MILITARY MEDICAL EVALUATION BOARDS

[Rocky]

MILITARY MEDICAL EVALUATION BOARDS

How Does an Army National Guard Soldier Get into the Physical Disability
Evaluation System (also known as the MEB/PEB Process) for Mental Health
Issues?

First and Most Important: Do Not Sign the Non-Duty Related Medical Discharge
paperwork you have probably been given. This is incorrect and does not
follow Army Regulations. If you were on Active Duty for more than 30 days
and received your injury, whether physical or psychological (PTSD), then you
are entitled to be processed through the Active Duty Army Physical Disability
Evaluation System. If you sign the Non-Duty Related Medical Discharge
Paperwork you will be Discharged without the opportunity to present your case
and be given a possible Disability Rating that would entitle you to severance
pay or Medical Retirement from the Active Duty Military. If you have already
signed and been discharged, there is a way for you to seek relief from the
incorrect way you where discharged.

The Army National Guard Command Staff, Medical Branch, Inspector General,
etc. will actively and aggressively try to deter the soldier from going
forward with the Medical Evaluation Board (MEB). They are wrong and this
goes against Army Regulations (see paragraphs below). A soldier who has
obtained an injury/disability in combat or while on Active Duty for a period
of more than 30 days are required to be discharged only after you have gone
through the Disability Evaluation System.

Please note that the Non-duty related medical discharge paperwork does not
say "Non-Duty" on it. It only says that the soldier is being discharged for
"Medically Unfit for Military Service". Not until you read through the
appeal requirements does it state appeal for Non-Duty Related (NDR) cases
only. Also on the paperwork it states that you have the right to appeal to
the Physical Evaluation Board (PEB), however this is only to determine if you
are fit or unfit for duty. This is not used to determine if you meet the
requirements for a Disability Rating from the Army. Please see attached
copies for an example of the Non-duty related Medical Discharge paperwork
that the National Guard will probably send you.

Bottom Line: Do not sign the paperwork that you are given by the ARNG, you
will be forfeiting your right given to you by Army Regulations to either a
medical discharge or medical retirement from the Active Military. Do not let
anyone, your Commander, 1SG, State Surgeon, IG, TAG, State Command SGM order
you to sign the Non duty related medical discharge. Do not let them advise
you the course of action laid out below is not in keeping with Army
Regulations, they are wrong. Fight for your rights!

The following is information about the steps that need to be taken to start
the MEB. Also included are Army Regulation excerpts that pertain to your
rights in accessing the MEB/PEB process.

v Call Post-Deployment Health Reassessment (PDHRA):

§ Call Center 1-888-PDHRA-99

§ Request a referral for Mental Health

§ Request a copy of PDHRA DD form 2900 be sent to yourself

§ Request an LOD (Line of Duty) be filled out

§ A copy of the PDHRA will be sent to Medical Branch and the Soldier's Unit



Soldier's Commander must make the referral for a Mental Health Evaluation
at Ireland Army Medical Center at Ft. Knox, Kentucky.

§ Commander must call the Ireland Army Medical Center Behavioral Health
Clinic to set up an appointment for the soldier. Phone: (502) 624-0321
§ Commander will fill out letter "Commanding Officer request for routine
(non-emergency) Mental Health Evaluation" see attachment for a sample letter

§ The soldier will then have an appointment and will be put on travel orders
to go to Ft. Knox, Kentucky for an initial Mental Health Evaluation to
determine if the Mental Health issues warrant referral to the Medical
Evaluation Board (MEB).

§ If you are referred to the MEB another meeting will be set up in Kentucky
to begin the process. At that time a Physical Evaluation Liaison Officer
(PEBLO) will be assigned to assist you through the process.



Medical Evaluation Board (MEB) Purpose

§ Designed to evaluate the Active Duty or the Reserve Component member's
Medical Condition(s) to determine if they do or do not meet the medical
retention standards in accordance with AR 40-501, Chapter 3.

§ Documents a Soldier's medical condition(s) and duty limitations.
§ Refers Soldiers to Physical Evaluation Board (PEB), when the findings and
recommendations stipulate the Soldier does not meet retention standards.



Relevant Army Regulations pertaining to the Mental Health Evaluation

§ DoDD 6490.1 Mental Health Evaluations of Members of the Armed Forces

Section 4.6.3: Fitness and Suitability for Continued Service. The
mental healthcare provider shall advise the commanding officer about a
recommendation for return of the Service member to duty, referral of the
Service member to a Medical Evaluation Board for processing through the
Disability Evaluation System, or administrative separation of the Service
member for personality disorder and unsuitability for continued military
service.

Section 4.6.3.1: If the Service member is clinically determined to
not meet retention standards as defined in DoD Directive 1332.18 based upon a
DSMIV Axis I or Axis III medical condition under reference (l), a medical
board report shall be forwarded to the Service's Physical Evaluation Board
for determination of fitness for continued military service.

§ DoDD 6490.4 Requirements for Mental Health Evaluations of Members of the
Armed Forces
· Enclosure 3: Commanding Officer Request for Routine (Non Emergency)

Mental Health Evaluation See attachment

Enclosure 4: Service Member Notification of Commanding Officer
Referral for Mental Health Evaluation See attachment



v Relevant Army Regulations pertaining to the rights of Reserve Component
Soldiers that were physically or psychologically injured while on Active Duty

§ AR 40-400 Patient Administration Chapter 7

This is an overview of the Military Personnel Physical Disability
Processing

§ AR 40-501 Standards of Medical Fitness Chapters 3,7 & 10

Chapter 3: Medical Fitness Standards for Retention and Separation,
Including Retirement

Section 3-33 Anxiety, Somatoform, or dissociative disorders

This is the section for PTSD although it is not specifically listed

Chapter 7: Physical Profiling

This chapter refers to PULHES requirements

A Soldier should have a 3 or 4 in one of the areas to be referred to
the MEB
· Chapter 10: Army National Guard

Information on procedures for National Guard Soldiers who have
Non-Duty Related Medical Issues

§ AR 635-40 Physical Evaluation for Retention, Retirement, or Separation

· Chapter 4 Procedures

Section II: Initiation of Medical Evaluation This describes the
Commanders referral process to the MEB for a Soldier.

· Appendix B: Army Application of the Department of Veterans Affairs
Schedule for Rating Disabilities (VASRD)

¨ B-107. 9200-9511 Mental Disorders

Lists the Criteria that are "supposed" to be used to determine disability
rating of Soldiers.

§ Department of Defense Directive (DoDD) 1332.18 Separation or Retirement
for Physical Disability

Section 1.4 Establishes policy for processing Active and Reserve
component members who have conditions that are cause for referral for
physical disability evaluation.

§ Department of Defense Instruction (DoDI) 1332.38 Physical Disability
Evaluation>
Section 4.3: The applicable standards for all determinations
related to physical disability evaluation shall be consistently and equitably
applied, in accordance with 10 U.S.C., to Active component and Ready Reserve
members.

Enclosure 3 (E3.P4.3) Applicable Statute for Reserve Component
Members:

A Reserve component member shall be adjudicated under the statutory
provisions applicable to his or her duty status at the time of onset or
aggravation of the condition for which the member is determined unfit. This
means a Ready Reserve member not on extended active duty at the time of his
or her referral into the DES, but who is determined unfit for a disability
incurred or aggravated while the member was on a call to active duty of more
than 30 days, comes under the provisions of 10 U.S.C. 1201-10 U.S.C. 1203 and
not 10 U.S.C. 1204-1206. In such a situation, "in line of duty while
entitled to basic pay" rather than "proximate result" is the applicable
statutory requirement for entitlement to disability compensation.

· Enclosure 4 Guidelines Regarding Medical Conditions and Physical
Defects that are cause for referral into the Disability Evaluation System

¨ Section E4.13 Psychiatric Disorders

Ø Use of the Multiaxial System of Diagnosis

§ DoDI 1332.39 Application of the Veterans Administration Schedule for
Rating Disabilities

· Enclosure 2 (E2.A1.5.1) 9200-9511 Mental Disorders

This section describes the criteria for evaluation of Mental Disorders
and includes Table 8 Psychiatric Functional Impairment Guideline summary.
See attachment

This information was put together to assist soldiers in their rights
pertaining to the Disability Evaluation System. For further information or
clarification e-mail: fourdogweekend@yahoo.com
mailto:fourdogweekend@yahoo.com .

A really good forum for the DES process is www.pebforum.com
http://www.pebforum.com/ .

[Jumpmaster_AJ]

Brother, unless the system has changed in the last few years, that whole process (MEB/PEB) is a FUCKING nightmare! The Soldier and his chain of command are overwhelmed with information and it makes the process damn near impossible. I worked as a PSG for a Med Hold Company and know this firsthand. However, the system may be more steamlined now.

[Rocky]

Brother, unless the system has changed in the last few years, that whole process (MEB/PEB) is a FUCKING nightmare! The Soldier and his chain of command are overwhelmed with information and it makes the process damn near impossible. I worked as a PSG for a Med Hold Company and know this firsthand. However, the system may be more steamlined now.

I totally understand what you are saying here brother, it is, like the VA a piss poor system, however, some changes are being made due to Congress getting involved due to the Personality Disorder discharge bullshit the military was pulling on todays soldiers. This info is the latest I have and it was put together by a vet and his wife who just went through the process and got satisfactory action, so, I am hoping that there have been enough changes to make it somewhat easier on those already suffering enough as it is due to regulatory redtape bullshit.

[Psycho7]

Rocky I wholeheartedly concur.

LRMC and WRAMC took good care when I went thru there in late 04.

I was lessed than impressed with IACH. Hopefully things have gotten better.

As for the State commands

Here read this.

Behavioral health treatment can and will revoke a security clearnce. You can't do your job as a leader without one.

A stigma of weakness is hung on the servicemember seeking treatment.

Most units will push for a discharge. Instead of treatment. Get rid of the problem.

Anybody who has served knows the Army screws people over daily and twice on sundays.

Myself I was EVAC'd back to the U.S.A. for PTSD. SOP in 2004 was everyone went to ward 54 till a psychiaritrist did an eval and determined if you was an immediate threat to yourself or others. I lucked out and was recommended for outpatient treatment after spending about 10 hours on Ward 54. 2 weeks later they determined I should be treated closer to home. So to Ft. Knox I went via Camp Atterbury. They had no clue how to treat or handle PTSD. They REFRAD'd me back to traditional status. As a soldier who was cross-leveled to another unit. I had to go to the unit I was actually assigned to. I hadn't drilled with in over 3 years. I did have a good realationship with the UA and URNCO. When I came home I was eligible for re-enlistment. The fat pogue, REMF, leg unit commander would not let me re-enlist until a med board was convened. I called
to the retention hotline. I was recommended for an ART15 for circumventing the CoC for calling the retention holine. I called and told them(retention hotline) That ended. I was also undergoing treatment for TB. The unit got a new URNCO and UA with command guidance to seperate all medically nondeployable soldiers. All the paperwork I submitted thru the unit to go to the medical branch was lost. So I mailed it directly. This inflamed the commander and URNCO. after being home for 120 days I went from an S-3 profile to an S-2. They let me re-up for a year.
After a flaming for circumventing their BS. They still called for a MEB. In the process my CSM(my running buddy) from the unit I deployed with calls me and asks where I was? I told him about being reverted back to my old unit. He said he wanted me back. So did the new commander, and the rest of the soldiers I went to war with. They cut a transfer the unit I went back to was glad to get rid of me. They informed me they had recommended me to be medically retired. My PUHLES was: 213312.
I told the unit I was transferred back to. It took 3 E8's, two E9,s, an O4, 2 O5's (my cmdr in Iraq and the new unit cmdr) and an O6 thru the state AG to tell the state surgeon to cool his heels on medically retiring me. I was counseled that i was non-promotable, non-deployable and if I was rated at 40% or higher for VA disability. I would face a MEB. I was able to stay in the ARNG for 2 more years mentoring and teaching other soldiers. Oct. 06 I was rated 40%. I applied for retirement and 1JAN07. I was retired.

The unit from hell I left. in 05 I found out the commander and 1SG got relieved. the URNCO got reduced and fired.

[SOWT]

Things are slightly better, the mobilised some Reserve JAG officers to represent the soldiers, and they are getting better treatment, and higher ratings. Those who want to stay in are getting (in most cases) a chance to stay.
the 2nd group of JAG are being mobbed in a month, so the Army is semi-serious about ensuring they get better treatment.

[cmiller198418]

They can't ask you about your mental status on the SF 86 when you apply for a clearance or if you hold one. I know I work as a S-2 NCOIC. Trying to avoid Soldiers not seeking the help they need.

[CAL]

I know I work as a S-2 NCOIC.

Please post an introduction. You get a pass for now because the rules aren't posted right now due to the upgrade we're going through.

[VB]

Not only that he dug up a thread from March '08.