DODMERB Remedial process

Goat 965

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DD is in remedial with Dodmerb, and she thought that all paperwork was in, but they are still looking for medical records from counseling that DD has with a therapist. The info was faxed to them, but it was a summary letter, and they are looking for notes from every visit. The counselor does a lot of court work, and said that she never gives notes from private sessions unless under subpoena . I saw the summary and it was well written, addressed frequency of visits, basics of discussion etc. I have a sense that Dodmerb is going to DQ her, because we can't provide doctors records etc. This is not conducted at a medical office, there is no office personnel etc, and I respect the counselors opinion to protect that informaion. What happens now? Should DD call her MALO and see what he thinks the next step would be? DD has come a long way, need to keep the ball moving.
 
DoDMERB does not negotiate. They follow their procedures to the letter because if they didn't, there would be a bunch of kids who don't actually meet medical standards for service in the services...this is why DoDMERB makes initial decisions about medical status and why I was disqualified the first time around. If the counselor does not hand in the notes, your DD will very likely be medically disqualified.

However, do not panic, as if this happens USMA may request a waiver on behalf of your DD. I went through the process and a waiver was approved for me. If she has an LOE, LOA, or any other indication that USMA is interested in her, her condition should be waived provided it is waivable and meets the basic requirements for service entry with the specific medical issue.

If the counselor doesn't give DoDMERB what they're asking for, you also risk the possibility of USMA asking for the same notes, as USMA Admissions are advised by initially DoDMERB based on its determination, and later the Army Hospital...

It'd be best to just get the notes from the counselor if you can. It's great that you respect this counselor's privacy, but it's your DD's privacy that is really recorded on those notes and it is her future that she wants to spend at USMA.
 
Dd has a nom, and LOA, and has been cleared academically and physically.
 
I would concur with GoArmy2022. DoDMERB is not in the business of negotiating. I would work tirelessly to get the documents they are requesting.

Your DD is clearly in a strong position having a nom and LOA, but at this point, she needs the clearance from DoDMERB and they will await the notes they have requested.

Best of luck to your DD!
 
"I respect the counselors opinion to protect that information"

Ummmmm - aren't your DD's medical records [including mental health] hers to decide on and not the therapist's??

I am familiar with HIPAA but never heard of a situation where a provider refuses to disclose records on request? And BTW it shouldn't be a request - it should be an instruction. As in 'you are hereby instructed to send complete transcripts of Jane Doe's records to DodMERB ASAP as previously requested.'

Try again but if push comes to shove hire an atty to send the therapist a letter instructing her to send the notes. Atty can explain consequences of DD being DQd if instructions are not followed.

Just out of curiosity has your DD requested this from her therapist directly or have the requests come from a parent . . . ? Is DD 18 yet? That comes into play I guess but nonetheless I don't think the therapist can lawfully refuse this request from authorized party.

Good luck - in case you can't tell I am long since fed up dealing with medical bureaucracies.
 
The APA states the following regarding psychotherapy notes:

Is There Any Special Protection for Psychotherapy Notes Under the Privacy Rule?

Yes, the Privacy Rule provides a higher level of protection for psychotherapy notes than for other types of patient information. For example, in most situations you cannot release psychotherapy notes without the patient signing a detailed authorization form specifically for the release of psychotherapy notes. By contrast, in most states you could release the patient’s other records for most treatment and payment purposes without consent, or with just the patient’s signature on a simpler general consent form.

Source:
http://www.apapracticecentral.org/business/hipaa/faq.aspx
 
The APA states the following regarding psychotherapy notes:

Is There Any Special Protection for Psychotherapy Notes Under the Privacy Rule?

Yes, the Privacy Rule provides a higher level of protection for psychotherapy notes than for other types of patient information. For example, in most situations you cannot release psychotherapy notes without the patient signing a detailed authorization form specifically for the release of psychotherapy notes. By contrast, in most states you could release the patient’s other records for most treatment and payment purposes without consent, or with just the patient’s signature on a simpler general consent form.

Good catch on tighter standards for psych -

But even this refers to provider releasing info other than at the direct request of the patient. I am unaware of any scenario where a provider can decline to release records at the direction of the patient.
 
It’s not really a HIPAA thing since its provider to provider communication. The therapist has the right to refuse to provide clinical documentation to a third party. Have you spoken to the therapist directly? Also, the record may just not exist anymore. The standard is 3 years after a minor reaches maturity or 7 years for an adult. Keep in mind that is APA guidance. In some cases states regulate how long you keep records.

http://www.apapracticecentral.org/update/2008/09-30/client-record-retention.aspx

Basically just beg the therapist for the records...
 
Good catch on tighter standards for psych -

I am unaware of any scenario where a provider can decline to release records at the direction of the patient.

If releasing the record has the potential to cause the patient harm, the therapist can refuse pending a court order.
 
If releasing the record has the potential to cause the patient harm, the therapist can refuse pending a court order.

In this case the OP should convince the therapist that NOT releasing the notes has the potential to cause the patient harm. (unless the therapist does not agree that military service is suitable for the patient).
 
Can't speak for OP but I would have an atty send the letter today; time is of the essence.

Any delay longer than 5 business days go get a court order - irreparable harm faces a fully qualified candidate that cannot get their medical records to DoDMERB in a timely fashion. Holidays approaching and SA application deadline is Feb 1. Do NOT let this drag on. DoDMERB waivers take time if needed.

Good Luck to OP !!
 
It's not the end of the road if she does not pass dodmerb. Sounds like the record is strong. If dq'd the service academy can and depending on the strength of the candidate will look at a medical waiver. This will be handled by the service academy. This can include a follow up appointment with a third party speciallist. Quite common. If your dd is medically dqd... she should contact her RC and follow all instructions. Deep breathe. My 2019 went through a similar experience....
 
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