New MEB initiated for receiving Botox

DRVL0064

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PEB Forum Veteran
Registered Member
Hello all, i am active duty Air Force at 12 years in. I have been seen at an army hospital for the last four years and about two of those, I’ve been receiving Botox.
I recently pcsd and was told by my new pcm that Botox is an automatic MEB. And that’s all she said really. I reviewed my notes on MHS and they stated the following.

“Migraine with aura well controlled
  • Patient was seeing neurology every 3 months for Botox (see JLV for notes)
  • Referral:

30-year-old active duty female with chronic migraines. Patient has been seeing neurology and receiving Botox injections every 3 months for the last 2 years. Patient's last Botox injection was Dec Rimegepant sulfate 75 mg Rapid dissolve tablet for migraines. Patient is currently well controlled on this plan. Please evaluate and treat.

  • MSD: L19:Migraine and other headache disorders manifested by attacks requiring frequent absences from duty, mobility restrictions, or frequent specialty follow-up. Note: Botox use requires DW or ALC
  • Will refer for AMRO review. Will recommend DW. “

Honestly I have no idea what this means for me since she just said it would initiate the board. Does that mean I will go through the process or just be ok’d since I’m ok with the Botox?
I did make a follow up with her because since moving to my new location and being at a higher elevation, I’ve been getting BAD migraines - like nausea light and sound sensitivity and having to lay down immediately upon returning home from my day.

I’m new to the base so I’m afraid to be “that person” that’s always gone but if I keep having these, I’m going to have to get quarters because I can’t keep suffering at work all day.

Sorry I know, long post but ANY insight is welcomed and in your experience were you retained or retired/separated. Thank you!!
 
Hello all, i am active duty Air Force at 12 years in. I have been seen at an army hospital for the last four years and about two of those, I’ve been receiving Botox.
I recently pcsd and was told by my new pcm that Botox is an automatic MEB. And that’s all she said really. I reviewed my notes on MHS and they stated the following.

“Migraine with aura well controlled
  • Patient was seeing neurology every 3 months for Botox (see JLV for notes)
  • Referral:

30-year-old active duty female with chronic migraines. Patient has been seeing neurology and receiving Botox injections every 3 months for the last 2 years. Patient's last Botox injection was Dec Rimegepant sulfate 75 mg Rapid dissolve tablet for migraines. Patient is currently well controlled on this plan. Please evaluate and treat.

  • MSD: L19:Migraine and other headache disorders manifested by attacks requiring frequent absences from duty, mobility restrictions, or frequent specialty follow-up. Note: Botox use requires DW or ALC
  • Will refer for AMRO review. Will recommend DW. “

Honestly I have no idea what this means for me since she just said it would initiate the board. Does that mean I will go through the process or just be ok’d since I’m ok with the Botox?
I did make a follow up with her because since moving to my new location and being at a higher elevation, I’ve been getting BAD migraines - like nausea light and sound sensitivity and having to lay down immediately upon returning home from my day.

I’m new to the base so I’m afraid to be “that person” that’s always gone but if I keep having these, I’m going to have to get quarters because I can’t keep suffering at work all day.

Sorry I know, long post but ANY insight is welcomed and in your experience were you retained or retired/separated. Thank you!!
Migraines can be unfitting and Botox Injections require you to be near a specialist so you can't serve in an Austere Environment. My wife was MEB'd due to migraines and other conditions. She get Botox Injections. So yes you can be put in IDES for migraines. Also, its possible to stay in but a lot depends on your job. The PEB rules on if your condition is unfitting and prohibits you from doing your job. Also, check out the VA ratings for migraines. They are 0%, 10%, 30% and 50%. If no other conditions are determined to be unfitting you want to make sure you will get 30% or greater to be medically retired.

Since you are AF you may be code 31 and depending on the Commander's Impact Statement and NARSUM you may be retained but limited to certain duty assignments. If they think you are unfit for one or more condition then they designate code 37 and you get put in full IDES and the PEB makes a determination. I would consult private attorneys for advice and consider hiring one as the process is subjective and the results can greatly depending on your strategy, evidence gathering and legal representation.
 
Migraines can be unfitting and Botox Injections require you to be near a specialist so you can't serve in an Austere Environment. My wife was MEB'd due to migraines and other conditions. She get Botox Injections. So yes you can be put in IDES for migraines. Also, its possible to stay in but a lot depends on your job. The PEB rules on if your condition is unfitting and prohibits you from doing your job. Also, check out the VA ratings for migraines. They are 0%, 10%, 30% and 50%. If no other conditions are determined to be unfitting you want to make sure you will get 30% or greater to be medically retired.

Since you are AF you may be code 31 and depending on the Commander's Impact Statement and NARSUM you may be retained but limited to certain duty assignments. If they think you are unfit for one or more condition then they designate code 37 and you get put in full IDES and the PEB makes a determination. I would consult private attorneys for advice and consider hiring one as the process is subjective and the results can greatly depending on your strategy, evidence gathering and legal representation.
You mentioned other unfitting conditions-I thought it was only one issue that is being meb’d. I definitely have other health things but I’m unsure if it’s all put into one case. Will I be contacted at some point or is the retain/not retain portion conducted solely through my current documentation? I saw the will recommend DW and have 0 idea what that means.
 
You mentioned other unfitting conditions-I thought it was only one issue that is being meb’d. I definitely have other health things but I’m unsure if it’s all put into one case. Will I be contacted at some point or is the retain/not retain portion conducted solely through my current documentation? I saw the will recommend DW and have 0 idea what that means.
Just because they refer you for one condition doesn't mean you can't get others added. That's where strategy is involved. My wife's attorney did an amazing job helping her argue that mental health should be added that by the NARSUM stage they added that condition without needing to do further appeals. Though her attorney and my wife's military leadership helped by crafting a commander's impact statement that included mental health etc. This whole process is complicated and you don't know what you don't know. Just like the legal system, those with elite representation get better results than those who rely on a public defender.
 
I can't say I've been through exactly the same situation, but I do understand the uncertainty you're feeling. It's a bit daunting when you're facing a medical evaluation board. Your well-documented history with Botox should be in your favor. Just be honest during the process, and if your migraines are impacting your duty, don't hesitate to get the medical support you need. Also, it is better to use Argireline to deal with wrinkles next time. I hope that helps!
 
I can't say I've been through exactly the same situation, but I do understand the uncertainty you're feeling. It's a bit daunting when you're facing a medical evaluation board. Your well-documented history with Botox should be in your favor. Just be honest during the process, and if your migraines are impacting your duty, don't hesitate to get the medical support you need. Also, it is better to use Argireline to deal with wrinkles next time. I hope that helps!
I’ll be out in the next month or two just waiting on the va. I don’t get Botox for wrinkles….
 
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