18 Year SGM Seeking advice about Type 1 Diabetes and the MEB process.

H

hankP

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Registered Member
Good afternoon,

First and foremost, what a great platform to educate and inform servicemembers, thanks to the admin team and the expert professional advisors for everything they do!

I have been in the Active Army for 18, almost 19 years and am a recently promoted SGM (E9). I recently found out that I am a type 1 Diabetic. I have to take both slow dose and fast acting insulin multiple times a day in order to manage my glucose.

Thankfully, a MEB has yet to be initiated (although my time is limited), and I am in the panic/research phase of the process. My fear is that I will not be retained during the MEB, and have not met the 20yr requirement for retirement, nor completed the SRR for the promotion. Although I believe in time, I will be able to manage the glucose effectively, my thoughts remain focused on the stability of my family through compensation.

It is my understanding that if I am not retained in the MEB, I will be awarded 40% during a medical retirement, instead of continuing to serve well past 20 years and garnering a larger retirement evaluation.

Unfortunately, I have lived the stigma of never making medical appointments out of fear of profiles limiting promotion potential, and as such have no other diagnosed injuries that would bolster my medical retirement compensation.

I am not even sure what advice I'm attempting to solicit honestly. I suppose I am seeking advice on what others have experienced (if any), going through the process so that I can remain as prepared as possible. I did hear today, there may be an option for the Army to determine my MEB at my MRD (30 years), basically stating "He could have served 30 years, if not having this disability". Although I cannot seem to find any hard facts of that thus far.

Thank you again for the platform and for any advice this may provide, the irony of being the person who is supposed to have the experience and advice to get Soldiers through issues like this is not lost on me. I hope everyone has a great week!
 
If the PEB finds you unfit, you will still retire as a SGM. The down side is your high three will be in part based on some of your E-8 time.

Your DoD percentage of retirement will be calculated based on all unfit conditions.

If an MEB is started, I suggest you get a civilian attorney with experience in the MEB/PEB process. There are several on this forum. The goal would be to slow down the process, so you reach 20 YOS. This should be easy. Your attorney can guide you through all the steps for dragging out the process.

An attorney will be expensive, but getting to 20 YOS will greatly increase your retired income. Every dollar spent will be returned many fold.

I suggest you search this forum. You will find many post on slowing down the process.
 
Anytime they want you to sign for something consult with your attorney first. Save your leave.
 
Sergeant Major:

BLUF: For a diagnosis of Type 1 diabetes mellitus you will almost certainly be referred to a MEB and likely to a PEB. Whether the PEB determines that you are fit or unfit will turn on the current status of your Type I diabetes including your HgA1C levels, the existence of any residual effects such as diabetic retinopathy or episodes of ketoacidosis or hypoglycemic reactions, the manner in which the disease must be managed, i.e., restricted diet alone, diet and regulation of activities, oral medication, or injection of insulin. A requirement to use insulin or the existence of any residual effects will weigh heavily in favor of a finding of unfitness. Strong chain of command and other support from those with whom or for whom you work or worked will also be very important to convince a PEB that you are fit for duty and should be retained.

I have attached an information sheet put together by the Army Office of Soldier's Counsel regarding Type 1 diabetes for your situational awareness. Chaplain Charlie's advice is, as usual, spot on. Your best bet will be to string out the IDES process so that you hit 20 years and are eligible for a longevity retirement regardless of a referral to the IDES or its outcome. If you are nearly at 19 years and haven't been referred yet, you have a pretty good chance of getting to 20 before a final medical disposition.

The principal decision the MEB makes is whether a Soldier’s condition fails to meet medical retention standards under the guidelines of Army Regulation (AR) 40-501. If so, and if there is some indication that the condition may prevent the Soldier from reasonably performing his military duties, the Soldier’s case is referred to a Physical Evaluation Board (PEB). AR 40-501, paragraph 3–29(d)(1) specifies that all cases of Type I diabetes mellitus fail retention standards, so it is highly likely your case will be referred to a PEB.

A PEB will make the determination whether your Type I diabetes renders you unfit to perform your military duties. AR 635-40, Disability Evaluation for Retention, Retirement, or Separation (19 January 2017), paragraph 5–1 provides the standard for unfitness due to disability: “A Soldier will be considered unfit when the preponderance of evidence establishes that the Soldier, due to disability, is unable to reasonably perform the duties of their office, grade, rank, or rating…” In making a determination of unfitness, paragraph 5-3 provides that the following criteria may be included in the assessment:

a. The medical condition represents a decided medical risk to the health of the Soldier or to the welfare of other Soldiers were the Soldier to continue on active duty or in an active Reserve status.

b. The medical condition imposes unreasonable requirements on the Army to maintain or protect the Soldier.

Paragraph 5–4 outlines the factors to be used to determine whether a Soldier’s medical impairments preclude the Soldier from reasonably performing their duties, including whether the Soldier can perform the common military tasks required for the Soldier’s office, grade, rank, or rating, including the functional tasks listed on DA Form 3349, and whether the Soldier is medically prohibited from taking the Army Physical Fitness Test (APFT). A Soldier’s inability to pass the APFT does not preclude a finding of fitness.

Army Directive 2024-01 (Army Fitness Determinations and Deployability) (Feb. 9, 2024) revises AR 635–40 by authorizing the Physical Evaluation Board (PEB) to determine a Soldier’s fitness for duty based on multiple criteria, including the ability to deploy with a medical waiver. The Directive states at paragraph 4.:

a. When determining a Soldier’s ability to be found fit in consideration of deployability, the PEB will consider the following:

(1) Does the Soldier have specialized skills and/or experience/seniority the U.S. Army requires?

(2) Does the nonmedical record, including, but not limited to, letters, personal testimony, and/or evaluation reports, support that the Soldier can reasonably perform the duties of the office, grade, or rank?

(3) Is the Soldier’s medical condition well controlled such that it is not currently a decided medical risk to the Soldier’s health or the welfare of other Soldiers?

(4) Can the Soldier’s environment be controlled to prevent exacerbating existing medical conditions without imposing on the Army unreasonable requirements to maintain or protect the Soldier?

(5) Does the Soldier’s referred condition(s) make it unlikely the Soldier would receive a medical waiver to deploy to a Combatant Command Area of Responsibility?

b. No single factor is dispositive, and the PEB may find the Soldier fit for duty based on the Soldier’s ability to perform the duties of the assigned office, grade, rank, or rating.

According to the OSC Info Paper, a Soldier with Type 1 diabetes who has a HgA1C reading below 7.0 may have a chance of being found fit. A reading of 7.1 or above, which typically involves the need for insulin to manage the disease, will be found unfit based on the inability to deploy due to the need for insulin access in austere environments. Short of that, however, as noted in the Info Paper, demonstrating that management of the disease does not require insulin (at least yet) together with a strong showing of excellent APFT scores, excellent OER’s, and strong chain of command and other support for retention may be sufficient to carry the day. Make sure that your medical records properly document the proper status of the disease and, more importantly, the manner in which it is currently managed. Retention will be much more difficult if you require insulin to manage the disease or have any residual impacts or restrictions on your ability to perform your duties in any environment.

You should also be mindful that if the PEB finds you unfit, your military disability rating will be determined by the VA consistent with the VA Schedule of Disability Ratings at 38 C.F.R. § 4.119, Diagnostic Code 7913 for Diabetes Mellitus. To be eligible for a military disability retirement, your rating must be 30% or more, which in your case would mean a 40% rating under DC 7913, the evaluation criteria of which provide: 40%: Requiring one or more daily injection of insulin, restricted diet, and regulation of activities; 20%: Requiring one or more daily injection of insulin and restricted diet, or; oral hypoglycemic agent and restricted diet. If you don't have to inject insulin to control the disease, it is likely you'll be rated at 20% or less, which would not make you eligible for a disability retirement. Your final rating, though, would also include any other conditions an MEB identified that a PEB also found unfitting, so that may put you up to or over 30%. Your potential eligibility for a disability retirement compared to the likelihood a PEB will find you fit or unfit is a calculus of which you will need to remain mindful depending on the status of the disease.

You eventually will be referred to Soldier’s Counsel to represent you at the PEB, but they are all extremely overworked and won’t focus on your case until it’s well down the PEB path. I concur with Chaplain Charlie and recommend you consider consulting with private counsel such as Jack Gately, Brian Schenk, or Jason Perry to name a few (you can Google them for details), as they can help you strategize your approach and be properly prepared at each important gatepost in the Integrated Disability Evaluation Process. Often it is the steps taken during the MEB stage or the Informal PEB stage that will be dispositive for a desired outcome later.
 

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hankP said:
Good afternoon,

First and foremost, what a great platform to educate and inform servicemembers, thanks to the admin team and the expert professional advisors for everything they do!

I have been in the Active Army for 18, almost 19 years and am a recently promoted SGM (E9). I recently found out that I am a type 1 Diabetic. I have to take both slow dose and fast acting insulin multiple times a day in order to manage my glucose.

Thankfully, a MEB has yet to be initiated (although my time is limited), and I am in the panic/research phase of the process. My fear is that I will not be retained during the MEB, and have not met the 20yr requirement for retirement, nor completed the SRR for the promotion. Although I believe in time, I will be able to manage the glucose effectively, my thoughts remain focused on the stability of my family through compensation.

It is my understanding that if I am not retained in the MEB, I will be awarded 40% during a medical retirement, instead of continuing to serve well past 20 years and garnering a larger retirement evaluation.

Unfortunately, I have lived the stigma of never making medical appointments out of fear of profiles limiting promotion potential, and as such have no other diagnosed injuries that would bolster my medical retirement compensation.

I am not even sure what advice I'm attempting to solicit honestly. I suppose I am seeking advice on what others have experienced (if any), going through the process so that I can remain as prepared as possible. I did hear today, there may be an option for the Army to determine my MEB at my MRD (30 years), basically stating "He could have served 30 years, if not having this disability". Although I cannot seem to find any hard facts of that thus far.

Thank you again for the platform and for any advice this may provide, the irony of being the person who is supposed to have the experience and advice to get Soldiers through issues like this is not lost on me. I hope everyone has a great week!
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Not sure if any of this was already mentioned, as it looks like you've gotten a ton of good info so far, but I'll just add my .02 in case it's relevant:

1. I'm AD Navy, and during my MEDBOARD, I had to go to two different classes, very similar to TAPS, but tailored specifically for MEDBOARD, that were each one full day. In one of said classes, we were told that for those who are put on MEDBOARD so close to there 20-year mark, that there is a command-approved 'permanent LIMDU' that you can be placed on, which is essentially a means to get you to your 20 years prior to being medically discharged. Since you are Army, that's why I say 'in case it's relevant', as I don't know if that same rule applies, but it is definitely a question I would bring up to your Chain.

2. I, like you, also neglected a majority of my medical issues throughout my career. The good news is, again referring to the above classes, we were told to take this time now, book as many appointments as you can, and just get everything documented in your record. I have several claims that I filed, which were not even mentioned in my record until after this class, and I still had a scheduled C&P exam for each of them, and the DBQ's for each are all written in my favor. So it's absolutely not too late, but you need to start with the appointments ASAP.

Hope this helps a bit, and best of luck!

Shaun
 
hankP said:
Good afternoon,

First and foremost, what a great platform to educate and inform servicemembers, thanks to the admin team and the expert professional advisors for everything they do!

I have been in the Active Army for 18, almost 19 years and am a recently promoted SGM (E9). I recently found out that I am a type 1 Diabetic. I have to take both slow dose and fast acting insulin multiple times a day in order to manage my glucose.

Thankfully, a MEB has yet to be initiated (although my time is limited), and I am in the panic/research phase of the process. My fear is that I will not be retained during the MEB, and have not met the 20yr requirement for retirement, nor completed the SRR for the promotion. Although I believe in time, I will be able to manage the glucose effectively, my thoughts remain focused on the stability of my family through compensation.

It is my understanding that if I am not retained in the MEB, I will be awarded 40% during a medical retirement, instead of continuing to serve well past 20 years and garnering a larger retirement evaluation.

Unfortunately, I have lived the stigma of never making medical appointments out of fear of profiles limiting promotion potential, and as such have no other diagnosed injuries that would bolster my medical retirement compensation.

I am not even sure what advice I'm attempting to solicit honestly. I suppose I am seeking advice on what others have experienced (if any), going through the process so that I can remain as prepared as possible. I did hear today, there may be an option for the Army to determine my MEB at my MRD (30 years), basically stating "He could have served 30 years, if not having this disability". Although I cannot seem to find any hard facts of that thus far.

Thank you again for the platform and for any advice this may provide, the irony of being the person who is supposed to have the experience and advice to get Soldiers through issues like this is not lost on me. I hope everyone has a great week!
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You should be able to stretch this out to 20 years which is the only way to go. Let everyone know that you are close to 20 AFS. Your PEBLO can lose your paperwork for a month. You can state no worries on timeline to everyone. You can take your sweet time to do all of your C&P exams. Schedule them out as far as possible.

I don't see a way to not hit 20 AFS if you delay as much a as possible. You appeal at each step. There are appeals within appeals such as at the NARSUM stage. When you get the NARSUM you can request an IMR which is an independent medical review by a 2nd doc. Once that comes back you can submit a written rebuttal to it. You should get 6 days to do each step so you wait until the 6th day to appeal. Then wait to the 6th day to submit a written rebuttal etc. Requesting a FPEB in person can make it drawn out longer too. Save all of your leave.

When found unfit you can apply for COAD. Its basically a program for Soldiers in your situation where they just let you stay in to hit 20 years and you retire right when you reach the 20 year mark to retire. I would apply for it regardless of the outcome unless iPEB found you fit. If they find you fit then you are good and can just stay in and retire when you want to.
 
Good afternoon everyone,

I just wanted to take a moment to sincerely thank you all for the expert MEB/PEB/PEBLO/Type 1 advice and mentorship you’ve provided. Your input has been incredibly helpful and means a lot to me as I navigate this process. The guidance I’ve received here has given me a clearer understanding of the steps to move forward as I not only delay the process as long as possible, but to also seek medical assistance on any other myriads of issues on the way out (it looks like for now I'm in the clear by the way).

I truly appreciate the time and care you’ve taken to share your knowledge and experiences. It’s a reminder of how fortunate we are to be part of a military communities that genuinely support one another. Thank you again for all of your help.

Best regards
 
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