inferred that the condition should be unfitting:)

I have yet to find a Soldier who wasn't happy with their outcome when they were proactive throughout the entire process!

*Qualifier..... If you are trying to get an outcome that isn't reasonable you won't have a chance! Anything you are trying to add should be something any logical person could take a position on since the evidence created a narrative that produced the conclusion that you are arguing for. Also, I always recommend checking out a private attorney as they are dedicated to your case and are working on it throughout the process instead of a free JAG that just will review things for you if you choose to consult them. It's the difference between being proactive and reactive and it is huge!

Lastly, the longer you have been in the more you have to lose (or gain)! My wife had 17 AFS and was an O4 so it was super scary to get that far and possibly lose it all with a crappy consolation prize of a severance payment that would be recouped by any VA compensation received those unfitting conditions.
 
I am active duty Marine, with almost 21 years active duty time. I have been waiting on my NARSUM for over 15 work days, I had a lot of claims. Based on the results from my C&P appts it is clear they did not do a thorough review of my records, so I am confident I will have to appeal or do a rebuttal letter, not sure of the proper terminology. Hopefully it helps for me to match my claims to my medical records.
I'm wondering how a 1 hr va exam is supposed to determine if I have a condition or not? When they ask for evidence, will a direct correlation to a medical diagnosis be enough? I didn't claim anything that wasn't in my medical record.
 
USMC2002 said:
I am active duty Marine, with almost 21 years active duty time. I have been waiting on my NARSUM for over 15 work days, I had a lot of claims. Based on the results from my C&P appts it is clear they did not do a thorough review of my records, so I am confident I will have to appeal or do a rebuttal letter, not sure of the proper terminology. Hopefully it helps for me to match my claims to my medical records.
I'm wondering how a 1 hr va exam is supposed to determine if I have a condition or not? When they ask for evidence, will a direct correlation to a medical diagnosis be enough? I didn't claim anything that wasn't in my medical record.
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If you have active duty regular retirement earned you really have nothing to lose since you will qualify for CRDP as long as your VA rating is 50% or higher. You can only challenge VA ratings via a VARR for unfitting condition. However, once you get out you can appeal any VA conditions not properly rated once you are no long active duty.
 
This was excellent information. I was referred for neck/upper back/pain and upper extremity radiculopathy. These were referred and I had a P3 for them.

CPs came and went and received NARSUM. Cp came back a “cervical strain” which was incorrect, initial P3 was for thoracic pain. NARSUM basically blew off upper back pain. Evidence “baseline documentation” had NONE of my treatment records or MRIs under diagnostic images.

Was referred for upper extremity radiculopathy. The CP stated bilateral radiculopathy..not even a peep on the NARSUM.

Good info. Talking with legal tomorrow
 
Most cases are NOT complicated and result in fair results. A risk reward analysis should be considered before taking action. What does a NARSUM do or fail to do in an individual’s case must be explored. The best course when you have concerns might be to consult free legal counsel.
 
Provis said:
You are definitely on track! Most times you won't get them to change anything but the key is to dispute anything you believe to be incorrect throughout the process. It will help you build your case for a FPEB later on. My wife challenged the combat related designation with a NARSUM rebuttal that her private dedicated attorney had written up. When it was time for a FPEB she felt she had the best chance possible to get a favorable FPEB designation due to preplanning and challenging anything incorrect throughout the process. She did get one condition changed to combat related by the FPEB so it was totally worth it to have her chapter 61 pension to be exempt from federal taxes!

Also, if you were to get denied from a FPEB there is 1 new last appeal you can do after the FPEB that most soldiers don't know about that is in the AR. You can appeal again if need be. The reason to fight for the right outcome even if you lose through the end is that you then can explore other options to remedy it after you are out such a a ABCMR etc!
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Where does the law state that military disability retirement has to be combat related in order to receive tax free treatment? Combat related is one requirement. The other is on application, a veteran is able to receive VA compensation. Why is the second requirement always overlooked?
 
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