Thoughts on IG Complaint and NARSUM Change?

mcdonaldj2323

Registered Member
Folks,

I filed an IG complaint locally to address med group AFI and DODI violations, to get a NARSUM changed and to get second opinions on referred conditions. In the NARSUM, the local med group included a high level of detail on PTSD and Low Back Pain in addition to the mandatory original referred condition - Sleep Apnea. The PTSD addendum attached to the NARSUM was particularly negative and would likely have resulted in an unfit result which I do not want with 19 years in this January, 2019. The med group stated their internal investigation led them to make a few process changes but that they did not violate any instructions (a claim that is entirely unsupported in their response and counter to multiple instructions I have read). They also failed to address not providing me with second opinions which I requested.

The medical group commander formally responded with the below statement:

"Finally, your medical narrative summary is currently being updated to reflect Obstructive Sleep Apnea as the only unfitting diagnosis. Your other medical conditions will be listed in the pertinent medical history section of the initial review-in-lieu-of medical board template."

Does anyone know what the medical board template is or even better have the IRILO template or filled out example? If the conditions are merely listed, I have no real issue. My chief concern is the med group will still include negative information in the "medical history" section (ie; just move it from one spot to another) - is this a legitimate concern based on past experiences?
 

chaplaincharlie

Staff Member
PEB Forum Lifetime Supporter
PEB Forum Veteran
Registered Member
All summary of all health conditions is a requirement. The PEB process is a whole person process. The PEB is required to consider all possible unfitting conditions. OSA is rarely found unfitting.

A strong command letter will help. You might readdress the lack of a second opinion with the the MDG/CC. You can also address your concerns with the joint commission.

"Reporting of Complaints. You have the right to a fair and objective review of any complaint you have. You are entitled to information about the MTF/DTF mechanisms for the initiation, review, and resolution of complaints. Please direct concerns to the Customer Relations Representative at the MTF/DTF. If your concerns are not adequately resolved, you have the right to contact The Joint Commission at 1-800-994-6610."
 
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