The Armed Forces, an unwell serving member and duty of care.
Discussion
Hello.
I'm looking for help from anyone either in the forces and/or from a Doctor.
Although this post talks about medical problems it is mainly about the forces and legal issues surrounding duty of care.
This is a long post so sorry in advance.
A friend works for the forces and is currently based in the uk. She is separated with two children under 4 who live with her.
She has diagnosed depression, worsening two years ago after separation and on medication.
She was posted to a major city, which is away from friend and family support. It's a very long story but the highlights are:
At the new post, line manager was/is horrendous. In my opinion, a bully and very immature. My friend is a manager and she reports to this bully.
One of her children had/has a medical problem which put them in hospital 4 times in the last month which means my friend has had to take lots of time off work and is being put under pressure from work because of this.
Other issues include severe money worries, ex not helping at all, car troubles, house problems, etc. She had a chest infection, flu and other issues last month but had to keep going because of the children. She has other medical issues.
She has zero support where she lives. She has had to take a lot of time off for reasons above, as annual leave, sick leave and compassionate leave.
Her normal day is up at 5am and out the door with two small children at 6.45. Kids to nursey which is costing her a fortune and finally home at 6.30. Sort kids out, bed, sort house/tomorrow out and finally see bed by 10....and get up at 5 to do it again five days a week. The weekend seems to be just catching up and then do the week again.
She wants a medical geographical posting to be near family support so she can get better but they will not allow this.
The other option she could have would be preferential treatment post, which they are delaying and will not guarantee. This has been going on for 3+ months now.
She is at her wits end, exhausted and feels her only recourse is to leave. This would be a shame as she has been in 14 years, has worked through the ranks and used to enjoy her job.
The immediate problem is that the doctor that she has seen who works for the forces will not sign her off on medical grounds. The doctor agrees that she is exhausted but the fact that she 'gets up in the morning' shows, in the doctor's opinion, that she is coping even though she cried throughout the whole last appointment.
She has other medical signs of stress and depression but the doctor will not sign her off sick or agree to a medical geographical posting. This means she HAS to go to work and continue on the hamster wheel in a terrible exhausted state until something breaks which is very close.
If she does not go to work without being signed off then she is AWOL and will be arrested.
She is the sole carer for the children, so giving up is just not an option. If she does, children would have to go into care.
She feels that the doctor is acting completely unreasonable by not signing her off as sick.
She, and we, feel the doctor is failing in their duty of care.
She is completely stuck and is desperate for help. She doesn't want to PVR but feels she has no choice.
Any suggestions as to what to do next?
Thanks.
I'm looking for help from anyone either in the forces and/or from a Doctor.
Although this post talks about medical problems it is mainly about the forces and legal issues surrounding duty of care.
This is a long post so sorry in advance.
A friend works for the forces and is currently based in the uk. She is separated with two children under 4 who live with her.
She has diagnosed depression, worsening two years ago after separation and on medication.
She was posted to a major city, which is away from friend and family support. It's a very long story but the highlights are:
At the new post, line manager was/is horrendous. In my opinion, a bully and very immature. My friend is a manager and she reports to this bully.
One of her children had/has a medical problem which put them in hospital 4 times in the last month which means my friend has had to take lots of time off work and is being put under pressure from work because of this.
Other issues include severe money worries, ex not helping at all, car troubles, house problems, etc. She had a chest infection, flu and other issues last month but had to keep going because of the children. She has other medical issues.
She has zero support where she lives. She has had to take a lot of time off for reasons above, as annual leave, sick leave and compassionate leave.
Her normal day is up at 5am and out the door with two small children at 6.45. Kids to nursey which is costing her a fortune and finally home at 6.30. Sort kids out, bed, sort house/tomorrow out and finally see bed by 10....and get up at 5 to do it again five days a week. The weekend seems to be just catching up and then do the week again.
She wants a medical geographical posting to be near family support so she can get better but they will not allow this.
The other option she could have would be preferential treatment post, which they are delaying and will not guarantee. This has been going on for 3+ months now.
She is at her wits end, exhausted and feels her only recourse is to leave. This would be a shame as she has been in 14 years, has worked through the ranks and used to enjoy her job.
The immediate problem is that the doctor that she has seen who works for the forces will not sign her off on medical grounds. The doctor agrees that she is exhausted but the fact that she 'gets up in the morning' shows, in the doctor's opinion, that she is coping even though she cried throughout the whole last appointment.
She has other medical signs of stress and depression but the doctor will not sign her off sick or agree to a medical geographical posting. This means she HAS to go to work and continue on the hamster wheel in a terrible exhausted state until something breaks which is very close.
If she does not go to work without being signed off then she is AWOL and will be arrested.
She is the sole carer for the children, so giving up is just not an option. If she does, children would have to go into care.
She feels that the doctor is acting completely unreasonable by not signing her off as sick.
She, and we, feel the doctor is failing in their duty of care.
She is completely stuck and is desperate for help. She doesn't want to PVR but feels she has no choice.
Any suggestions as to what to do next?
Thanks.
It does sound as though the doctor isn't really taking this very seriously. Is there any chance she can see a GP who isn't in the forces?
Also, you say the children's father is not around is he meeting his responsibilities financially and morally?
Not much help I'm afraid but all the best to your friend.
Also, you say the children's father is not around is he meeting his responsibilities financially and morally?
Not much help I'm afraid but all the best to your friend.
She is registered to this current one and doesn't think she can change to a civilian one. Maybe someone in the forces could say a diffinitive yes or no....?
The father is meeting his commitment financially but is not really around to help. Sometimes he does help but mostly be cancels or says he is otherwise busy....
Thanks for the reply.
The father is meeting his commitment financially but is not really around to help. Sometimes he does help but mostly be cancels or says he is otherwise busy....
Thanks for the reply.
What rank is she?
There are plenty of ways to flag to someone other than direct line of command if you have issues that are not being taken seriously. Who to speak to depends upon your position in the pecking order.
If, as you allege, it's verging on bullying, the forces now take this very seriously indeed.
There are plenty of ways to flag to someone other than direct line of command if you have issues that are not being taken seriously. Who to speak to depends upon your position in the pecking order.
If, as you allege, it's verging on bullying, the forces now take this very seriously indeed.
frodo_monkey said:
May i commend SSAFA, the Padre or the Hive to your friend? Even if the SMO/RMO/whatever the Navy equivalent is of 'doctor' is unsympathetic, those three should have a direct line into Stn Cdr/Col/Navy equiv to be able to assist.
This. Padre can open doors I didn't know existed! Couple of options she can take.
1. Speak to padre/Chaplin and get them involved with the compassionate side, god squad are normally very good at this.
2. Speak to CO of her regiment via RSM, unless her boss is RSM.
3. Request another medical officer, sometimes difficult if they only have 1 or 2 as they will tend to stick together. Civi GP isn't an option, they will not want to get dragged into a possible medical discharge compensation issue.
If she didn't go to work she could get classed as awol, but the likelihood of the RMP/regt police arresting her whilst in a quarter is slim, if she's living off camp they could move her on and confine to quarter for medical help. Is she full time regular or mod employee?
1. Speak to padre/Chaplin and get them involved with the compassionate side, god squad are normally very good at this.
2. Speak to CO of her regiment via RSM, unless her boss is RSM.
3. Request another medical officer, sometimes difficult if they only have 1 or 2 as they will tend to stick together. Civi GP isn't an option, they will not want to get dragged into a possible medical discharge compensation issue.
If she didn't go to work she could get classed as awol, but the likelihood of the RMP/regt police arresting her whilst in a quarter is slim, if she's living off camp they could move her on and confine to quarter for medical help. Is she full time regular or mod employee?
I'm forces, I have to say that in general the care we get is great and in situations of a compassionate nature the RAF in my case have been excellent. I even spent 3 years on Hercs' and if a comp case came in it was a case of drop everything and get the plane prepped and in the correct role fit ASAP. I am aware though that we are a fighting force and with depression she will never be issued a weapon. A fellow colleague of mine a few years back (also a single mum from up north living hundreds of miles from any other family) had a case to go to the med centre with depression and she was posted within 48 hours but lost her green card straight away.
I feel sorry for your friend but sometimes service life is not compatible with your own life and in that case she needs to decide if staying in is worth it. She takes the pay cheque and therefore has to be able to do they job and if child/family /medical conditions are a LONG TERM issue then she needs to consider her future.
I would like to caviars that the last statement is about long term issues. If she is just having temporary problems then the armed forces in my experience are excellent at dealing with their manpower.
As a side note. Get her to go to HR and ask them to explain the redress procedure and see what her options are over bullying.
Oh and as others have mentioned the pardre has direct access to lots of people and facilities. It is truest amazing how high and how fast people run when they get involved.
I feel sorry for your friend but sometimes service life is not compatible with your own life and in that case she needs to decide if staying in is worth it. She takes the pay cheque and therefore has to be able to do they job and if child/family /medical conditions are a LONG TERM issue then she needs to consider her future.
I would like to caviars that the last statement is about long term issues. If she is just having temporary problems then the armed forces in my experience are excellent at dealing with their manpower.
As a side note. Get her to go to HR and ask them to explain the redress procedure and see what her options are over bullying.
Oh and as others have mentioned the pardre has direct access to lots of people and facilities. It is truest amazing how high and how fast people run when they get involved.
Edited by Markbarry1977 on Saturday 14th January 14:05
JumboBeef said:
She is registered to this current one and doesn't think she can change to a civilian one. Maybe someone in the forces could say a diffinitive yes or no....?
The father is meeting his commitment financially but is not really around to help. Sometimes he does help but mostly be cancels or says he is otherwise busy....
Thanks for the reply.
Any serviceman has the right to choose a civilian doctor in the local area. It's a pita, and the medical centre have to be kept informed of all medical problems. You can't hide stuff by going to a civie doctor and I believe ultimately an armed forces doctor can overrule a civie doctor in terms of sick notes etc. The father is meeting his commitment financially but is not really around to help. Sometimes he does help but mostly be cancels or says he is otherwise busy....
Thanks for the reply.
Has she sort to get a light duties chit or maybe see about getting a restricted hours chit. I know of one you SAC who they found out had a heart problem about 3 years in. He ultimately was on a light duties chit and 1/2 days. He ended up with a medical discharge in the end.
Welfare officer, every unit should have one. If she hasn't already then she can see him/her and explain the issue. Equally and as noted previously, padres can be worth their weight in gold but not every unit has one of course. If her immediate line manager is being a complete dick there is always the Service Complaint route and there is a dedicated team for bullying and harassment in the Services. There are ways out of this miserable predicament she's in but it does take a degree of 'balls' to do it.
Padre and SSAFA first thing in the morning.
Ours are contactable 24/7.
Bullying complaint for the future. Go above her line manager. It would certainly not be ignored at my establishment, it would be taken very seriously.
Do they have those details to hand? Do you need someone to find them for you?
Can you say which service? Regular or MOD civilian?
Ours are contactable 24/7.
Bullying complaint for the future. Go above her line manager. It would certainly not be ignored at my establishment, it would be taken very seriously.
Do they have those details to hand? Do you need someone to find them for you?
Can you say which service? Regular or MOD civilian?
I'm in the Army (15 years) and am pretty familiar with their medical regs - RAF and Navy will be slightly different (for no obvious reason), but my points will still broadly stand.
1. If she is anything other than fully deployable then she will have been issued with a document which details exactly what she can and can't do in terms of employment. It's called a PAP 10 Apendix 9. She should have a copy, as should her line manager. If, as you say, she has been diagnosed with depression then I very much doubt she will be allowed to handle live weapons, so will not be fully deployable. Thus, she will almost certainly be downgraded and have an Appendix 9. In order to extend a downgrade beyond 12 months requires a 2 member medical board, so a single rogue doctor should not be able to screw her over.
2. As long as her boss is complying with the limitations set out in her Appendix 9, then he isn't breaking any rules. Obviously, he can apply discretion on top of that, but that's a separate issue. Some soldiers will try every trick in the book to weasel their way out of work, and that is exactly why we have such a system. I'm not saying it's the case here, but if others are having to pick up the work that she doesn't do then that can breed resentment, which her boss has to manage. I've seen this happen, and it's a pain in the arse. Bosses aren't medical experts - doctors are. We listen to the doctors and act on their advice.
3. Specialist mental health care is available for serving personnel at 16 Department of Community Mental Health (DCMH) centres. They are very good - I have personally been treated at one. However, like most aspects of the public sector, they are under resourced and oversubscribed. If she hasn't been to one then she needs to specifically ask for a referral to one.
4. Any permanent (or expected to exceed 12 months) medical condition that renders you unable to work for at least 32 hours per week will result in medical discharge. If the medical condition was caused by the military then she will get a juicy tax-free pension.
5. If her boss is being excessively unsympathetic or expecting her to work beyond the limitations of her appendix 9 then she has several options: padre, welfare office or she can submit a service complaint. The service complaint is a slightly nuclear option, but things will happen. She just needs to make sure of her position and gather the evidence before firing the cannon. Bullying is definitely not tolerated in the armed forces and will be dealt with if raised.
6. Service life is demanding. When you join up, you do so knowing that you might be sent to work in distant places without friends or family close by. If her circumstances are such that she can no longer accept this condition of service, then maybe whe needs to reconsider whether being in the military is right for her. If she's commissioned then she'll be 2 years from her immediate pension point, so leaving will be a very difficult decision. If she's an NCO then she's got a bit longer to push.
My advice, in the first instance, would be to go through the welfare office route, or via the padre. She has my sympathies - I wouldn't want to be serving as a single parent.
1. If she is anything other than fully deployable then she will have been issued with a document which details exactly what she can and can't do in terms of employment. It's called a PAP 10 Apendix 9. She should have a copy, as should her line manager. If, as you say, she has been diagnosed with depression then I very much doubt she will be allowed to handle live weapons, so will not be fully deployable. Thus, she will almost certainly be downgraded and have an Appendix 9. In order to extend a downgrade beyond 12 months requires a 2 member medical board, so a single rogue doctor should not be able to screw her over.
2. As long as her boss is complying with the limitations set out in her Appendix 9, then he isn't breaking any rules. Obviously, he can apply discretion on top of that, but that's a separate issue. Some soldiers will try every trick in the book to weasel their way out of work, and that is exactly why we have such a system. I'm not saying it's the case here, but if others are having to pick up the work that she doesn't do then that can breed resentment, which her boss has to manage. I've seen this happen, and it's a pain in the arse. Bosses aren't medical experts - doctors are. We listen to the doctors and act on their advice.
3. Specialist mental health care is available for serving personnel at 16 Department of Community Mental Health (DCMH) centres. They are very good - I have personally been treated at one. However, like most aspects of the public sector, they are under resourced and oversubscribed. If she hasn't been to one then she needs to specifically ask for a referral to one.
4. Any permanent (or expected to exceed 12 months) medical condition that renders you unable to work for at least 32 hours per week will result in medical discharge. If the medical condition was caused by the military then she will get a juicy tax-free pension.
5. If her boss is being excessively unsympathetic or expecting her to work beyond the limitations of her appendix 9 then she has several options: padre, welfare office or she can submit a service complaint. The service complaint is a slightly nuclear option, but things will happen. She just needs to make sure of her position and gather the evidence before firing the cannon. Bullying is definitely not tolerated in the armed forces and will be dealt with if raised.
6. Service life is demanding. When you join up, you do so knowing that you might be sent to work in distant places without friends or family close by. If her circumstances are such that she can no longer accept this condition of service, then maybe whe needs to reconsider whether being in the military is right for her. If she's commissioned then she'll be 2 years from her immediate pension point, so leaving will be a very difficult decision. If she's an NCO then she's got a bit longer to push.
My advice, in the first instance, would be to go through the welfare office route, or via the padre. She has my sympathies - I wouldn't want to be serving as a single parent.
Unless there are specific forces regulations which I am unaware of, she is perfectly entitled to register with a local GP surgery and be seen and treated by them. In addition they will be completely independent and I would expect their opinion to carry more weight than the forces medic as a result.
jm doc said:
Unless there are specific forces regulations which I am unaware of, she is perfectly entitled to register with a local GP surgery and be seen and treated by them. In addition they will be completely independent and I would expect their opinion to carry more weight than the forces medic as a result.
The GP can refuse and refer them back to the units medical officer, sometimes a civilian GP that works for the MoD or a military doctor. If she lives on camp then I can't see any GP getting involved, if she lives off camp and it's a distance she could drop in as an occasional patient, but that's up to the GP. I've had this when I lived off camp, 50+ miles from my unit, the Practice refused to see me and my wife and referred us back to our medical officer. Fozziebear said:
jm doc said:
Unless there are specific forces regulations which I am unaware of, she is perfectly entitled to register with a local GP surgery and be seen and treated by them. In addition they will be completely independent and I would expect their opinion to carry more weight than the forces medic as a result.
The GP can refuse and refer them back to the units medical officer, sometimes a civilian GP that works for the MoD or a military doctor. If she lives on camp then I can't see any GP getting involved, if she lives off camp and it's a distance she could drop in as an occasional patient, but that's up to the GP. I've had this when I lived off camp, 50+ miles from my unit, the Practice refused to see me and my wife and referred us back to our medical officer. jm doc said:
Unless there are specific forces regulations which I am unaware of, she is perfectly entitled to register with a local GP surgery and be seen and treated by them. In addition they will be completely independent and I would expect their opinion to carry more weight than the forces medic as a result.
I am serving member of the RAF. She IS NOT entitled to register with a civilian GP unless she is on leave and it is on a temporary/emergency basis only and there are no military units near by which can see her. The NHS has specific contracts with the MOD to provide certain services at certain hospitals and in the case of smaller units, the local GP surgery may be contracted to provide services beyond the units own. In short even though we pay national insurance we have no entitlement to NHS services. Emergency Care such as A and E works as normal and I presume the MOD is billed.OP, please get your friend to get in contact with SSAFA. She should not have to suffer like that and they WILL sort this issue. It would most likely result in a preferential posting which would impact promotion but by the sounds of it, it's the least of her worries.
More worryingly is the numbers of people recently who seemed to have been advised by their Mil Admin or HR who have not dissimilar circumstances that the armed forces may no longer be a good fit for them rather than trying to work the issue in any real depth.
Lastly the numbers of personnel being allowed to work on with permanent injuries and disabilities seems to have increased somewhat in recent years presumably in favour of avoiding medical discharge and associated costs. One person I've worked with even requires wheel chair use is still serving very capably in a desk job.
jm doc said:
Unless there are specific forces regulations which I am unaware of, she is perfectly entitled to register with a local GP surgery and be seen and treated by them. In addition they will be completely independent and I would expect their opinion to carry more weight than the forces medic as a result.
Whilst I agree with the first part I certainly don't agree with the second. In reality, the civilian GP is likely to carry less weight in the eyes of the military simply because a civilian GP will have less experience of the pressures and different circumstances that service personnel are exposed to. This is not a criticism, it is just how it is. For the purposes of military life, any serviceman who has been diagnosed by a civilian will need to be assessed by a military doctor in order to grade them in terms of deployability and a military doctor will not take a civilian diagnosis at face value. Where service personnel are referred to a civilian specialist then of course the process will be different. An interesting factor in the OP's case is that he seems to imply that the doctor works for the forces than being a uniformed doctor and this is far from unusual. The reality is that the Army is short of GPs and many are civilians contracted in to work for the military and have done for some time and that comes with a degree of risk with regard to self-interest, an understanding of the serviceman's needs and occasional indifference. It is rare for a military doctor to ignore a serviceman who is genuinely in need of help, the checks and balances from within help to mitigate some of the risk associated with poor care but there is also an element of looking after their own which drives many military doctors to join up in the first place and these motivational aspects are not so prevalent within the contracted community. In short, some are not that morally driven to do the right thing and perversely place a greater emphasis on a serviceman to 'just get on with it' because that's what they believe they are paid to do, in a clumsy sort of way. The reality is that service personnel are just like any other people in society in their health seeking behaviour, the stressors may be unique to service life but the symptoms are not wildly different. A military doctor will have a greater understanding of service life than a civilian doctor will. She can of course register with a civilian doctor but if that doctor signs her off she will still need to be seen by a service doctor in order to manage her long term care and suitability for deployment and ongoing service life.
It's difficult to comment on the OP's friend because we do not have all the facts but if we were to take the story at face value then it would seem that the care she is receiving is below par and not what would normally expect in service life. She is far from unusual, there are many military single mothers who manage a career in the forces with little or no problems but it does take a chain of command to make it work and when it doesn't, there are ways to redress it some of which have been highlighted above. In short, the problem highlighted above is fixable but if her first hurdle is her GP then she will need to go through her Welfare Officer who has a great deal of power at Unit Health Committees to recommend a particular course of action. She is also entitled to be seen by another doctor if she is unhappy with the care she is receiving and she can make a complaint. Service personnel have the same rights as civilians in this regard however military people are not very good at this for fear of rocking the boat. Daft but true.
Edited by Osinjak on Saturday 14th January 23:50
Edited by Osinjak on Sunday 15th January 12:19
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