Referred to MEB

Z

zero_cool88

PEB Forum Regular Member
Registered Member
MEB Gang,

My PA initially referred me to IDES for OSA w/ CPAP causing somnolence requiring an alerting medication (on modafinil for 3 months) and a recent Rheumatoid Arthritis diagnose (on prednisone and hydroxy).

The IDES doc called me and asked me "why were you referred to me" so I started to discuss the two conditions and the doc did not concur with OSA + stimulant being a condition warranting an MEB. However, they stated they would review all of my records and write what the board would concur with. I sat down with my PEBLO to sign my initial counseling and I noticed that my only referred condition was an L5-S1 herniation, which in conjunction with my RA is wreaking havoc. I'm assuming the doc saw the additional diagnoses associated with the low back injury (L4-L5 bulge, DDD, sacrolitis, narrowing etc) and decided that was the low hanging fruit?

AR 40-501 is clear regarding alerting medication and RA if it requires geographic limitations (I'm not on injectables yet). Should I be concerned about the IDES doc disregarding the OSA and RA?

I had a great experience with my MSC and we were in agreeance with the claims that I've submitted. The C&P exams are my 10M target, however, I don't want to miss out on maximizing my ability for an unfit verdict and reaching the magic number for my DoD rating. I have over a decade of active service, so I'm not shy about putting up a fight if I'm being treated unfairly during this process.

Any advice would be appreciated!
 
zero_cool88 said:
MEB Gang,

My PA initially referred me to IDES for OSA w/ CPAP causing somnolence requiring an alerting medication (on modafinil for 3 months) and a recent Rheumatoid Arthritis diagnose (on prednisone and hydroxy).

The IDES doc called me and asked me "why were you referred to me" so I started to discuss the two conditions and the doc did not concur with OSA + stimulant being a condition warranting an MEB. However, they stated they would review all of my records and write what the board would concur with. I sat down with my PEBLO to sign my initial counseling and I noticed that my only referred condition was an L5-S1 herniation, which in conjunction with my RA is wreaking havoc. I'm assuming the doc saw the additional diagnoses associated with the low back injury (L4-L5 bulge, DDD, sacrolitis, narrowing etc) and decided that was the low hanging fruit?

AR 40-501 is clear regarding alerting medication and RA if it requires geographic limitations (I'm not on injectables yet). Should I be concerned about the IDES doc disregarding the OSA and RA?

I had a great experience with my MSC and we were in agreeance with the claims that I've submitted. The C&P exams are my 10M target, however, I don't want to miss out on maximizing my ability for an unfit verdict and reaching the magic number for my DoD rating. I have over a decade of active service, so I'm not shy about putting up a fight if I'm being treated unfairly during this process.

Any advice would be appreciated!
Click to expand...
just to clarify, the doc is stating you have an unfitting herniation and your RA is a secondary to that or just the herniation? Also what branch are you? for your MEB1 and MEB2 disagree it'll be an interesting shit show for sure.
 
I'm active Army. I'm unsure what stage I'm in but my MSC claims were signed this week. The IDES doc wrote on the IDES referral "herniated L5-S1 disc". There is no mention of the RA on the referral despite the civilian Rheum diagnosis and notes being in my medical records. I felt the RA and OSA should be on the referral since both conditions meet criteria according to AR 40-501, but the doc took a very aggressive posture during the telephonic interview regarding OSA. The doc literally stated "I don't care if you're on alerting medication, the board members won't care either". I sent the RA records to my PEBLO and they haven't responded with an answer regarding the doc having access to them prior to submitting the IDES referral.

Should I ask the doc to add the RA and OSA via my PEBLO? Either condition will hit the 30% and build my case to be unfit.

Any feedback is greatly appreciated!
 
*Obligatory not a medical or legal dude*
Speaking as someone who wishes they updated their case as it was going I would push to get it added. I believe you push your PCM to update your board referral but im not 100%. Make sure you continue your appointments and make sure their notes are matching what you need in the VASR. I'm currently going to FPEB because when I got my formal diagnosis of Meniere's Disease I didn't push to get my referring condition changed so I went up as just "Dizziness." Talk with your IDES Attorney ASAP and try and talk with your PCM.
 
zero_cool88 said:
MEB Gang,

My PA initially referred me to IDES for OSA w/ CPAP causing somnolence requiring an alerting medication (on modafinil for 3 months) and a recent Rheumatoid Arthritis diagnose (on prednisone and hydroxy).

The IDES doc called me and asked me "why were you referred to me" so I started to discuss the two conditions and the doc did not concur with OSA + stimulant being a condition warranting an MEB. However, they stated they would review all of my records and write what the board would concur with. I sat down with my PEBLO to sign my initial counseling and I noticed that my only referred condition was an L5-S1 herniation, which in conjunction with my RA is wreaking havoc. I'm assuming the doc saw the additional diagnoses associated with the low back injury (L4-L5 bulge, DDD, sacrolitis, narrowing etc) and decided that was the low hanging fruit?

AR 40-501 is clear regarding alerting medication and RA if it requires geographic limitations (I'm not on injectables yet). Should I be concerned about the IDES doc disregarding the OSA and RA?

I had a great experience with my MSC and we were in agreeance with the claims that I've submitted. The C&P exams are my 10M target, however, I don't want to miss out on maximizing my ability for an unfit verdict and reaching the magic number for my DoD rating. I have over a decade of active service, so I'm not shy about putting up a fight if I'm being treated unfairly during this process.

Any advice would be appreciated!
Click to expand...
They are going to do what they are going to do. Once your NARSUM comes out that's the time to submit a rebuttal and or IMR. Anything that isn't the way it should be can be challenged throughout the process and you need to do that so if it comes down to a FPEB to request another unfitting condition you have shown throughout the process that you don't agree and your responses are your reasons. Also, after you get the NARSUM you will have an idea on how the IPEB is going to rule. So you can strategize with your IDES counsel to work on evidence between now and that point. I strongly recommend hiring a dedicated private IDES attorney. The results have lifetime financial implications.
 
My PEBLO related that I can discuss these concerns with the IDES doc during the NARSUM “dictation”.

Seems like they’re kicking the can down the road.
 
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