Outcome of IPEB, should I request formal PEB?

JBALLS77

JBALLS77

PEB Forum Regular Member
US Army, SGT, 6 years, USASOC
I am curious, just received my PEB proceedings from Walter Reed and was given 50% for PTSD, TDRL, with its cause being by an instrumentality of war and onset occuring in combat theater. My concern is the basis for the MEB referral was for chronic dysphagia. My real diagnosis is a functional GI disorder from UNC at Chapel Hill, of course this does not exist to the DoD so they went with dysphagia. The PEB ruled that it was not rated, not unfitting, and the mere presence does not result in an unfit determination. I was treated for GERD via medicine for three plus years over four combat deployments. In January 2009, it was decided to go in and look and a 4 cm hiatal hernia was found as well as no stomach valve. I had Nissen fundoplication surgery Feb 17, 2009 at Womack Army Medical Center and have never recovered. I am still on an all liquid and ice cream diet and receive weekly treatments at UNC Chapel Hill as a result of never recovering from the surgery. The Army states it is all mental and too toughen up. UNC, the premier GI center in the region diagnosed me with Brain-Gut dysfunction/Functional GI disorder. Anytime I eat, I vomit, and am in a biofeedbackback program to help the condition but no success yet. The question I have is would you fight this with already getting 50% TDRL for PTSD. My close friends say to not bother but this is my main condition and I do not understand the non rating. i have 7 days remaining to turn in my proceedings to my PEBLO, anyone have any advice.

James
 
50% with TDRL sounds great but if you have other medical problems that didn't get rated then I would fight it. Remember, you need to supply new medical evidence to support your claim to why you believe you need an increase.

My question is... what did the VA rate you because that's the important factor???

Also, DOD will rate the medical issues if it makes you unfit for the military. VA rates for everything that happened to you while on AD.
 
The call to fight it is yours. However, keep in mind that since you were diagnosed, treated and rated at 50% for PTSD (PTSD is an unfitting factor and is ratable at not less then 50% and placement on the TDRL [FYI... The verbiage is something like "a mental impairment caused by combat" which is minimum 50%]). I can't remember who posted the link (I'll try to find it) but, appeals to the FPEB board had approx a 93% chance of staying the same or being increased. So, the odds are definitely in your favor. I think that since the wrong diagnosis was placed in your package, you would have a strong case to be rated under a different code in which the residual effects are evaluated and rated. However, this will definitely extend your time on AD and in either case you will still be placed on the TDRL due to the PTSD (so the army can re-evaluate it down the road). Let us know what you decide and good luck!
 
JBALLS77,

Welcome!

A few points-

PTSD is rated at the minimum of 50% due to this VA regulation (so you know it applies to both military and VA):
38 CFR 4.129, "When a mental disorder that develops in service as a result of a highly stressful event is severe enough to bring about the veteran's release from active military service, the rating agency shall assign an evaluation of not less than 50 percent and schedule an examination within the six month period following the veteran's discharge to determine whether a change in evaluation is warranted." So your only real possible bad outcome is if they found you fit due to PTSD. I am guessing that this is not very likely.

Under current law, because you do not have more than 20 years of service, you don't qualify for CRDP. However, for your combat-related conditions, you do qualify for CRSC (though this benefit is limited to the max of your years of service times 2.5% times retired base pay) What I would do is compare what additional benefit a higher rating combining your GI condition with PTSD would net. I tend to think, given your rank and years of service that there may not be much of a benefit, compensation wise.

That being said, even if there were no or little financial compensation to getting your GI condition rated, I would consider one other factor. Depending on the severity of your PTSD and your future response to treatment, after the TDRL re-evaluation, you may find that having the additional GI Condition rated to be helpful for ultimately getting a final retirement finding.

To sum up, seems like you face a relatively small risk (but a risk, nonetheless) of a negative/worse outcome of the Formal PEB. On the other hand, there may not be a financial net benefit to a higher rating given VA and DoD rules against dual receipt of compensation. Even if there is no financial benefit, there is a benefit to having the additional GI condition rated because it increases your chances for eventual retirement if your PTSD rating is lowered at a later evaluation.

Hope this helped and that you get a great outcome.
 
How strong is your case for PTSD? As a fellow sufferer I'm not trying to make light here, but my concern would be that being on TDRL you would get reassesed and the PTSD rating would drop before you get to PDRL. I don't think you'd ever get to a fit rating...but it could drop below the magic 30% mark. I'd say if you have GOOD evidence for your GI problems (which it appears you do)....take it to the formal. On the formal, I'd just attack the arguement that it is fitting. Explain fully how it impacts your position. I mean really...are you supposed to eat ice cream & liquid on deployment? You go to UNC now great, but what about at your next duty station....how are they going to support that? Are you putting others at risk because you can't do your job? You are in USASOC....have you missed a significant amount of time from work because of this? Does this cause any restriction to your duties? Oh yeah, I'd fight it and win

BTW....this is just my .02 cents. I am feeling rather fiesty this evening. Please also listen to the "experts".

Nate
 
I know it has been a long time but the saga finally finished. Appeared at the Formal PEB at Army's Cornerstone of Medicine WRAMC with great evidence and a witness in April. Verdict, same 50% but combined PTSD and and Brain Gut dysfunction stating the PTSD worsened the Brain Gut. The USPDA concurred and my DA 199 reflected 50%. I then wrote an appeal asking to spilt the two conditions asking for a higher rating for the PTSD, 70%, and rate the Brain Gut (dysphagia) to 7203 Esophagus, stricture of: Permitting passage of liquids only, with marked impairment of general health. It came back denied again from WRAMC dated 12 May 2010 with a retirement date of 18 AUG 2010. Then boom, this email this morning:

Good morning,

I have received a DA 18 to your case. The PDA has made a change to your
findings and have given you 70% for the PTSD & 50% for the Esophageal
stricture, which makes it a combined rating of 90%, TDRL.

My advice to all, put the dice in your hands, blow, then throw. If anyone needs help or wants to read the documents including you Jason, just send me a PM.
 
Congratulations! Way to stick to your guns and persevering.
 
Way to go!
 
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