Physicians Meeting Hospital Credentials as Fit Finding?

chaplaincharlie

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I think that is a key point. As a physician, I am focused on the MEB aspect, but you are right - they are dead locked to keep me on AD even though I do less than 2 hours of work per day.
I am not against you, just making an observation. However, I believe the treatment docs are receiving is not IAW DoD policy.

DoDI 1332.18 says in part "c. The standards for all determinations related to disability evaluation will be consistently and equitably applied, in accordance with Reference (c), to all Service members, and be uniform within the components of the Military Departments. "

I am NOT an attorney, but I believe the conduct of the PEB is operating outside the DoDI. Perhaps the IG should investigate the PEB's compliance with DoDI.
 

maruchan

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There was another post by an AF physician this past week - that officer noted they were found unfit, which seemed to be a surprise. I would be curious to know your thoughts on that case in relation to OP's predicament chaplaincharlie. Are there service specific rules regarding fit/unfit findings for MC officers?
 

arthursz

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I don't believe there are service specific rules. I was also found unfit for 3 conditions, but they still opted to retain me. Can you point me to that physicians post? I could find it.
 

arthursz

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During the process, I had two additional conditions neurogenic thoracic outlet, bilateral, and l5-s1 radiculopathy added to my permanent profile. I submitted the new conditions with my request for Formal PEB, and they kicked my packet back to MEB for additional exams, narsum, and decision on those conditions.
 

docjester9

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Got my appeal denied for unfit finding/FPEB. I submitted documentation from my ED visits a plus letters from my Mayo Clinic doc and my fellowship director. At this point not sure what to do. As was mentioned above I think the rules are not applied to medical personnel as they are to everyone. I’m going to enter this cycle now of being waived from every physical fitness test and then getting referred again for PEB and also implications of being nondeployable and outlook for promotion are abysmal as I won’t be able to promote and basically feel like an indentured servant at this point....
 

maruchan

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Sorry to hear that. What was the reason for the fit finding per the IPEB? There is an Army specific clause in 635-40 that MC officers cannot be found unfit solely due to geographic limitations (which by my interpretation was superseded by the DODI requiring all Soldiers to be worldwide deployable). If your comfortable with it, could you elaborate on the IPEB findings?
 

arthursz

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DocJester, sorry to hear it, it is frustrating. Maruchan has a wealth of knowledge on this stuff as does Jason Perry. I have used both of them and found it to be extremely helpful. Unfortunately, I am not the expert here and learning every minute. This board has pointed me in the right direction. I wish you luck, on my side, they want me to stop, but I get the idea that with each appeal they are actually reading it now. The first go around, I felt like the PEB just rubber stamped. Now I feel like it is really being evaluated. I would just say push on if you have it in you. I know what it is like to feel the pressure of being non deplorable, they nearly force you to sign waivers, and when you get over there, you cannot limit yourself from doing what is ordered. It is an difficult time right now with the op tempo, but the root of it is you. You have to fight with what is right for yourself. Good luck.
 

docjester9

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The reasons listed were that I haven't missed work thus far or my "quality of care" hasn't been impacted. This was decided in spite of the NMA and NARSUM both unequivocally recommending separation. In my appeal, I included a letter from the physician I was seen by at the Mayo Clinic reinforcing the recommendation and also a letter from my fellowship director who was aware of my diagnosis and directed me to evaluated in the ER at their hospital during a bout of chest pain. I have since been to the ER again ( as I was instructed to do so any time I feel something out of the ordinary). I have cancelled a case because of this in the past as well and documentation was provided to support this in the appeal letter and still the appeal for FPEB/finding of unfit was denied. Currently I will be permanently waived from participating in the physical fitness test and also be permanently nondeployable. The disability attorney suggested at this point that this will not be prejudicial for promotion, which I don't think is true. The SECNAV instruction was recently updated as of 23SEP2019 to reflect that the finding of unfit can hinge simply on the fact you are non-deployable or other factors to include the physical fitness test. I place plenty of PEB referrals for ortho conditions that are not as serious as my Cardiothoracic issue and are found unfit. In the SECNAV instruction it does state that "equitable application to all members" or something to that effect. I have spoken with my referring CT surgeon, Mayo Doc, Dept Chair and others and are all basically in disbelief. I am now trying to figure out the next step would be as at this point I have the feeling I'm an indentured servant.
 

maruchan

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I wonder what IG would think of all this? I can't imagine that what you're describing is within the intent or letter of the updated regulatory guidance. Unequivocally this would not meet regulatory guidance for Army personnel based on my experience with similar cases. But I am not an attorney; you might consider speaking with Jason Perry.
 

docjester9

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I wonder what IG would think of all this? I can't imagine that what you're describing is within the intent or letter of the updated regulatory guidance. Unequivocally this would not meet regulatory guidance for Army personnel based on my experience with similar cases. But I am not an attorney; you might consider speaking with Jason Perry.
Some suggestions that the provided attorney recommended were allow my credentials to expire, and some other nonsense, but I think talking to Mr Perry is something I can do at this point to gain some insight.
 

Usndocgreen

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Thank you for all these posts. I am in a very similar boat except I am on my 3rd peb and a total of 5 meb’s. 0-4 surgeon at 14 years (academy time not included). My package is with the board now. My NMA recommended not good for continued service and my docs said to discharge. I have had many people along the way tell me as long as I am credentialed still I will be found fit. I did some reading when the recent instructions came out about deployability and there are clear sections about critical skills retention. It essentially says we aren’t going to treat you like everyone else if you perform xyz critical task. I think it’s crap honestly because I hear stuff all the time how the 0-whatever has to be treated just the same as the E1. This process needs to be fair no matter if you are a senior doctor or a new recruit.
 

chaplaincharlie

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It is not and O and E issues. There are E's with critical skills.

The PEB process is a personnel process. Personnel issues are considered. Docs have always had a more difficult time in the PEB process (before, the deployability guidance was issued). The guidance specifically had more steps for Docs.

It is clearly an unequal treatment issue. Perhaps an attorney could advise on the possiblities of a legal course of action. www.peblawyer.com
 

Usndocgreen

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It is not and O and E issues. There are E's with critical skills.

The PEB process is a personnel process. Personnel issues are considered. Docs have always had a more difficult time in the PEB process (before, the deployability guidance was issued). The guidance specifically had more steps for Docs.

It is clearly an unequal treatment issue. Perhaps an attorney could advise on the possiblities of a legal course of action. www.peblawyer.com
With regards to O’s and E’s I was just referring to the spread of the most junior to the most senior. It wasn’t to imply critical skills is an officer only issue. Thanks for your feedback I did reach out at peblawyer via email yesterday!
 

GHS

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Hi all. I’m new here and also a Navy doctor. I am in my first MEB. My packet is with CO for NMA right now. My PEBLO also said at the start of this that he has not seen a doc get out if they still have credentials. It’s awful being stuck in a dept that is already undermanned and be the “slacker” who can’t take call and works less then everyone. I’m hoping for unfit but we will see how it goes.
 

GHS

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I wonder if there are any cases that have been won on behalf of a doctor who fought to be treated like any other Sailor.
 

Usndocgreen

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I would love to hear of any! It’s absurd. Total
Double standard. I am in a department that deploys to support medical missions by the US. It’s not fair to my co workers or me eventually when they get tapped repeatedly when I can’t deploy.
 

Usndocgreen

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I thought I’d update y’all. I sent up my request for fpeb 2 weeks ago after my third fit finding by an ipeb over 8 years. This one had letters from my 0-6 department head and 0-6 clinic manager. They were very clear I’m their recommendation to find unfit. Waiting again now to hear
 

GHS

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I thought I’d update y’all. I sent up my request for fpeb 2 weeks ago after my third fit finding by an ipeb over 8 years. This one had letters from my 0-6 department head and 0-6 clinic manager. They were very clear I’m their recommendation to find unfit. Waiting again now to hear
Good luck. My initial PEB is currently with the MO. My specialty is not wartime related so perhaps it will be looked at differently then surgeon. We will see.
 
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