Requesting Reconsideration of my un-fitting conditions.

rdrobin6718

PEB Forum Regular Member
I returned my DA199 to my legal counsel and PEBLO today requesting a formal PEB appeal. I have a rare condition called a Rathke's Cleft Cyst resulting in hypopituitarism or panhypopituitarism. The treatment was a surgery through my nose to remove it. The neurosurgeon was able to remove most of the cyst, but damage had already been done to my pituitary gland resulting in hypopituitarism/panhypopituitarism.
On my DA 199 I was given a 20%DOD/30%VA rating. I don't disagree with the ratings I was given, but I do disagree that the only coniditions I was rated on were adrenal insufficiency and hypthyroidism. The adrenal insufficiency was un-fitting at 20%(DOD&VA) and the hypothyroidism was given an additional 10% rating by the VA. My concern is that these are both secondary condition caused by the hypopituitarism/ panhypopititarism. There was no mention at all of a third condition that results from the panhypopituitarism called hypogonadism. Due to all three secondary conditions being caused by the overlying condition of hypopituitarism/panhypopituitarism mean that they be rated togethor as unfitting. I can't find anything in the VASRD that refers to pituitary disorders/disfunction.
I understand that the DOD only rates conditions that make you unable to serve, so I could potentially see an argument for breaking the secondary conditions up and viewing them individually. The hypogonadism, in my case, is severe. Without replacement hormones I quickly become fatigued, weak (no where close to meeting APFT standards), and (embarassingly) emotional.
I feel that I did a great disservice to myself early in this process due to not understanding the severity of my conditions. Thankfully, my conditions were noticed right away after the surgery, so I don't know what the effects will really be when/if my hormone levels become low. Under any kind of stress, I require increased hydrocortisone replacement therapy or I rather quickly get into trouble (fatigue, adrenal shock, coma, death). I want to continue to serve, but as I (and my command) have learned more about my conditions it has become clear that I could/would at some point put others and myself in danger. So far, I have had only one instance where a simple flu bug required me to seek medical care because I quickly (less than 24 hours) became dizzy and lightheaded due to not being able to keep my hormone pills down.
As I said before, it is very rare to have this type of cyst and and even more rare to have any symptoms/problems from it. I have found it difficult to research, and my civilian specialist is 100 miles away. What is the best way to make my argument at the FPEB that these should be rated togethor, or at least look at the hypogonadism as unfitting? Is there something I'm missing? I really don't want to be seperated/retired, but without my chain of command recommending me to stay, I don't feel that is much of an option at this point.
 

Warrior644

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I returned my DA199 to my legal counsel and PEBLO today requesting a formal PEB appeal. I have a rare condition called a Rathke's Cleft Cyst resulting in hypopituitarism or panhypopituitarism. The treatment was a surgery through my nose to remove it. The neurosurgeon was able to remove most of the cyst, but damage had already been done to my pituitary gland resulting in hypopituitarism/panhypopituitarism.
On my DA 199 I was given a 20%DOD/30%VA rating. I don't disagree with the ratings I was given, but I do disagree that the only coniditions I was rated on were adrenal insufficiency and hypthyroidism. The adrenal insufficiency was un-fitting at 20%(DOD&VA) and the hypothyroidism was given an additional 10% rating by the VA. My concern is that these are both secondary condition caused by the hypopituitarism/ panhypopititarism. There was no mention at all of a third condition that results from the panhypopituitarism called hypogonadism. Due to all three secondary conditions being caused by the overlying condition of hypopituitarism/panhypopituitarism mean that they be rated togethor as unfitting. I can't find anything in the VASRD that refers to pituitary disorders/disfunction.
I understand that the DOD only rates conditions that make you unable to serve, so I could potentially see an argument for breaking the secondary conditions up and viewing them individually. The hypogonadism, in my case, is severe. Without replacement hormones I quickly become fatigued, weak (no where close to meeting APFT standards), and (embarassingly) emotional.
I feel that I did a great disservice to myself early in this process due to not understanding the severity of my conditions. Thankfully, my conditions were noticed right away after the surgery, so I don't know what the effects will really be when/if my hormone levels become low. Under any kind of stress, I require increased hydrocortisone replacement therapy or I rather quickly get into trouble (fatigue, adrenal shock, coma, death). I want to continue to serve, but as I (and my command) have learned more about my conditions it has become clear that I could/would at some point put others and myself in danger. So far, I have had only one instance where a simple flu bug required me to seek medical care because I quickly (less than 24 hours) became dizzy and lightheaded due to not being able to keep my hormone pills down.
As I said before, it is very rare to have this type of cyst and and even more rare to have any symptoms/problems from it. I have found it difficult to research, and my civilian specialist is 100 miles away. What is the best way to make my argument at the FPEB that these should be rated togethor, or at least look at the hypogonadism as unfitting? Is there something I'm missing? I really don't want to be seperated/retired, but without my chain of command recommending me to stay, I don't feel that is much of an option at this point.
Welcome to the PEB Forum! :)

From my experiences within the DoD IDES MEB/PEB process, it's important to show at the formal PEB (FPEB) hearing how your medical conditions affect your ability to perform your assigned military duties with the assistance of the designated SPEBC attorney if you elected one, or hire your own legal representation at zero cost to the U.S. Government.

As provided by law, no active-duty or Reserve Soldier found unfit by an informal PEB (IPEB) may be retired or separated for physical disability without being given the right to demand a formal hearing.

As such, the FPEB is your opportunity with the assistance of legal counsel to present evidence, testimony, witness statements, and documents in support of your case. Once the formal board convenes to consider your case, the informal board findings become null and void. The formal board will then issue new findings without regard to the previous informal board findings.

During the FPEB, anticipate questions relating to how and when your condition occurred, treatments received, medication, and work limitations that it impose. You will be provided the opportunity to discuss your case in detail.

Moreover, the FPEB panel will usually have your medical records, medical reports, administrative and performance records, and statements from your chain of command concerning current duty performance.

With that all said, to potentially avoid undue delay and any detriment, you should arrive at the FPEB hearing with copies of all materials necessary to present your case. It is highly recommended that you submit any documentation not contained in the PEB packet to the board at least 24 hours prior to the actual board date. The FPEB members use all of this information in the decision-making process.

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer."

Best Wishes!
 

Robert Albright

PEB Forum Regular Member
PEB Forum Veteran
I relizee this is an old thread but Im posting hoping that this may help someone else. I was diagnosed, for hypogonadism, after I had been to the formal PEB and had already receive the maximum rating that I could obtain. If I had had to present the case for hypogonadism, personally I would have argued the point that the muscular atrophy I had experience made it a failing condition; perhaps since I was infantry they might have considered it.
 
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