Medical Evaluation Board (MEB) Lawyer
The moment a military physician refers a servicemember to a Medical Evaluation Board, the clock starts on one of the most consequential administrative processes in the armed forces. What follows will determine whether that person continues serving, separates with disability benefits, or walks away with nothing. A Medical Evaluation Board (MEB) lawyer who genuinely understands how this system operates, not just on paper but from the inside, can be the difference between a rating that reflects your actual condition and one that leaves you fighting for years to come.
The MEB is not a neutral fact-finding exercise. It is the military’s tool for deciding whether you meet medical retention standards, and the findings it generates feed directly into the Physical Evaluation Board process that ultimately controls your disability rating, your separation pay, and your access to military retirement. Servicemembers who go through this process without representation frequently discover, too late, that they failed to raise conditions, failed to challenge unfavorable language in the narrative summary, or accepted a proposed rating without understanding what they were giving up. The IDES process moves according to strict timelines, and mistakes made early are difficult or impossible to undo.
Citizen Soldier Law was built around this exact problem. The firm was founded specifically to provide legal representation to servicemembers going through MEB, PEB, and IDES proceedings, and that focus has remained central to everything the firm does since its establishment in 2013. This is not a generalist firm that occasionally handles military matters. Military disability representation is the founding purpose.
What the MEB Process Actually Looks Like from Inside the System
The Integrated Disability Evaluation System connects the MEB and PEB into a single process that runs concurrently with a VA disability evaluation. In theory, this produces faster outcomes and coordinated ratings. In practice, servicemembers regularly find themselves navigating a bureaucracy that generates paperwork at a pace that outstrips their ability to review it, where advisors are technically available but practically unavailable, and where the substantive differences between informal and formal PEB hearings are rarely explained before a servicemember has already waived their right to one.
The Medical Evaluation Board stage begins when a military treatment facility physician drafts a Narrative Summary, known as the NARSUM. This document describes your medical conditions, explains how they affect your military duties, and concludes whether you meet the applicable medical retention standards for your branch. What the NARSUM says, and crucially, what it leaves out, determines the trajectory of everything that follows. Conditions that are not documented in the NARSUM may not be rated. Conditions described in vague or minimizing language may receive lower ratings than the underlying diagnosis warrants. The servicemember generally has a brief window to review the NARSUM and submit a rebuttal, and that window is where experienced legal involvement has the most immediate impact.
An MEB attorney who has worked in JAG settings, who understands how NARSUMs are drafted and how PEB officials read them, can identify the gaps before they become permanent. Attorney Thomas Roughneen and the team at Citizen Soldier Law bring that perspective. They are not reading these documents as outsiders learning a new system. They are reading them the way people who have lived in military legal environments read them.
Why Citizen Soldier Law Handles These Cases Differently
Most disability evaluation systems, civilian or military, reward people who understand the mechanics of the process. What makes Citizen Soldier Law genuinely suited to MEB representation is not simply that the firm has handled these cases, but that the people doing the work have served in the roles that generate and review these proceedings. Attorney Thomas Roughneen is a retired, part-time JAG lawyer with National Guard service. The firm counts among its team experienced and retired JAG lawyers, a retired Army National Guard human resources NCO, and a board-certified physician specializing in Physical Medicine and Rehabilitation, Dr. Alice Tzeng, M.D. That physician is not a consultant the firm calls occasionally. She is a team member.
The presence of a board-certified physiatrist on staff is significant for MEB cases specifically. Physical Medicine and Rehabilitation is the specialty most directly concerned with functional capacity, chronic pain, traumatic injuries, and long-term disability, the precise categories that generate most MEB referrals. When the firm reviews a NARSUM or prepares a rebuttal, that medical perspective is part of the analysis. When conditions are being identified for inclusion or challenged for inaccurate characterization, a physician who understands the clinical standards is contributing to that work, not being consulted after the fact.
The firm’s combined military service exceeds one hundred years across its attorneys and staff, including veterans of Operation Iraqi Freedom. This is not a marketing statistic. It means the people reviewing your case have personal context for what service looks like, what injuries mean in a deployment environment, and what is lost when a servicemember is separated without the benefits they earned. The firm was founded in 2013 with IDES representation as its core mission, and that original commitment has shaped how it approaches every MEB case today.
The Conditions and Circumstances That Drive MEB Referrals
- Musculoskeletal injuries: Back injuries, knee damage, shoulder conditions, and joint disorders are among the most common reasons for MEB referrals, particularly for soldiers and Marines with combat deployments or physically demanding MOSs. Whether the injury results from a training accident, a vehicle rollover, or years of load-bearing service, its accurate documentation in the NARSUM determines its rating potential.
- Traumatic Brain Injury and neurological conditions: TBI generated by blast exposure, falls, or vehicle accidents affects cognitive function, sleep, and emotional regulation in ways that are not always visible and are routinely underrated. Connecting the documented diagnosis to actual functional limitations requires detailed medical and occupational evidence.
- Post-Traumatic Stress Disorder and mental health conditions: PTSD, major depressive disorder, and anxiety disorders frequently accompany physical injuries but are sometimes omitted from NARSUMs or listed as secondary conditions. Including these conditions and giving them appropriate weight in the evaluation is a common area where legal and medical advocacy matters most.
- Reserve and National Guard component referrals: Guard and Reserve servicemembers face unique complications because their status at the time of injury, whether on Title 10 orders, state active duty, or weekend drill, affects which disability system applies and what benefits are available. All IDES decisions are processed in Title 10 settings, but reaching that point requires navigating component-specific rules that differ from active duty processes.
- Conditions identified after initial referral: Servicemembers often have multiple medical conditions when they enter the MEB process, but only one condition may have triggered the referral. Raising additional conditions, including those that may not individually meet the threshold for failing retention standards but contribute to the overall disability picture, requires knowing the regulatory framework well enough to build that argument.
- Formal PEB hearing requests: When the Informal PEB produces an unfavorable finding, the servicemember has the right to demand a formal hearing. Exercising that right and preparing effectively for a formal PEB requires legal representation that understands not just what arguments to make but how PEB panels actually weigh evidence and testimony.
- VA rating disputes within IDES: The IDES process produces a VA rating that the military uses to determine separation benefits. When that rating does not accurately reflect the servicemember’s conditions, challenging it through the appropriate channels before final separation is essential, because the window for doing so without a separate VA appeals process is limited.
What to Do When You Receive an MEB Referral
The first and most practical step is to secure and review every medical record in your military treatment file before the NARSUM is finalized. Servicemembers are entitled to review their records, and doing so early gives you and your attorney the opportunity to identify conditions that have been treated but may not be characterized correctly in the MEB documentation. Waiting until after the NARSUM is drafted means working reactively. Starting before it is finalized means you can shape what goes into it.
Request a copy of the NARSUM as soon as it is complete and understand that you have a limited time window to submit a rebuttal. That window varies by branch and by the stage of the process, but it is not extended simply because you need more time to gather evidence or locate medical records. If you have private medical records, civilian physician opinions, or documentation of conditions not treated by military providers, those need to be in your attorney’s hands immediately so they can be incorporated before the rebuttal window closes.
Do not sign anything acknowledging the NARSUM findings without first understanding exactly what you are acknowledging. Servicemembers are sometimes presented with documents at briefings or appointments and told that signing is routine. Your MEB attorney should review any document before you sign it. Waivers of formal PEB hearings, in particular, are difficult to undo after the fact.
Guard and Reserve servicemembers in particular should contact legal representation immediately upon MEB referral because the component-specific questions about your status and applicable system require early analysis. The same holds true if you are close to completing a period of service that would otherwise qualify you for Reserve retirement, because the MEB timeline can intersect with that in ways that affect your options. Citizen Soldier Law handles IDES representation for servicemembers across all branches, both active duty and Reserve Component, on a national basis. The firm is not limited to New Jersey servicemembers and regularly advises and represents clients regardless of where they are stationed or where their unit is located.
A common and costly mistake is treating the Military Evaluation Board process as primarily a medical process rather than a legal and administrative one. The medical foundation matters, but the outcome is determined by how that medical information is documented, argued, and evaluated under regulatory standards. Servicemembers who rely entirely on their treating physicians to advocate for them, without legal involvement, frequently find that their physicians, however well-meaning, are not trained in how to make legal arguments before a board.
Questions About the MEB and PEB Process
What is the difference between an MEB and a PEB?
The Medical Evaluation Board determines whether a servicemember meets the medical retention standards for their branch. If the MEB concludes they do not, the case moves to the Physical Evaluation Board, which determines whether the servicemember is fit for duty, and if not, what disability rating applies. The MEB gathers and documents the medical facts; the PEB makes the fitness and rating determinations. Under IDES, both processes run alongside a concurrent VA evaluation.
Can I request that additional conditions be evaluated in the MEB?
Yes. Servicemembers can and should raise all conditions that are related to their military service or that affect their ability to perform their duties. The MEB is not limited to the single condition that triggered the referral. Raising additional conditions, and doing so in a way that is legally and medically documented, is one of the most important things legal representation can accomplish during the MEB phase.
What happens if I disagree with the NARSUM?
You have the right to submit a written rebuttal to the NARSUM. That rebuttal can challenge the characterization of your conditions, raise conditions that were omitted, submit independent medical opinions, and present evidence that contradicts the narrative summary’s findings. The rebuttal process is your primary opportunity to correct the record before the case moves to the PEB, and it should be taken seriously.
What is the difference between an informal and a formal PEB?
An informal PEB reviews your case on the paper record, without a hearing. You receive a written decision and have the option to accept it, rebut it, or demand a formal hearing. A formal PEB is an actual hearing at which you and your attorney can appear, present evidence, call witnesses, and make legal arguments. Demanding a formal hearing is a significant decision with strategic implications that should be made with legal counsel.
How does the IDES rating affect my VA benefits?
Under IDES, the VA assigns a disability rating that the military uses as its baseline for separation purposes. That rating also establishes your initial VA benefits. If you believe the rating is inaccurate, addressing it during the IDES process is generally more efficient than filing a separate VA appeal after separation, because the record is fresher and the window for correction is clearly defined.
Does the MEB process work differently for National Guard and Reserve members?
Yes, in several respects. The status of a Guard or Reserve servicemember at the time of injury or diagnosis affects which laws apply and what benefits are available. However, all IDES proceedings, including the MEB and PEB stages, are conducted in Title 10 active duty settings regardless of component. Guard and Reserve members should have legal representation that is specifically familiar with component-specific rules, because the pathway to the IDES process itself is different from the active duty pathway.
Can I continue to receive my salary during the MEB process?
Active duty servicemembers generally continue to receive pay and benefits while the MEB and PEB process is underway. Reserve and National Guard members’ pay situations depend on their orders status and whether they are on extended active duty. This is one of several reasons why the status question for Reserve component members requires careful analysis early in the process.
What if the PEB finds me fit for duty but I believe I am not?
A finding of fit for duty from the informal PEB can be challenged by demanding a formal PEB hearing. At the formal hearing, you can present medical evidence, expert testimony, and legal argument challenging the fitness determination. This is a situation where legal representation is particularly important, because reversing a fitness finding requires building an evidentiary record that directly contradicts the board’s initial assessment.
Can conditions that existed before I joined the military be included in an MEB?
Pre-existing conditions can be included if they were aggravated by military service beyond their natural progression. The standard for service-connected aggravation is a legal and medical question that requires careful documentation. Simply having a pre-existing condition does not disqualify it from the MEB process, but establishing aggravation requires evidence that connects military service to the worsening of that condition.
What happens to my case if I separate before the MEB process is complete?
Separating before the MEB process concludes can complicate or foreclose your ability to use the IDES system and may require you to pursue disability compensation entirely through the VA. Servicemembers should be very cautious about any separation action that is proposed while an MEB is pending, and should have legal representation review the situation before agreeing to any administrative separation, retirement, or discharge action.
Is it worth getting a lawyer for an MEB if my condition seems straightforward?
The cases that appear most straightforward are sometimes the ones where the most is left on the table. A servicemember with a clear, documented injury may receive a rating far below what the condition actually warrants because secondary conditions were not raised, because the NARSUM used imprecise language, or because the servicemember accepted an informal PEB decision without realizing a formal hearing was available. Legal review early in the process costs far less than the long-term difference between an accurate rating and an undervalued one.
MEB and IDES Representation Across the Country
Because all IDES proceedings are conducted under Title 10 federal authority, Citizen Soldier Law’s representation in MEB and PEB matters is not limited by geography. The firm serves servicemembers at installations and bases across the country, including those stationed in New Jersey, New York, Pennsylvania, Delaware, and throughout the Northeast corridor. The firm also represents Guard and Reserve members from units across the mid-Atlantic region, including New Jersey Army National Guard and Air National Guard components, as well as servicemembers from Connecticut, Maryland, Virginia, and beyond.
The national scope extends further. Servicemembers stationed at installations in the Southeast, Midwest, and South regularly work with the firm on IDES matters because the legal and regulatory questions are federal in nature. Clients from states including North Carolina, Georgia, Texas, Colorado, Washington, and California have sought the firm’s assistance, particularly Guard and Reserve members whose home state units may not have easy access to experienced MEB counsel. The firm also handles IDES cases for servicemembers from all branches, Army, Navy, Marine Corps, Air Force, Space Force, and Coast Guard, because the Title 10 system applies across components.
Speak With an MEB Attorney About Your Evaluation
If you have received an MEB referral, received a NARSUM you believe is inaccurate, or are facing a PEB determination that does not reflect the severity of your conditions, consulting a Medical Evaluation Board attorney early in the process gives you the best possible foundation for what comes next. The team at Citizen Soldier Law, including attorneys with JAG experience, a medical professional, and staff with deep military service backgrounds, reviews these cases with the specific knowledge that the process requires. Contact the firm directly to discuss your situation and learn what legal representation can do at your stage of the IDES process.
