Shaw AFB Timeline (Ankylosing Spondylitis)

The VA finished my ratings on May 2nd. The second claim on eBenefits disappeared so I called my VA rep here on base. She was able to confirm that the ratings had been determined and should be on their way back to the IPEB. I am hoping that they decide my asthma is unfitting as well as the AS. I will share ratings when I officially receive them.
Well congrats, I hope everything works out well for you. If you don't mind me asking, what were your ROM measurements of you back for AS? I am wondering how my case compares to yours. Also, I still have no news. My case was sent to AFPC on 31 March 2016. I am very curious to find out what is taking them so long. What sucks is I am supposed to separate on 13 July but they won't project my separation because of my PEB.
 
Don't be in a hurry to get out right now. Let the process work and collect the disability compensation you are entitled to for the rest of your life. I don't have my exam reports at my desk right now but I claimed ROM loss in my shoulders, wrists, knees, ankles, SI joints and lower back all as secondary to the AS.

What treatment are you taking right now for AS? What is your status in eBenefits? Have you called Providence?
 
Man, I've been ready to separate on my ETS for a long time now lol. But I'm trying to be patient. My status on eBenefits is under review. My case is still at AFPC. I take Humira for AS. And I don't know what providence is. Who works there? I called the VA and all they tell me is what I can see online.
 
If/When the IPEB makes an unfit decision you will see another case open in eBenefits that says "Preparation for Decision". If that happens the IPEB has found you unfit for duty and you will be retired/separated with severance pay. After that happens you can call providence 401-223-3700 and get updates on your case (I recommend once a week).

Talk to your PEBLO and ask if the fit/unfit decision has been made. They usually know a few days before its updated in eBenefits.
 
I received my ratings on Monday. 50% DOD and 80% VA. However I do not agree with the VA ratings. I called the Airmen's Counsel and they were not helpful at all. The woman I spoke with told me the only thing they could do was try and increase the Category I unfitting conditions already listed.

My first issue is, I would think that all conditions that were secondary to AS would be listed in Category I. I am not as concerned with getting my DOD rating raised.

My second issue is, I claimed both shoulders, both wrists, both SI joints, both Knees, and both Ankles. The VA only rated my shoulders and one wrist. I was under the impression that any joint effected with pain was rated at 10%. Is my best option to do a rating reconsideration?
 
I would. Specifically ask for the rating rationale under the active process rating criteria and the chronic residuals rating criteria. Can you share the language from their AS rating criteria?

Mike
 
Mr. Parker, I sent you a message. The Findings and Ratings are attached here also.
 

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I only see the PEB determination. Do you have the proposed VA ratings? On the PEB determination, they do not cite DC 5002 rating codes. That is a huge red flag. You should go to the Board of Veterans Appeals website and search for AS cases rated correctly. You can use such cases in your request for a ratings review to help ensure they rate your AS correctly.

Mike
 
Mr Parker,
for some reason the attachment on this forum only took the first page. This attachment should have it all.
 

Attachments

Here is what I took from that

"The Veteran's lumbar spine disability is currently evaluated pursuant to 38 C.F.R. § 4.71, Diagnostic Code (DC) 5240, which specifically addresses ankylosing spondylitis. Information set forth in the February 2009 Compensation & Pension Service Bulletin, however, indicates that when evaluating ankylosing spondylitis, the rater must determine whether it is an active process and if so, it should be evaluated under DC 5009, which directs the disability to be rated as rheumatoid arthritis under DC 5002."

So what I need to appeal is that they rated my AS under 5240 and never stated that it was in active process?

If they had, then according to the February 2009 Compensation & Pension Service Bulletin it should have been evaluated under DC 5009, which directs it to be evaluated under DC 5002.
 
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Yes. Regardless, the condition needs to be rated under the criteria of DC 5002. They should rate under both the active process and chronic residual criteria and assigned the higher rating.

Under the chronic residual criteria, affected areas are rated under the specific code for that issue. The back is rated under DC 5240 but other areas are rated under the criteria for those areas. These affected area ratings are combined and assigned as the AS rating under DC 5009-5002.

All too often the get this wrong.

Mike
 
Mr. Parker,
I think I have a way better picture now. I talked to the Airmen's Counsel again and they were more helpful this time. I think I will be getting a lawyer assigned. Thank you for steering me in the right direction.
 
I still have not heard back from the lawyer yet and I have until Friday to sign the 1180. I plan on requesting a rating reconsideration and including a letter from my Rheumatologist stating that I am taking Nabumetone to treat the pain and stiffness in all joints (Wrists, Shoulders, Knees, Ankles, SI, Lower Back) affected by my AS.

I will submit a rebuttal letter myself stating that "The VA rated my Ankylosing Spondylitis using DC-5240. According to the Compensation and Pension Service Bulletin of 2009 it should have been rated by DC-5009 which directs the disability to be rated as rheumatoid arthritis under DC-5002. The AS rating should have included my back, shoulders, wrists, knees, and ankles."

The VA didn’t even rate my knees and ankles because the Dr. did not make the correct notes during the exam. I am hoping that the letter from my rheumatologist will remedy that issue.

Does anyone have any advice or recommendations?
 
I can't get the lawyer to call me back.. I am sending a Rebuttal Letter. If someone would like to provide feedback here is the content. Thank you in advance.


"1. Upon reviewing my Findings and Recommended Disposition from the Physical Evaluation Board it is apparent that my Ankylosing Spondylitis was not rated correctly. I have found a similar case on the Board of Veterans’ Appeals. The most recent case was from 2015 with the Citation Number 1525647. In this case it is stated:

“The Veteran's lumbar spine disability is currently evaluated pursuant to 38 C.F.R. § 4.71, Diagnostic Code (DC) 5240, which specifically addresses ankylosing spondylitis. Information set forth in the February 2009 Compensation & Pension Service Bulletin, however, indicates that when evaluating ankylosing spondylitis, the rater must determine whether it is an active process and if so, it should be evaluated under DC 5009, which directs the disability to be rated as rheumatoid arthritis under DC 5002.”

My ankylosing spondylitis is in active process and should be rated under diagnostic code 5009 and then directed to diagnostic code 5002. According to diagnostic code 5002 all of the joints that the VA did not rate for pain should also have also been rated:

“Where, however, the limitation of motion of the specific joint or joints involved is noncompensable under the codes a rating of 10 percent is for application for each such major joint or group of minor joints affected by limitation of motion, to be combined, not added under diagnostic code 5002."


2. I submitted a rebuttal letter for the VA exams at the beginning of the process stating that the examiner did not make any note of pain in my left wrist, right knee, left knee, left ankle and right ankle. I am not sure why this wasn’t noted because it was a direct claim and I did voice that I had pain in all of the joints during movement which was increased after periods of rest or inactivity. According to diagnostic code 5002 all of these joints should have been rated at 10% each. These conditions along with my shoulders, back, SI joints and radiculopathy of the sciatic nerve are all secondary to Ankylosing Spondylitis. Therefore they should have been rated under diagnostic code 5002 according to the information provided in paragraph 1. I am also including another letter from my Rheumatologist stating that I am being treated for all of the listed conditions. My Rheumatologist just recently started me on Nabumetone to help alieve all of the secondary joint pain and stiffness. This is a chronic condition and is directly rated to the Ankylosing Spondylitis. My Rheumatologist has offered to answer any questions or concerns in his letter.


3. In conclusion I would like for the joints with pain during movement be rated along with all other previously rated conditions and be combined in accordance with diagnostic code 5002."
 
Just an update, I spoke to the lawyer finally. I am appealing the ratings and going to the formal board to try and get the AS rated appropriately.

On other news I got a line number for E7, to bad I'll never be in long enough to sew it on.
 
any advice here please help i have been diagnosed with AS last month and started humira "lifelong" i am 27 years old active army and to be starting the MEB process hopefully next week no later then sept. im curious as to what to expect i only have 2 1/2 years in service stationed at the great place. any advice with possible outcomes would be great thanks
 
Dannyohh,
I am not familiar with the Army's process but make sure that you understand how the VA should rate your condition if it is found to be service related. You can scroll to previous posts on this thread from Mr. Parker giving detail about guidance for rating AS. I am in the process of trying to get my condition rated correctly.

I went to the FPEB last week to try and correct my ratings. The FPEB agreed with my concerns and kicked the ratings back to the VA for corrections.

Go to the Dr. anytime you are in pain or have a concern. That was my biggest limfac, I "played through the pain" a lot and it almost cost me in the end. Luckily my Rheumatologist kept accurate records documenting my joint pain. The VA showed that there was non-conclusive evidence to rate some of the joints that I claimed. Hopefully the medical records from my Rheumatologist will be reviewed and provide sufficient evidence of joint pain for the VA. If not I will continue to fight.
 
Just a few questions on how the process works and any input on my outcomes. I'm security forces and at shaw AFB, I know it's not the same condition as you, I'm just wondering when my process will most likely start. Feels like I'm just getting dragged thru the mud right now with my PCM PCSing and I'm getting a completely new PCM this month

2013 August had first knee surgery for debridment of thejoint. Seemed to help for some time.

2015 November, injured right knee during squadron PT, referred to ortho

2016 Feb, underwent Fulkerson osteotomyand lateral release.

2016 May, underwent knee manipulation under anesthesia.

2016 July, refered to DAWG for possible MEB

2016 July, dawg recommends reevaluation by
1oct2016.

August 2016, released by Ortho and physical therapist with permanent limitations, no kneeling, running, push ups, sit ups or high impact activities. And Come September I will be exempt from my last 2 PT tests.

Will my MEB most likely start on 1 OCtober after the dawg looks into it again? Thank you for your times. I was diagnosed with osteoarthritis and chrondomalica patella disorder with no help from the surgery or physical therapy.
 
I'm not sure I can answer that question. There are a lot of factors that the DAWG looks at. With those limitations and being SF I would assume that they will recommend a full MEB. As far as timeline from the DAWG's recommendation to the MEB actually starting I am not sure. As far as your concerns about PCS'ing, I wouldn't plan on going anywhere, if they recommend full MEB, for about a year.
 
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