US Navy Medical Corps Officer denied LIMDU- Questions of how they will categorize me

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Found this forum while searching around and have been extremely hard pressed to find an answer to my question. A brief background. I am an active duty physician who has been diagnosed with an immune deficiency requiring monthly infusions to boost my immune system. As a result, I have been told I am non-deployable. The medical department where I am working was required to file LIMDU paperwork to "put me in the system" since big navy was attempting to deploy me. I recently was told that PERS denied the LIMDU and asked for me to go directly to a MEB. The confusing part for me is that the med board "expert" at the clinic told me that I would be found fit for service due to my being a physician and that the medical dept should try to make that finding themselves and not have me referred to a MEB.

1. How can I be fit for duty yet still require monthly infusions which make me non-deployable? Also due to immune deficiency I am at risk for infections etc.

2. Does a finding of fit or unfit mean that I am not eligible for disability benefits for my condition?- I have been on active duty for 12 yrs and have only had issues leading to the diagnosis for 2 years.

3. How the heck do I proceed and what should my response be to the command who wants to just find me fit? Im concerned about being deployed to an area, being sick and having no backup to take care of those who need the medical care.

Thanks for the input.

V/r
 
US Navy Medical Corps Officer denied LIMDU- Questions of how they will categorize

Welcome, glad you found us!

It is EXTREMELY difficult (i.e., I have never seen it happen) for a physician to be found unfit. In part, I think, this is due to the value of the skills and knowledge physicians have, but also because of separate rules about unfit findings for these members:

SECNAVINST 1850.4E:

3304., b. General, Flag, and Medical Officers. An officer in pay grade O-7 or higher or a medical officer in any grade shall not be determined Unfit because of physical disability if
the member can be expected to perform satisfactorily in an assignment appropriate to his or her grade, qualifications, and experience. Thus, the inability to perform specialized duties or the fact the member has a condition that is cause for referral to a PEB is not justification for a finding of Unfit. Medical doctors will have a review of clinical privileges with peer review required.


1. How can I be fit for duty yet still require monthly infusions which make me non-deployable? Also due to immune deficiency I am at risk for infections etc.
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It is possible that you are not fit...however, it is unlikely that this will be the outcome. To show how hard it is, I had a client a few years ago who was a physician, he had severe health issues and was basically assigned to his quarters where he performed 2 hours of work per day reviewing profiles and deployment paperwork. In spite of this, he was found fit.

2. Does a finding of fit or unfit mean that I am not eligible for disability benefits for my condition?- I have been on active duty for 12 yrs and have only had issues leading to the diagnosis for 2 years.
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A fit finding means that you will not receive either severance pay of military disability retired pay but will continue to serve. An unfit finding with severance means that you will receive only severance pay from DoN, but no other benefits; if retired, you would draw retired pay and get all other retiree benefits (eligibility for TriCare, commissary/PX priviliges, etc.). In either case, you will be otherwise still eligible for Dept. of Veterans Affairs benefits once you are a veteran.

3. How the heck do I proceed and what should my response be to the command who wants to just find me fit? Im concerned about being deployed to an area, being sick and having no backup to take care of those who need the medical care.
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I think you can prepare your case for the outcome you would want, but you should keep in mind that you will likely be found fit. Even if fit, you may be restricted from deploying or even from ship board duties. The assignment limitations do not necessarily mean that you would be unfit.

I hope all goes well for you, both health wise and through the administrative process.
 
US Navy Medical Corps Officer denied LIMDU- Questions of how they will categorize

Jason hit this on the head. What they are trying to do by forcing you to MEB, is to get a finding that will basically limit you to a major facility. What would most likely happen is you would finish out your time at one of the hospitals. I recommend NAS Jax, Lord knows they can use more doctors. I know they will send someone to you house here to do IVIG injections, so I would imagine that as long as those facilities are available you could be sent somewhere stateside.
 
US Navy Medical Corps Officer denied LIMDU- Questions of how they will categorize

The history here is that many moons ago, generals and docs were, at the ends of their careers, putting themselves in for disability retirement. This led to Congress passing a law (see section d of 10 USC 1216 below) that put restrictions on DES cases of generals and docs. Maybe the pendulum has swung too far the other way. Perhaps you should contact your senators and representative on your case to illustrate to them the problem. I wonder how an immune deficient doc can work in and around sick people. It seems to be a risk to the doc and other patients. Do your IVs keep your immune system in the normal range?

The law below speaks of a ban for those being processed for LOS or age based retirement but I am sure the law made DoD hypersensitive to disability retirements of generals and docs beyond the intent of the law. However, I have seen a recent case (last three years) of a general being medically retired. He was injured in an IED blast.

Mike

10 USC 1216. Secretaries: powers, functions, and duties


(a) The Secretary concerned shall prescribe regulations to carry out this chapter within his department.
(b) Except as provided in subsection (d), the Secretary concerned has all powers, functions, and duties incident to the determination under this chapter of—
(1) the fitness for active duty of any member of an armed force under his jurisdiction;
(2) the percentage of disability of any such member at the time of his separation from active duty;
(3) the suitability of any member for reappointment, reenlistment, or reentry upon active duty in an armed force under his jurisdiction; and
(4) the entitlement to, and payment of, disability severance pay to any member of an armed force under his jurisdiction.
(c) The Secretary concerned or the Secretary of Veterans Affairs, as prescribed by the President, has the powers, functions, and duties under this chapter incident to hospitalization, reexaminations, and the payment of disability retired pay within his department or agency.
(d) The Secretary concerned may not, with respect to any member who is a general officer or flag officer or is a medical officer being processed for retirement under any provisions of this title by reason of age or length of service—
(1) retire such member under section 1201 of this title;
(2) place such member on the temporary disability retired list pursuant to section 1202 of this title; or
(3) separate such member from an armed force pursuant to section 1203 of this title by reason of unfitness to perform the duties of his office, grade, rank, or rating unless the determination of the Secretary concerned with respect to unfitness is first approved by the Secretary of Defense on the recommendation of the Assistant Secretary of Defense for Health Affairs.
 
US Navy Medical Corps Officer denied LIMDU- Questions of how they will categorize

The big one here is 1850.4E stating
All medical boards involving medical officers as patients forwarded to the PEB
for consideration will be accompanied by a separate command evaluation to include the
medical officer’s current overall level of function, and a Peer Review delineating clinical​
privileges (SECNAVINST 6320.23 applies).

I believe this is the step which is designed to prevent your "buddies" from rating you. So the policy is there to make it happen. The reason you were denied LIMDU is because your condition will never get better. PERS only want to approve LIMDU for persons that may return to service. As far as the PEB finding you fit due to a critical skill, I have no data. Sorry.
 
US Navy Medical Corps Officer denied LIMDU- Questions of how they will categorize

Thank you for all the gouge. I am just beginning my course of infusions so truly not aware of any change in status(esp since I just am recovering from my third pneumonia in 2 years.) Im in a great smaller location with other physicians who cove me when I need my infusions(only a few hours a month) and they can be done right down the hall from the OR so I can do cases/be on call right after completed. Im truly sadded by not being able to deploy but hopefully will be able to in future. Ill keep you updated as to my status etc. Thanks again.
 
Sorry to drag this up again, but my colleague who happens to be the Department Head has tried to have me "readdress this" and is pushing me to see the Senior Medical Officer and Director of Health Services in regards to having a full med board put in. I have no issue with the request, but my concern is that I can/might be Adsep without benefits. I am a Uniformed Services University Grad with 8 yrs service(my yrs in Med School dont count toward retirement.) I still owe the Navy 7 yrs due to med school and residency. My biggest concern is lack of disablity rating and lack of medical coverage if adsep. Recently I was denied my application for SGLI(I had declined it upon entry into the Navy.) I was declined due to my IGG deficiency. My condition has been stable with me still requiring infusions every 6 weeks to maintain my levels and I have had one case of infection yet I m non-deployable. I have missed no days of work due to illness and can still perform(and do perform) my Anesthesiology duties at all times without any limitations. Does anyone have any advice on how to proceed? The command(and my colleague) wants me to be put in some status as non-deployable but there appears to be no such status. Do I need to retain counsel or seek assistance from JAG? I really dont want to contact senators/congressmen etc b/c it seems like I would be complaining and I like my command, wish to extend here for another 3 year set of orders etc. Thanks for the info.
 
Well, I think that aside from the difficulties in getting an unfit finding, I think that if they try to ADSEP you do to limitations from your disabilities, then there is a strong argument that you are actually unfit. The Department of the Navy seems the worst branch about this and I doubt they would agree. In this case, you may have to challenge an ADSEP in later appeals (likely in court).

I don't see much value in filing a Congressional inquiry in these types of case. Given that, and that you want your command to be on your side as much as possible, in this type of case I would likely stay away from filing a Congressional.

Hope it all goes well for you.
 
Resurrecting this thread as another medical corps officer facing a board -- please let me know if I should start another thread instead! I really hope things ultimately went well for you, USNDOC.

I'm facing my second board in less than 2 years. Every time I get two consecutive PRT waivers, one gets forced. I was found fit the first time (of course), and am about to receive findings for the second -- which will surely be "fit" as they returned in less than 2 weeks. At this point I've had over 8 providers across three specialties recommend medical separation, and my command wholeheartedly agrees (nonmedical assessment was deemed strong by JAG). At this point I'm just frustrated. I've paid back my initial HPSP obligation, and owe only through October for my specialty bonus. I'm not trying to game the system -- I'm just miserable. Chronic severe pain impacts my ability to do my job (can elaborate on diagnoses if necessary), I can't deploy and am heavily resented in my specialty for it, and the command is tired of my limitations. I was ready to resign out of shear misery, but was told by several that technically, said resignation should not be accepted if there's any question of fitness for duty, hence I "had" to do the board to "do the right thing." Now, by ensuring everything is well documented in preparation for the board, I've effectively ensured that I'll never, ever be able to afford a disability or life insurance policy again. Additionally, I'm miserable, my command wants me out, and I'm denied effective physical therapy that reduces my pain (PT only wants to see me if I get better. They flat out told me they no longer wish to see me, even though it helps, because I didn't get better -- they only want to see people short-term who get better. Instead I'm left with sedating/job affecting pharmacological options at best.) So -- I'm too "sick" to merit continued therapy, yet I'm fit enough to stay in, and my career won't progress because I'm non-deployable and my job performance is suffering, and when/if I resign, I'll never be able to get disability coverage to protect the investment of years and years of training and look out for my family should I be unable to provide for them for any reason in the future.

Given the examples/experiences above, I'm led to believe a formal hearing would be pointless -- am I right? Should I just accept the inevitable and seek resignation?

Thanks for any and all input/advice!
 
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