Navy Formal Board Advice

[kr1390]

Looking for some advice and input on my case. Without going into too much detail here is a little background:

O3 in Nurse Corps with 5 years of service. In March of 2017 I was hospitalized for a SA and medevac’ed to WRNMMC. History of a MST in March 2016 and diagnosed by several providers with PTSD from the MST, major depressive disorder and chronic eating disorder. I have been out of my rate as a registered nurse since March of 2017 and am currently in a non working patient status. In July, I was sent on no cost TAD to my HOR to be with my family and have a support system partially in thanks to a congressional case I have open with Senator Gillibrand.

My IPEB came back with a FIT finding stating that I had not been to a single appointment since July and I was “manipulating the system”. In July was when I went tad and my care transitioned from the MTF to a VA medical center where I have been extremely compliant with my treatment. Went to a formal board this past week which I did over the phone per a letter from my VA providers.

Formal board grilled me for over two hours and was bringing up small details from my notes that had nothing to do with my medical prognosis, such as the ability to care for my daughter (which I do with much help from my husband and family), travel over a year ago to the funeral of a very close friend (which I did with my husband who drove to WR to pick me up and drive 7 hours home to NY), and past career plans of resigning my commission at the end of my contract.

My attorney and I diligently worked to bring the focus back to the impacts my conditions have had on me in my occupational and social life , such as not being in a working status for over a year. I was told it would be 2-3 months for results.

One question I have is that I still have my congressional case open with Senator Gillibrand’s office, and I know one of her platforms is assistance to victims of MST. At this point should I reach back out to her for help and to inquire with the formal board? Or would that just make things worse.

Any advice would be helpful. The bottom line was I had all the medical documentation and providers recommendations for unfit, I have been told that the boards are harder on medical corps and officers which is why this is such a shit show.

 

[Chaps_Z]

Just a few thoughts and opinions that may or may not be helpful....

1) I'm sorry for your traumatic experience. No one should have to endure such a terrible thing.

2) When you transitioned to care at the VA facility, the AHLTA system should have shown your continued appointments and treatment.

3) It has not been my experience that the board is any harder on officers than any other. I went through as a staff corps officer and felt I was treated fairly. Experiences truly vary.

4) Congressionals work differently and many times much slower than even the PEB process. The congressional may help if the formal board finds you fit once again.

 

[oddpedestrian]

They slam officers in MST cases from what I read from the BCMR board alone your formal board sounds somewhat familiar. Making an educated guess I would say they feel leaders are responsible for protecting soldiers from these assaults and expect immediate reporting and police cooperation if victim yourself. If they sense you was complacent or is was partially consenting they treat you as a toxic leader. Read what happen to some of the women in the General Sinclair sex scandle the board was brutal.

 

[Jason Perry]

@kr1390,

I am sorry to hear that you were assaulted, your poor experience(s) with getting resolution with your case, and the issues you have faced overall. Here are my thoughts:

Looking for some advice and input on my case. Without going into too much detail here is a little background:

I understand not sharing everything or providing a lot of detail...that said, without full knowledge of your case, any input is necessarily limited.

My attorney and I diligently worked to bring the focus back to the impacts my conditions have had on me in my occupational and social life , such as not being in a working status for over a year. I was told it would be 2-3 months for results.

I quoted this twice, because I think it bears on several issues. First, I can't/won't second guess your attorney's advice.

It seems like a very bizarre and incorrect finding that you were found fit based on the circumstances you described. You mentioned your provider's/medical input supporting an unfit finding. I did not see any statement about what your commander recommended. What did your command state and recommend as to your ability to perform your duties? What profiles do you have? What are your limitations as far as clinical/licensing issues?

O3 in Nurse Corps with 5 years of service. In March of 2017 I was hospitalized for a SA and medevac’ed to WRNMMC. History of a MST in March 2016 and diagnosed by several providers with PTSD from the MST, major depressive disorder and chronic eating disorder. I have been out of my rate as a registered nurse since March of 2017 and am currently in a non working patient status. In July, I was sent on no cost TAD to my HOR to be with my family and have a support system partially in thanks to a congressional case I have open with Senator Gillibrand.

Does the above describe two separate Sexual Assaults? Or the SA was in MAR 2016, with the hospitalization in MAR 2017 as a result of complications/worsening of symptoms from the MAR 2016 SA?
Are there any issues/questions about your MDD/chronic eating disorder being service connected?

Was the hospitalization voluntary? Were you ever command referred for mental health evaluation?

I am wondering why the "no cost TAD." It seems to me that it should have been a paid move.

Do you have formal limitations on your clinical privileges? What about "informal limitations," (e.g., even if not explicitly limited, are there any memos, directions, orders, keeping you from performing patient care)?

My IPEB came back with a FIT finding stating that I had not been to a single appointment since July and I was “manipulating the system”. In July was when I went tad and my care transitioned from the MTF to a VA medical center where I have been extremely compliant with my treatment. Went to a formal board this past week which I did over the phone per a letter from my VA providers.

Are you an active duty member? If a reservist, have you been on extended orders?

Are you saying that you actually have had appointments that you attended since last July? If not, is this true, that you have not been treated since last July? Something seems wrong here...if you have been seen, did they not have your medical records documenting the treatment? If you have not been treated, this is not completely unheard of...I have had clients who flat out hated seeing doctors or providers (it was essentially exacerbating their conditions to seek treatment and the treatment that was received did not help). Still, I need to understand what is going on with this issue. At a minimum, a VA provider apparently opined that telephonic appearance at the FPEB was in your health interest. I don't get the disconnect between the IPEB stating your have not been seen since last year, and the apparent situation suggesting that you have been seen.

Formal board grilled me for over two hours and was bringing up small details from my notes that had nothing to do with my medical prognosis, such as the ability to care for my daughter (which I do with much help from my husband and family), travel over a year ago to the funeral of a very close friend (which I did with my husband who drove to WR to pick me up and drive 7 hours home to NY), and past career plans of resigning my commission at the end of my contract.

Two points here- your fitness to perform your duties is the main issue, not prognosis. It is important that you track the baseline issue for the PEB.

Second, the past career plans to resign may have hurt your case. It may be true that these were your plans, but, it does not help your case for the board to have known about it or focused on it.

I wonder what your MEB stated. That is a key issue and the findings of the MEB would shape how to approach the case overall. See my next comment for more.

My attorney and I diligently worked to bring the focus back to the impacts my conditions have had on me in my occupational and social life , such as not being in a working status for over a year. I was told it would be 2-3 months for results.

Did you use assigned military counsel or private civilian counsel?

I can't suss out what happened in your case. I am not sure what was in your MEB, but, I also have doubts/questions about the choice to have you testify given what may or may not have been in your MEB (and the MEB's findings and recommendations). Something seems off, but, I can't tell without knowing more about your case.

2-3 months for a decision seems long by far. I am not sure why it would take more than a few weeks at most. This makes me lean towards thinking that somethign is "off" in your case.

One question I have is that I still have my congressional case open with Senator Gillibrand’s office, and I know one of her platforms is assistance to victims of MST. At this point should I reach back out to her for help and to inquire with the formal board? Or would that just make things worse.

Based on what you have stated, I don't see how reaching back out would help. You don't have a decision yet, so, I don't see how reaching back out would help your case and it could, potentially, hurt it (again, based on what you have stated). Maybe it is something to consider later, if you get a poor outcome. However, I would tend to think you should wait until exercising your appeal rights (PFR), before seeking additional help from your Senator. I don't see much that an inquiry could help with at this point in time. Again, I don't know enough about your case to offer definitive input.

Any advice would be helpful. The bottom line was I had all the medical documentation and providers recommendations for unfit, I have been told that the boards are harder on medical corps and officers which is why this is such a shit show.

Not to beat the dead horse again, but, I don't know enough about your case to say for sure. That said, I am not sure that being medical corps or an officer is the cause for the "shit show." I suspect that there are issues that have not been properly addressed in your case.

I hope this was helpful and that you ultimately get your desired outcome. Best of luck!

 

[johnbgately]

Jason's comments are spot on, as usual, but I will say that my experience representing clients in hearings at the Navy Yard is that it is harder for medical providers and JAGs to be found Unfit. It is possible, but requires solid non-medical evidence in addition to providers' notes, narrative summaries and speciality addenda. A solid NMA is usually not enough and typically needs to be supplemented by non-medical evidence letters from peers and supervisors, often backed up by live or telephonic testimony from the individuals whom your counsel determines will best support your case. If you have not yet received a decision from the FPEB , then your counsel should be able to inquire through the FPEB admin staff as to where things stand in the adjudication process. It may well be that the case is under review by Mr. Reeser- the PEB President- or even by Mr. Riehl at the CORB level to determine whether it needs to be sent back for further development or if the initial legal and quality review found the board's rationale to be lacking. If it has been sent off to the D-RAS Rating Activity, then your present counsel should be able to ascertain that info with a quick phone call or e-mail to LNC Price or LN1 Cowan. If an adverse decision is issued, then you will need to work with your counsel on a Petition for relief. ("PFR"). As for Congressionals, they rarely make a difference in such proceedings and are premature when a decision has not yet been issued. If you do intend to file one, please review it with your present counsel so that he or she is not blindsided by it

 

[kr1390]

It seems like a very bizarre and incorrect finding that you were found fit based on the circumstances you described. You mentioned your provider's/medical input supporting an unfit finding. I did not see any statement about what your commander recommended. What did your command state and recommend as to your ability to perform your duties? What profiles do you have? What are your limitations as far as clinical/licensing issues?

My command wrote on my NMA that I was unfit and unable to perform my duties as an officer and a nurse. I had been placed on LIMDU 3 times, which in my limitations stated unable to perform patient care, deploy or handle a weapon.

Does the above describe two separate Sexual Assaults? Or the SA was in MAR 2016, with the hospitalization in MAR 2017 as a result of complications/worsening of symptoms from the MAR 2016 SA?

I'm sorry, the SA was suicide attempt, not an additional assault. And I was recommended for behavioral health evaluation by my command initially in JAN2017.

The no cost TAD was because I was returning to my HOR where my husband and family were located. I was told my command would be more likely to endorse sending me to my HOR if they didn't have to pay me for it. To make matters easier I didn't fight it since I was 8 months pregnant at the time and wanted to deliver where I had family support.

Are you an active duty member? If a reservist, have you been on extended orders?

Are you saying that you actually have had appointments that you attended since last July?

I am active duty, and YES I have attended regular appointments every 1-2 weeks since July. July was when my TAD started, and I transitioned my care from WRNMMC to the VA. Before my PEB, I asked my PEBLO if I needed to provide copies of my VA records, in which she told me NO, they had access to them. This clearly was not the case, and after the PEB came back with a FIT finding, I then had to sign medical releases and fax all my VA VISTA notes to my PEBLO.

MEB recommended UNFIT and stated there was substantial evidence to support this, which my attorney reiterated to the formal board. My counsel was military appointed.

I understand this is very confusing and seems off, I feel the same way. I have done everything my legal counsel has instructed me along the way as well as follow advice from the MEB office in Bethesda. At this point, I don't know if I am doing something wrong or if I am being mislead. Any advice is extremely appreciated.

 

[Matt Kozyra]

To piggyback off of Jason Perry and Jack Gately's comments, above, there is one unusual aspect to Medical Corps officers' cases in the Navy. That comes from SECNAVINST 1850.4e, section 3704. It imposes additional hurdles for a Medical Corps officer to overcome in order to be found Unfit. The section doesn't apply to you as a member of the Nurse Corps, but it's been my impression that the Navy Board tends to hold Nurse Corps and MSC officers to a similar standard for policy reasons. Without getting too deep in the weeds, it's harder for a medical officer to be found Unfit, by instruction, than any other specialty in the Navy.

It's also worth mentioning that it's harder to be found Unfit in the Navy than in any other branch of service. The last numbers I have are from January, but the rate of Fit findings that month were:
Army: 2%
Air Force: 5%
Marine Corps: 16%
Navy: 30%

Those numbers are pretty typical over the last two years or so.

So, if you're scratching your head and asking why the Board ignored your providers and your chain of command, it may help to know that approximately one out of every three people referred to the Navy Board is in the same boat. If that doesn't help, and instead just makes you more mad, then you're in good company. We're all pretty peeved about it.

I agree with Mr. Gately and Mr. Perry that you're too early in the process to get a Congressional spun up, and that there tends not to be any action taken as a result of them. I've had a number of clients write their Senators, and the Board just writes back a generic "we're doing everything right" letter. I don't think I've seen one actually change the result before.

To Mr. Perry's point about the timeline, 2-3 months is actually good news. The Board has been getting their decisions written and signed off within a few weeks, lately. But if you're found Unfit, the case then needs to go to the VA for rating. That can take another month to two months. So, while it's definitely hard to wait, the longer it takes for your case to come back, the better the result likely is.

Best of luck!

 

[concernedwife]

kr1390, hope that all is well. I know you and I spoke a few times, so just wanted to update you a little here.

My husband's FPEB, as you know, was 8 MAY and he received yet another FIT finding yesterday. We were told the same things being conveyed here - that if you're being told it would be 2-3 months, that's a good timeline to have; whereas FIT findings [most of the time, not all] are coming back within a sooner timeframe. I could be wrong, that has just been our experience. [Everyone's experience is different, timeline wise - but I know you're same branch as my husband, so figured it may be helpful] We are contesting this as well, due to his rationale being completely misleading, where they took a few sentences from a statement and pieced them together to "fit an agenda" against my husband getting an UNFIT finding. It's rather baffling, honestly.

At this time, I'm not sure if we're shaking our heads at this more so than everyone else involved in this process [command, doctors, neuro, etc] but - keep up the good fight. It's all we can do.