2 branches, many injuries MEB coming, need anwers

[disposableairman]

Long story, but here it goes.

In 1998 I joined the Marines as an infantryman. I was active duty for 4 years and then honorably discharged. At the time of discharge I was seriously in bad enough shape to be medically discharged. In my two units I was in, broken men were treated very poorly. I watched one of my good friends treated like shit for 2 years because of a severe back problem and this caused me to take my problems with me and hope the VA could fix me. Whoops!

In my first year in I started having lots of pain. I got shin splints and bad knees and bad shoulders. Physical therapy helped the shin splints but nothing else. The shoulders were “diagnosed” by about 10 doctors as bursitis. No diagnosis on the knees. I started getting ringing in my ears over the years. In 2001 I severely sprained my ankle in Jungle warfare training in Okinawa Japan but had to hike 6 miles to our base camp on it. I was not offered a trip the several hours to the closest hospital and feared looking bad to my Marines if I did leave. Big mistake again. The following week it was only x-rayed and came back negative. I wore a thin brace under my boots for the next year and ate plenty of Motrin, which I was already on a constant regimen for the increasingly worse shoulder problem. BTW, not once in the Marines were my shoulders x-rayed or MRI-ed. Then the last injury was pulling my back one month away from my exit date. I was picking up a prc-119 and tweaked it up good. It was diagnosed as a pulled muscle and no meds were prescribed since I was still on Motrin. Again no imaging was done for that either.

I left with my honorable in June 2002 and joined the Air Force Reserve in August 2002. I also filed with the VA who did an exam and also MRI-ed my shoulders. When I got the whole package back I was amazed. Denied on every injury. Un-believable. I was told I couldn’t receive VA compensation and military pay (not true) at the same time so I didn’t appeal it. Instead I sent in a personal letter and told the board they were complete morons and they were idiots if they thought my injuries were not service connected. They in turn sent me a letter saying I was now rated at 0% for 4 injuries including my shoulders. I figured at least when it gets worse later on I can fight to have it raised.

Fast forward. After 4.5 years in the reserves I was sent to a month long combat skills training and then on to Kuwait. The combat skills training brought back to life pain like I hadn’t know in some time. Just before I left I had a rheumatologist from the VA give a shot of steroids in each shoulder and prescribe hydrocodone 10/650s to help with the pain. I tried to take as little as possible of the pain meds and began only taking them before bed as I couldn’t sleep. Through the deployment my shoulders got worse from my job as a laborer/equipment operator. My knees and ankle got worse from running on asphalt 3 days a week (mandatory) We had no hospital and when I needed meds, I had to travel to another base which couldn’t be done conveniently. On one trip a doctor I hadn’t seen made a huge deal about operating equipment and carrying my rifle (daily) on narcotics. Because of that when our project in Kuwait was finished a few weeks later, instead of being sent to Iraq to finish the next 3 months of my 6 month deployment, I was sent to Al Udeid Qatar. I was given x-rays for my shoulders and knees and diagnosed with bilateral shoulder impingement (wrong) and runners knee for both knees. I did therapy for each and my knees didn’t improve, and my shoulders got worse. I was given 1 more shot in each shoulder. It was back to chronic pain in less than a day. I was also still working just not operating machinery and pulled my back again. After 6 weeks of physical therapy 3 times a week I was sent home (two weeks early).

When I got back to my home base I had MRI’s done. This showed some tearing in my shoulders and the doctors asked if I wanted surgery and of course jumped at the opportunity to fix the problem. I was told the doctor in Qatar was wrong and I didn’t have impingement syndrome. So in December 2007 I had my first surgery since the pain started in 1999. The bad news, when I got out of surgery the doctor told me I would be in pain most likely the rest of my life. He showed me the pictures and I had bone on bone inside. My humeral head was missing a lot of cartilage. I also had a torn rotator cuff which was fixed. I had my next surgery in March 2008 for the other side. The rotator cuff on my left was fine, but same story, cartilage was gone. I have seen 4 surgeons and they say the only thing to stop the pain is bilateral hemi-arthroplasty. Still no doctor has a clue how this happened. I then had a surgery on my right ankle in August 2008 which it seems is unsuccessful. It still hurts just as it did before surgery.

In the middle of all this I found out the VA had charged me for all my service connected issues since 2002 which I mistakenly paid. When I asked for an audit they told me I had no rating they could find in the system. I emailed my original 0% letter. Now I am told I was rated 10% for tinnitus so I have asked the DAV to look into it for me. I also pulled my VA records and it had my MRI results from my evaluation that actually showed some damage to my shoulders which I was never told about.

Now for the real problem I am concerned about. As you can tell I am in pretty poor shape to be in the military, they started an MEB in March of this year. I am still waiting on a IPEB since awhile ago the local board found me unfit for duty. My case manager and a Staff Sergeant at the hospital both told me I could only be medically boarded for one thing, and since my shoulders were the worst, I would be boarded for that. I didn’t agree with this policy since it is obvious my knees, ankle and back were also affecting my career. When my package was forwarded up to the IPEB I included my Marine medical records and a letter stating that all of my medical problems should be considered in the decision. Further, I asked them to consider the “existed prior to service” that was labeled in my package be changed, considering that the problems occurred originally on active duty (Marines). What I am worried about is that since all my medical problems are not being considered, I am not getting due process. I know I am only getting one shot and that is the formal board. I just know the informal board is not going to get all the information correct. I stand to get a very unfair rating since I was lied to in the beginning and my case manager refused to listen to me.

Points:
Injured both knees, both shoulders, back, and Right Ankle as an active duty Marine
Aggravated above injuries while deployed/activated Air Force reservist
Only being boarded for shoulders, even though all problems listed affect my afsc/mos
Is it still EPTS/Aggravated if all injuries occurred while active?

Is it possible to have a medical board pulled back and done correctly?
What else can I do to make sure I am being treated fairly?

Thank you for all your help.

[Jason]

disposibleairman,

Welcome! Sorry to hear about your injuries. That is a bunch of crap (to use a technical term) about only boarding you for your most serious condition.

To answer your question, it is possible to have a case returned to the MTF/MEB for proper evaluation. The PEB can order this on its own volition, or you can argue for it and request it either in a letter of disagreement to the MEBs findings, or at the PEB. The best chance for success is if you have DLC/AF IMT 469 listing limitations attributable to your other conditions (this is hard to find because the new 469, as opposed to the old 422 does not list conditions) or if your treatment notes/SF 600 has clear documentation that you have a condition and you can show that it fails retention standards.

One problem with AF cases is that the IPEB will make its decision and then forward your case to FPEB if you disagree. Once that happens, the IPEB does not act on the case further. The FPEB often takes the position that it won't/can't rule on a case until it hears the case. So, it is harder to get an earlier return of a case, in my opinion, than for Army cases where the IPEB/FPEB are the same board. I can say that I have had several AF cases returned to the MTF/MEB for further evaluation when I argued for it and thought that was the appropriate outcome. I have never had them deny a request I have made for this (though, this does not guarantee that every case will have the same outcome).

In cases like yours, I would prepare the argument for the rating you think is appropriate the best you can, but if the evidence is not there due to the inadequate MEB, you should argue for the return of the case. The bigger threshold will be, initially, having evidence of unfitness for your other conditions. BTW, cases like yours are exactly why Congress mandated the right to an Independent Medical Advisor on request.

Best of luck and please let us know any questions.

[disposableairman]

Thanks so Much,

I have been getting bad advice from "my side". It was so bad, I actually asked my case manager if there was anyone that helps me with questions and concerns and makes sure I am taken care of. She said "thats my job". "then I argued with her for 20 minutes that my leg problems were not boardable since I can be on a no running waiver. Well, I need my legs to work so I felt it was.

I will keep up with whats going on and I am glad I had a place to get real advice. My case manager/liason just doesnt want to cause more work for themselves. I get that, but I am only getting the boot once, and I want the soft and velvet boot (not a steel toe one)

Thanks Jason!

[disposableairman]

I got my informal board results. I got exactly what I expected. 10 % for left arm, 10% for right =19 +1.9% bilateral factor rounded down to 20%. It labeled the disability as bilateral shoulder pain due to rotator cuff tear. This is the least of my problems and shows how inaccurate they have been My shoulder pain is caused by NO-cartilage in my joint and oste-arthirtus. I called lackland by advisement of my so called case manager. I talked to a para-legal and he told me to fight it. He also said I can petittion the hospital commander to have my MEB redone at the local level. I finally got a copy of my one and only LOD (for my shoulders). I wrote other LODs, printed the corresponding medical records and made a package for my unit (reserve Dr. who also practices full time at a VA clinic) Dr. who somehow lost and never completed them. The para-legal at lackland said this is why I was rated so low and they are not considering anything else, despite my rebuttal letter and full medical records I submitted.

It is so frustrating. I could have fought the VA when I left the Marines for 20%. Why would I serve 6 more years in the military just to get what I could have got. I worked out the numbers and if I was returned to duty (I was told by my case manager if I fought at the formal board they could lower my rating or return me to duty) I could get 20% from the VA, my monthly drill pay and finish my 10 years. Then when I am 60 draw a real retirement. I added it up and it is about 1.4 million if I die at 90. That is 1 million more than getting the hard boot now and collecting only 20%. I want a retirement. I would prefer a 20 year retirement but would accept a =+50% medical retirement.

I have to assume the informal board didnt read my letter. How is it my Dr.s, case manager, peblo, and the informal board are not doing their jobs?

I did find out there is a new medical reseve squadron coming to nellis AFB. I have already contacted them and they said they will start re-writing my LOD's next week. My shoulder lod took 15 months and I am supposed to go to my formal board mid-January. If they are not done, I will fight to have it brought back. I dont trust the formal board to take all my problems seriously without these little pieces of paper.

I will keep it posted up here as it goes. I know there are folks alot worse than me and i hope everybody stands up for them selves. I have been on my MEB over 10 months, now I know why people just quit and sign their rights away.

[sfxer02]

welcome to the board

[disposableairman]

Ok, now I am frustrated. I have talked to a para-legal in Texas. He told me I have a few options. I could talk to the hospital commander and ask him to pull the board to have it re-evaluated and submittted properly with the LOD's completed for my back, knees and ankle. Or if I go to the formal board I can ask them to either consider my case without the LOD's or have them send the board back to have the paperwork re-done.

So I asked the patient advocate to let me see the hospital commander. I just received a call back from the patient advocate saying the hospital commander spoke to the medical group commander and they decided no dice. He said I could meet with him but the answer would still be no.

This is the same guy who denied my surgery after two surgeons said it would make me better. The cure for my shoulder problems (severe cartilage degeneration) is to have bilateral hemi-arthroplasty. Basically they would shave the bone down in my shoulder and place steel over the bad cartilage. Well, he said no and my case manager said it was because it would take to long to recover. About a year. If they had done it, I would be healthy by now. It has been a year and I am still around because they are completely incompetent.

Is it possible to get this surgery done that will fix me? How can I go over this local hospital's head to get it authorized? I figure at this point, if they wont retire me at a large number, I might as well be fixed.

[disposableairman]

I saw the hospital commander today. He said without them seriously breaking legal rules they would not pull the board back to the local level.

He did say they might do the surgery on my shoulders to correct the cartilage problem. I basically have to get the on-base surgeon to state that I for one need it, and two it may make me medically fit to stay in the Air Force.

As far as boarding me for everything relevant, I need to complete the Line of Dutys in record time and show I have been sidelined from my primary duties because of the other problems. The hard part about that, is profiles were random and didnt always include everything. So I will try to show them this is a pattern and not something I came up with just because I am being boarded.

The new morale of the story, I should have been building this case the entire time. I thought if I documented it at medical, that would be enough. Now I will be in a mad dash to get finished in time, or atleast present the strongest case possible.

The most important thing I learned today is that since it is possible, just rare, for a MEB to come back, my case manager and PEBLO are either liars, or not very informed. Either is bad, but I did read on hear 10 months ago in someone elses post, no one is your friend. Find out who is signing their checks, if it aint you, you're in trouble. (I believe an exception is the attorney team at the formal board, but correct me if I am wrong)

ps, is insomnia compensable, if it is caused by my medications and pain enough to keep me awake?

[robs42]

i feel your pain,

i've been going through this w/my MEB for a year and a half now. alot of the problems lye in a lack of knowledge and that they just don't care, because it dosn't affect them. i would deffinately start mentioning the lack of sleep to your PCM and get that stuff documented. i'm sure that along w/all of this comes some kind of depression/anxiety. it happened to me. one thing you can do is get in a counseling program. i went to the psychs. @ my mental health for a while, then i just started to go to the VA's Veteran's Center. i like it alot better.

but the big key is to stay on top of your case, document and get copies of everything, educate yourself an unfortunately you just have to be your own advocate. i know you are going to get all the correct info., that you need here. if you need any help along the way, don't hesistate to shoot me an e-mail. even if you just need to vent. good luck!

[disposableairman]

Thanks for the support Tucci,
I have been documenting the sleep problems since they started. Basically it started due to the vicodin family making me itch and all the pain in the joints keeping me up. It has gotten worse over this year and was so bad, I had a sleep study to be sure. They said I was fine, but I only got like 4% of rem sleep and I spent most of the night in stage one sleep. I just hate driving like this but I live 20 miles from the base and there is no other way to get to work. I am constantly late to work from not being able to wake up. I find I sleep best between 430 and 530!

I am lucky to have some support from a few friends who are all in the same boat. We are all RED HORSE in the AF but 2 of us are prior Marines, one prior corpsman (Navy) and one prior Seabee. And we are all eqipment operators/laborers. I would not see counselors or psych folks because my civilian job that is waiting on me is security at a government area that I need a top secret and prp clearance for. I dont want to lose my job over this. But it is interesting how anti-depressants are also used as sleep medication.