Military members seeking action through the PEB/MEB process encounter an extremely complex world with often-puzzling rules. Wise applicants must carefully prepare for the process.
Things begin when the examinee’s physician or commander identifies potentially unfitting conditions and triggers an MEB hearing to determine whether the applicant meets retention standards. The process might be initiated based on a continuing sub-par physical profile or because the individual was returned home from deployment due to a medical condition.
Let’s suppose an old-timer named SSgt S is entering the system. What should SSgt S do? Answer: Begin by reviewing handouts provided by the system, knowledgeable websites, and a series of practice tips provided below and in future blogs. Then, should concentrate on the following:
1. Become an expert at the new “IDES process.” Read and understand his hearing rights, which are listed at DoDI 1332.18, Appendix 2, Enclosure 3, para 3 h. Depending on whether he/she is an IDES case or a legacy case, also review applicable materials at DoD Manual 1332.18V-1, DES Manual: General Information and Legacy Disability Evaluation System (LCES) Time Standards and DoD Manual 1332.18-V2, DES Manual: Integrated Disability Evaluation System (IDES).
2. If SSgt S is incapable of making prudent decisions alone, seek help from spouse, parents, or trusted friends.
3. Get into action three ways: [a] Consult in depth with the PEBLO at his medical treatment facility to help develop the medical case file and link him to his commander and the IDES system; [b] read with care — numerous websites claiming to offer solid guidance on the MEB process range from excellent to anti-military; and [c] consider retaining competent civilian counsel — a free military attorney is not provided at this stage.
4. Thoroughly use the guidance provided by the IDES program; failure to pay attention to details could have severe negative consequences.
e MEB packet typically includes the member’s history, how the injury/illness occurred, and numerous details of his/her medical condition. Listing everything is crucial! If a medical condition is omitted, there is a strong possibility it will be ignored – if not written down, it “does not exist.”
6. Insist that all critical medical examinations have been performed and detailed in the case file, including recent updates.
7. Analyze whether there is any question of the system finding the member disqualified for benefits because the conditions existed EPTS [prior to entry into the service].
8. If his military facility fails to include all medical conditions in its initial decision, submit a detailed written rebuttal.
9. Focus on the desired goal from the start: Remain on active duty? Temporary retirement list? Leave with a proper disability rating?
10. If SSgt S wants to return to duty, he should begin building his case to show substantially uninterrupted and undiminished duty performance:  A physical profile listing as few physical restrictions as possible – to this end, he might persuade his physician that a less restrictive military profile is more accurate  A detailed statement of support from his commander that physical restrictions do not prevent SSgt S from performing assigned duties  Proof of consistent, satisfactory performance of basic duties and military skills in his career field, despite possible physical constraints  Passing grades on recent physical fitness tests  Annual evaluations and reports indicating proficient performance of military duties  Letters from supervisors, indicating Sgt. S performs required military tasks well, is motivated, and has potential for advancement  Statements from health caregivers – including physical therapists, chiropractors, and counselors — confirming an ability to perform military duties and offering a good future prognosis  Letters from peers who perform alongside the applicant and can attest to his alertness and ability to meet challenges of the duty day  Visual proof — photos or videos showing the applicant performing his mission, engaging in strenuous exercise, running or exercising, etc.  Letters from friends and peers confirming that the examinee has engaged in vigorous off-duty activities, especially those involving physical prowess or exertion.
11. Contrariwise, if SSgt S seeks to leave the service, he should gather all of the above information to demonstrate an inability to perform.
12. Determine – after the initial VA determination and while still in uniform — whether to exercise the option of requesting a one-time reconsideration of VA ratings.
13. Decide if an impartial medical review is needed. See DoD Manual 1332.18-V1, Appendix 2 to Enclosure 3, para e(4). This implements Section 1612[a]  [d] of the National Defense Authorization Act for 2008, which provides that examinees like SSgt S may request an independent physician review to determine whether the findings adequately reflect all pertinent injuries or illnesses.
14. After the independent review, submit a comment or rebuttal within seven calendar days, if necessary.
15. Check IDES guides and service regulations; each service tends to do things a bit differently.
16. Make full use of his VA liaison – the Military Services Coordinator, or MSC.
17. Carefully begin working the four questions which the formal PEB system will address , which will be covered in the next blog..