Ratings back from PEB. NOT HAPPY. Appeal is happening.

navywife2010

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We got our UNFIT ratings today. My husband is NOT HAPPY. He is an MMN and has been in this whole limbo process since January 2015. We sent off his PEB packet in February.

For ulcerative colitis and UC-related arthritis my husband received 10%, plus a severance for his separation. On the VA side, he received 50%, but they didn't even count his sleep apnea with a CPAP machine...they gave him zero percent on that. We have seen that it is an automatic 50% if you have to use a CPAP machine.

Not to mention that the intake paperwork with his findings states the incorrect name; it has his middle and last name on every single page. The PEBLO didn't even catch it. That alone does not give us faith in this military IDES process.

Next up, we talked to a lawyer who said we can get 30% due to multiple flares since he submitted the paperwork in January. We have new medical evidence on file to submit. There's apparently no clarification even on the VA end for what is "frequent" vs "infrequent" which is what they claim my husband's condition is: infrequent.

Should we contact DAV (Disabled American Veterans) at this point for help? Or should we wait and work with the lawyer on base and local VA rep? Here we thought we would be easily retired at 30% and ready to move back home so we can be settled in time for our baby to arrive. NOPE!

Sorry for the vent....but any advice would be appreciated!!! Especially from anyone who has IBD or ulcerative colitis and has successfully appealed a PEB decision.
 

brokeded

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Pretty sure we're in the same place and I agree. The IDES process, especially here, is unacceptably slow and misinforming. I would strongly urge him to continue getting legal help since it's free on base and also because it never hurts. Also, he should probably appeal the decision since it's obvious he wasn't happy with the outcome. You have me worried now because most of my case is GI related stuff and I've had the fear that they will low ball me when in reality a GI condition of any nature is absolutely horrible to deal with on a daily basis. I know that I will not be low balled. I will request a FPEB and shit my whites if necessary. But yeah, nobody cares about his medical board. The Navy's objective is to save money so obviously they will low ball when they can. Be your own advocate and don't settle for something that isn't right when you have the ability to appeal.
 

bleacherspy

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... But yeah, nobody cares about his medical board. The Navy's objective is to save money so obviously they will low ball when they can. Be your own advocate and don't settle for something that isn't right when you have the ability to appeal.
Very true! You have to know the regs and keep fighting. IMO, most base jags aren't going to get involved deep enough to help you. Get some DAV help fast.
 

navywife2010

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Pretty sure we're in the same place and I agree. The IDES process, especially here, is unacceptably slow and misinforming. I would strongly urge him to continue getting legal help since it's free on base and also because it never hurts. Also, he should probably appeal the decision since it's obvious he wasn't happy with the outcome. You have me worried now because most of my case is GI related stuff and I've had the fear that they will low ball me when in reality a GI condition of any nature is absolutely horrible to deal with on a daily basis. I know that I will not be low balled. I will request a FPEB and shit my whites if necessary. But yeah, nobody cares about his medical board. The Navy's objective is to save money so obviously they will low ball when they can. Be your own advocate and don't settle for something that isn't right when you have the ability to appeal.
We've spent the last two days in disbelief but also have used that to fuel our energy to back our case up. Having ten days to put everything together is a joke. If you get your findings back and are not happy with the rating for your claimed condition for the MED Board process (remember, the claims to the VA will be fought AFTER you get out), request a formal board immediately. They are so backed up right now that a request right now would give us a hearing in October or November, according to our lawyer. The lawyer said that buys us time to make sure we have ALL that we need and that it isn't a rushed job to just get our claim in. We went to medical and had all of my husband's records emailed to him (yep, you can do that) because it would have taken three weeks to have medical print it out for us. Don't trust that the PEB saw all your paperwork if your rating comes back low. I bet they lose something along the way. For your sake, I hope that they have their ducks in a row and give you a proper rating the first time around, though.

We are looking at this as a few more months of inconvenience and peddling paperwork to get a lifetime of benefits, not to mention insurance coverage, for a very expensive, incurable disease.

Do you have ulcerative colitis as well?
 

brokeded

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We've spent the last two days in disbelief but also have used that to fuel our energy to back our case up. Having ten days to put everything together is a joke. If you get your findings back and are not happy with the rating for your claimed condition for the MED Board process (remember, the claims to the VA will be fought AFTER you get out), request a formal board immediately. They are so backed up right now that a request right now would give us a hearing in October or November, according to our lawyer. The lawyer said that buys us time to make sure we have ALL that we need and that it isn't a rushed job to just get our claim in. We went to medical and had all of my husband's records emailed to him (yep, you can do that) because it would have taken three weeks to have medical print it out for us. Don't trust that the PEB saw all your paperwork if your rating comes back low. I bet they lose something along the way. For your sake, I hope that they have their ducks in a row and give you a proper rating the first time around, though.

We are looking at this as a few more months of inconvenience and peddling paperwork to get a lifetime of benefits, not to mention insurance coverage, for a very expensive, incurable disease.

Do you have ulcerative colitis as well?
I feel ya. This whole IDES process is not timely nor is it efficient. They spend SO much time just to make mistakes in the end. You would think evening having Pre and Post QA checks this would be a flawless system. But no. I read some of people's experiences and it honestly sounds like 3 year olds are making decisions up there. It's so stressful just reading about encounters because it makes me very nervous being that medical here isn't really good in doing really anything. No, I don't have UC. I have severe IBS and am most likely about to be diagnosed with Crohn's. Quite unfortunate that my referred conditions are the ones with the lowest percentages. MILMED really fucked me over with this whole thing but as long as I get 30% DOD I'll be fine. I can fight with the VA on my own.
 

LBCutta

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Did they ever give you an explanation as to why your Sleep Apnea claim didn't go thru? That's insane you should get 50% for that alone.
 

navywife2010

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Did they ever give you an explanation as to why your Sleep Apnea claim didn't go thru? That's insane you should get 50% for that alone.
The pulmonary Doctor didn't submit the proper paperwork the first time around.
 

rajeev2liz

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Very true! You have to know the regs and keep fighting. IMO, most base jags aren't going to get involved deep enough to help you. Get some DAV help fast.
If you can afford it I would encourage you to retain a civilian laywer who deals with the MEB process to help you out, it will cost a little but in the long run would pay off.
 

bleacherspy

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If you can afford it I would encourage you to retain a civilian laywer who deals with the MEB process to help you out, it will cost a little but in the long run would pay off.
Absolutely! I hired a civilian lawyer before my board process even began. It cost a lot, but I figure I will easily pay myself back over time by getting the best outcome from the start. Its been nice to attack the process as a team instead of by myself. My only worry for Navywife2010 is that it is fairly late in the process to hire someone now. Sure, some will take your money, but are they going to be able to do maximum work for you? You gotta ask those questions. I did a lot of research before I made my choice and I will offer my opinion that there are really only 4 to 5 people in the nation that I would trust to do the job well. DAV may get you maximum return for least price right now. If you have the funds, its worth a call, but do your homework!
 

navywife2010

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I wonder, too, if hiring a civilian lawyer for my husband's case would be wise to do. Especially since the letter from the VA addressed him by his middle name (which also happens to be his grandfather's name who also served in the Navy years ago) and put the wrong social on his preliminary benefits letter. If they screwed that up, there's no telling what ratings got messed up as well. We definitely want to appeal at this point. The PEBLO office is very resistant and keeps saying we have all we need now and to just submit it instead of requesting a formal board.

Today we signed off to have a formal board. The lawyer said he does this to give us more time to gather paperwork instead of rushing through the 10 days they initially give us to respond. We can withdraw the request for the board at any time once all the paperwork is in our hands (aka new evidence since the MEB was submitted) and then just submit the new evidence as a VA reconsideration. The lawyer has gone through this process himself, and he also has sat in on the formal board hearing for clients, so I feel like he is a good resource — he's just spread too thin.

DAV won't touch our case because it is a MED board process. They can "advise" but no representation from what we were told when we visited them earlier this week.

@bleacherspy Do you mind messaging or sharing the list of lawyers you recommend? We aren't scared to spend money as long as it will be worth it!
 

navywife2010

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Did they ever give you an explanation as to why your Sleep Apnea claim didn't go thru? That's insane you should get 50% for that alone.
After speaking with the local VA rep today, he said once we submit our new evidence that it should automatically be bumped up to 50% after we get out of the Navy. It just can't be dealt with now, which is rather annoying.
 

Navy1989

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What was the outcome of your husbands appeal? Navy gave 10% and va gave 50% too. The appeal is at the end of the month....
 
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