Can't seem to progress

StealthscrapE

StealthscrapE

PEB Forum Regular Member
PEB Forum Veteran
Active Duty Air Force (11 Years)
Initially diagnosed with asthma in Jul 2010
Fast Track MEB with Fit for Duty ALC- C2
RILO completed annually or sooner since then.
Results have always been that diagnosis is becoming more severe.

Problem:
Since at least February 2013 I have been receiving FL-4s that state Full MEB recommended after XX amount of months. The following are the notes from my last three FL4s that I have received.

February 2013 - FL4
"Continue on ALC-C2. NEXT RILO IS DUE 6 MONTHS (AUG 13). Member has has multiple exacerbations requiring systemic steroids, we need to re-eval this member for possible MEB if he cannot be controlled."

August 2013 - FL4
"Member's case has been reviewed and it is felt that the member is not ready to board and has been placed on Continuation of Military Medical Observation and Care for 3 months, at which time an "Initial RILO" will be done with consultations by Pulmonology. The "Initial RILO" should arrive at AFPC/DPANM NLT 21-Nov-13. Member must be placed on an AD Dorm 469, Duty Limiting Condition Report, with an Assignment Availability Code 37, for MEB/PEB processing."
"Steroid dependent asthma is NOT moderate. We are unable to complete this without a current 469, pulmonary consult, CC impact statement, DAWG recommendation, and allow time for stabilization. There are many steps from where this patient is now to completing a full MEB. Suggest the profile be looked at closely now and just prior to submission"

December 2013 - FL4
"Discussed with senior medical member of IPEB. Member is returned with ALC-C2. This member is not controlled, is and has been unable to deploy or perform any physical activity for 2 years. We must have some improve [sic] of control within 6 months or we must consider a full MEB. The next RILO is due NLT 30 Jul 14. Please prove a current [.....]"

Between the August and December, I was not seen by a single doctor so there was no "medical observation" that took place, or anything to justify deeming me fit for duty as opposed to moving forward in the process. Is there anything I can do to request a review or elevate this to another level. I just feel as I am not receiving the review that I deserve. Thanks for any help you all may offer.

Meds (for asthma only):
Symbicort
Albuterol
Allegra
Singulair
Prednisone (daily as well as 5-7 burst treatments per year)
 
As with anything in the military, if you want something done you have to do it yourself. If you are having exacerbations that require emergency room visits or hospitalizations, it is an automatic no go. If you are requiring systemic steroids it is also likely a no go , esp. if it happens 2 or more times per year. Same is likely true if it causes significant use of rescue inhalers or significantly limits your activities. The key to all of this is having it documented. Go to the doctor, make sure they are documenting thoroughly and get a copy. Hand deliver copies to your COC.
 
  • Sorry, I did not notice you are already on Prednisone. Aside from the previously mentioned. There may not be much you can do. I am not as familiar with the AF way of handling these things. I would assume a lot of it has to do with how well you are able to accomplish your mission. As long as you are getting done what they want you to do, there is probably not much you can do. Start missing work and they are more likely to do something.
 
I know a few, not many mind you, that are asthmatic on your meds and where not "controlled" or "improved" do their RILo every year, are on near dead man profiles and ALC 2'd as well. The PCM makes a recommendation like the ones you have, but the DAWG makes the determination, every month your file is reviewed for any updates changes etc. if nothing, then they do nothing regardless of recommendation from PCM, unless there is direct evidence of the condition worsening, if it is just the same, it is just the same as it was the time you were found fit.

Now if your curious as to what the IPEB/RILO doc seem to consider the most important point in contention for fitness? from my admintingly limited experience is the FEV level, if it is anything even close to 75 or 70 plus EVEN IF IT TAKES MEDICATION TO GET IT THERE, and you are not in a demanding AFSC etc. then your gonna be found fit.

IF you want a full blown MEB, let your chain know that you are having to continually work harder and harder to keep up, and that you do not want to "give up" but that you feel your condition is worsening and you feel that you are loosing future quality of life in order to perform now. Then make sure when it comes time to submoit a commanders letter, it reflects that he needs you gone to make room for someone he can send out, perform the job etc. Its tough, my CC loves me, I had my hand in every cookie jar, was kind of high profile etc etc. he took any mention of "could not" or "cannot depend on" type stuff out of my letter (i wrote it), and counseled me to not be so hard on myself. I submitted a letter attached to it before it went up with my original wording back in it, explaining that I try harder than everyone else but am loosing the ability to maintain the respect my role deserves and could not envision myself being an asett to the service in any regard with my constant lost duty days, inability to deploy or even perform the MX side of my AFSC.
 
Last edited:
LTPETERG said:
  • Sorry, I did not notice you are already on Prednisone. Aside from the previously mentioned. There may not be much you can do. I am not as familiar with the AF way of handling these things. I would assume a lot of it has to do with how well you are able to accomplish your mission. As long as you are getting done what they want you to do, there is probably not much you can do. Start missing work and they are more likely to do something.
Click to expand...
TSgt Twitch said:
I know a few, not many mind you, that are asthmatic on your meds and where not "controlled" or "improved" do their RILo every year, are on near dead man profiles and ALC 2'd as well. The PCM makes a recommendation like the ones you have, but the DAWG makes the determination, every month your file is reviewed for any updates changes etc. if nothing, then they do nothing regardless of recommendation from PCM, unless there is direct evidence of the condition worsening, if it is just the same, it is just the same as it was the time you were found fit.

Now if your curious as to what the IPEB/RILO doc seem to consider the most important point in contention for fitness? from my admintingly limited experience is the FEV level, if it is anything even close to 75 or 70 plus EVEN IF IT TAKES MEDICATION TO GET IT THERE, and you are not in a demanding AFSC etc. then your gonna be found fit.

IF you want a full blown MEB, let your chain know that you are having to continually work harder and harder to keep up, and that you do not want to "give up" but that you feel your condition is worsening and you feel that you are loosing future quality of life in order to perform now. Then make sure when it comes time to submoit a commanders letter, it reflects that he needs you gone to make room for someone he can send out, perform the job etc. Its tough, my CC loves me, I had my hand in every cookie jar, was kind of high profile etc etc. he took any mention of "could not" or "cannot depend on" type stuff out of my letter (i wrote it), and counseled me to not be so hard on myself. I submitted a letter attached to it before it went up with my original wording back in it, explaining that I try harder than everyone else but am loosing the ability to maintain the respect my role deserves and could not envision myself being an asett to the service in any regard with my constant lost duty days, inability to deploy or even perform the MX side of my AFSC.
Click to expand...

Thanks for the responses. In regards to what you have said, my job was pretty demanding. I am in a weird situation so I don't expect you to know how to respond to all of it, but ignoring the part at the end of this post... I have been medically disqualified from my career field last June. I have been unable to retrain due to my medical holdover that they started last August. I am currently coded as AFSC 9A500 "Airman Ineligible To Retrain Due to Medical Reasons Beyond Their Control". So it has affected my job so much so that I can no longer do it.

The part I mentioned to ignore above is that I am at a training unit for intermediate training that was over 6 months so I was PCS'd here. Because of that and having completed training, I have no job to perform. My daily duty because of this situation is to be a urinalysis observer. Yep, I went from an awesome, amazing job that I highly excelled at to watching people piss in a cup. Everyday. Anyway, because of all of that I have limited leadership and as I said, I don't have an official job anymore. My commanders have mentioned this in my CC impact statements, and the doctor's are well aware of the ER visits for breathing treatments and prednisone bursts.

EDIT:
I also have missed days of work, even when I was doing administrative work at the training unit, and as a urinalysis observer. I am on a profile that allows for no physical activity, and I am even not allowed to do projects or activities such as filing paperwork and cleaning due to the dusts and mold that the files and paperwork produce.
 
Last edited:
StealthscrapE said:
Thanks for the responses. In regards to what you have said, my job was pretty demanding. I am in a weird situation so I don't expect you to know how to respond to all of it, but ignoring the part at the end of this post... I have been medically disqualified from my career field last June. I have been unable to retrain due to my medical holdover that they started last August. I am currently coded as AFSC 9A500 "Airman Ineligible To Retrain Due to Medical Reasons Beyond Their Control". So it has affected my job so much so that I can no longer do it.

The part I mentioned to ignore above is that I am at a training unit for intermediate training that was over 6 months so I was PCS'd here. Because of that and having completed training, I have no job to perform. My daily duty because of this situation is to be a urinalysis observer. Yep, I went from an awesome, amazing job that I highly excelled at to watching people piss in a cup. Everyday. Anyway, because of all of that I have limited leadership and as I said, I don't have an official job anymore. My commanders have mentioned this in my CC impact statements, and the doctor's are well aware of the ER visits for breathing treatments and prednisone bursts.

EDIT:
I also have missed days of work, even when I was doing administrative work at the training unit, and as a urinalysis observer. I am on a profile that allows for no physical activity, and I am even not allowed to do projects or activities such as filing paperwork and cleaning due to the dusts and mold that the files and paperwork produce.
Click to expand...

It is indeed a bad spot, i would say something has to give one way or the other, and a Patient advocate, or IG may be in short order, if they will not employee you in an official AFSC (not an administrative one) due to your medical condition, then the full MEB is warranted, or the removal of the codes so that you can proceed. Something you left out however is, What is your FEV? What is your hope for the outcome of the MEB, would you rather have the codes lifted or the MEB etc. demanding something in the AF seldom gets one anywhere, BUT dropping hints and sugar coating it does. and while sugarcoating your chain and your PCM, be pounding on the IG's and the advocates desk. file a congressional for unfair treatment/breach of contract arena (not a legal breech mind you but it is the approach to take I believe as you sign up for a job and are no longer able to do it as a result of a medical condition, you require resolution one way or the other type deal). Yup, cannot offer much beyond that other than good luck. Leaving a service member in limbo awaiting action is one thing, leaving them in limbo due to inaction/incompetance/desire to have a full time Golden flow monitor is entirely another.
 
You must log in or register to reply here.
Top