CS1 Timothy Lalli introduction

italia289

Member
Registered Member
Good afternoon everyone.

I am active duty Culinary Specialist, US Navy with 14 years of service. Just recenly submitted for MEDBOARD to evaluate my Ankylosing Spondolytis.

~History

Prior to 2002, had NO issues or problems with any medical conditions. In 2002, slowly began to experience reoccuring pain in the lower back and hip areas that would last for a week or so then fade away only to reoccur a few weeks or a month later. The pain and length of symptoms steadily increased. Was seen on multiple occasions to treat the pain with no extensive testing to determine the cause and was just told "typical wear and tear on lower back" Dealt with the conditions and moved on. Symptoms spread further up the spine with pain in the neck and between the shoulders. Fast Forward to 2008, had difficulty getting approval for reenlistment until being seen by specialist. Finally given MRI and found Degenerative disc Disease, couple bluge discs and one with annular tear. Luckily was cleared to reenlist. Tried to minimize visits to the hospital as to not complicate career.

2011 was medevac'd off deployment due to severe neck pain. Placed on first 6 month LIMDU period with diagnosis of herniated cervical disc with non-surgical fusion of 2 cervical vertebre. Treated with trigger injections with great results. Returned to full duty and transfered to Yokosuka Japan. During the screening, there was incorrect information documented by my PCM that stated "mbr has no history or chornic or reoccuring neck or back pain" PCM also reassured me that the need of continuing trigger injections would be needed yearly to maintain and he said Yokosuka has the capabilities. Moved to Japan only to find out those procedures were not available locally, but rather in Okinawa via MEDEVAC. Hosptial stated that Medevacs would not be offered in support of continuing maintenance treatment. (Even though many other military members with similar conditions were receiving routine medevacs). At this time, still on full duty on a ship. Having frequent episodes of lower back back in addition to SEVERE abdominal pain that put me in the ER on many occasions. During one visit to the ER, a CT scan revealed a large blood clot. Immediately placed on blood thinners and sent to Tokyo for an Angiogram exactly one week later. Angiogram came back negative. Navy then conducted another CT scan which that as well came back negative for no blood clot. PCM then placed me on LIMDU for 3 months to treat with blood thinners.

During blood thinner treatments, pain still remained with no relief. Was scheduled for a MEDEVAC to Okinawa to receive spinal injections, with ultimate plan to return me CONUS since I was not suppose to have come to Japan in the first place. An inquirey was conducted with an overseas screen deficency report was finalized stating that service member filled all documents correctly but PCM did not follow through with confirming Yokosuka hospital capabilites. While on blood thinners and 1 day away from spinal injection treatment, I found warning information on blood thinner website that clearly stated : DO NOT undergo spinal puncture or epidural injections while on this medication as it can result in a blood clot of the spine resulting in permanant paralaysis. The following day I canceled my medevac and requested meeting with all doctors. Primary care doctor was smug in saying it would be unlikely anything would go wrong. Orthopedic doctor, (in the same room), said it was a good idea to cancel the procedure and he was unaware I was on blood thinners. After comming off blood thinners, I was sent to Tokyo for injections as they just opened a line of care for that procedure and I was the first Navy patient sent for that procedure. Injected in 4 locations lower back with the 3rd and 4th injection causing severe pain and immediate spasms of the right side of body. Immediate onset of severe headaches and naeseua. Couple days later was found to have a punctured dural sac and treated with 2 separate blood patches that unfortunately did not take. Had to wait 1 month for headaches to subside.

Fast forward- (Aug 2013) Transfered back to US, stationed on the STENNIS which was dry-docked. I was still in and out of hosptial for back and stomach pain which the Yoko hospital at one point diagnosed me with diverticulitis which PCM later said was incorrect. During a hosptial visit to the Bremerton Naval hospital, lab results raised concern and was kept 2 nights for further testing. Results came back showing positive for HLA-B27 blood gene with supporting imagery of sacrol joint inflamation and arthritis.

Over time, placed on many different meds with minimal success. Later placed on Humira with no success, in fact had adverse reactions and remained ill the entire time while testing Huimra. Later placed on sulfasalazine and other muscle relaxers and a narcotic and found enough relief to maintain without need of ER assistance. With the ship getting ready to leave dry-dock, it was the actions of the Senior Medical Officer in communications with my PCM at the hospital to initiate a MEDBOARD as they did not want to take a risk with me which brings me to present day.

I am at the beginning stages of the process. With my current medication, I'm under control and have been under control for the past 5 months where I can do my "physically demanding job" effectively.

I prefer nothing more than to be given the opportunity to fulfill my dream to proudly serve 20 years of service and retire. I am unsure if that will be an option. Any insight would be greatly apprecaited. If found unfit and given MEDSEP or MEDRET, how difficult would it be to contest the verdict in order to be given the opportunity to finish the remainder of my career?

There is so much more detail to the story that depicts the mistakes and negligence of medical treatment and processing that I even requested CO mast while in Japan to bring to the attention what I was going through and how other sailors were being given a treatment that I was denied and told they don't offer for that reason.

Sorry for making such a long introduction but wanted to give as much detail as possible as I'm wondering if it could weigh in my favor when going to contest the final verdict.

Thank you for taking the time to read and hope to provide any information I learn during this process to help others that are beginning theirs. I wish everyone the best in thier situations.

~Salute

CS1(sw) Timothy M. Lalli
US Navy
14 years active duty
 

maparker

Moderator
PEB Forum Veteran
Registered Member
Your story certainly demonstrates how difficult it often is to properly diagnose Ankylosing Spondylitis. I am HLA-B27 positive and I have both reactive arthritis and psoriatic arthritis (which are related to AS). These conditions tend to be more obvious when they manifest. I use Enbrel to treat these conditions. I also use Sulfasalazine and Indocin as well as Provigil to treat mental fatigue from the condition. Fortunately I had over 20 years before I was submitted to a MEB by the Army.

It terms of being found fit, that is a real wild card. Your MOS, time in service, needs of the Navy and reduction in force pressures all come into play. You commander's statement/non medical assessment will play a large role in whether you are found unfit or not.

What are your chances of being able to stay to 20 as an E-6? What are your chances of making E-7? What are the chances of being denied reenlistment or being selected for separation in a RIF board? What are your chances of getting permanent LIMDU? All questions for you to consider.

If you are deemed unfit, it is important to be rated correctly for your AS. In the past, there have been huge issues with the Services and the VA not documenting and rating AS correctly. Attached is an info paper I did addressing these issues. Note: The VA exam worksheets discussed in this paper have been replaced with Disability Benefits Questionnaires (DBQ's) which can be found here: http://benefits.va.gov/COMPENSATION/dbq_ListByDBQFormName.asp

It is important that all manifestations of your AS be properly documented and rated.

Staying to 20 years active duty has a huge benefit in that in will make you eligible for CRDP. This can mean thousands more to you each month depending on your VA ratings and DoD length of service retirement amount. TERA retirees considered length of service retirees. As such, the are eligible for CRDP so you might want to seriously consider a TERA retirement if eligible. Unfortunately, disability retirees with less than 20 years service are not eligible for CRDP. CRDP eligibility requires a 50% or greater VA disability rating so it is important to document and claim all conditions.

Fighting to be found fit by downplaying the impact of your condition can work against you as it could lead to a unfit finding with a lower rating leading to disability separation instead of disability retirement. Bear that in mind as you figure out how to proceed. In general, it is best to get a length of service retirement (be it 20 years+ or TERA) followed by a disability retirement and then disability separation with severance. The worst possible out come is separation w/o disability severance. There is a low risk of that happening to you especially if you go though a MEB/PEB. Do you have other medical conditions?

In the past, the Navy PEB has tied to say the fact one is HLA-B27+ make the condition Existing Prior to Service (EPTS) and not compensable. Nothing could be further from the truth and I have been able to straighten out the PEB when they tied to do this but be aware of the problem nonetheless. The fact you have 14 years active duty and are currently on active duty protects you from an EPTS finding per 10 USC 1207a.

Mike
 

Attachments

  • Documenting and Rating Spondylorathpathies.pdf
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Sioux565

PEB Forum Regular Member
PEB Forum Veteran
Registered Member
Welcome CS1 Lalli!

You will definitely want to know and stick with your end goal in mind throughout the MEB process. You will find some great information on this site throughout your IDES. It appears your condition has stabilized (over the last 5 months) and you've been able to do good work since then.

I wish you the best here and throughout your time going through the process. It can definitely be frustrating.

sioux565
 

italia289

Member
Registered Member
Thank you all for the information.
Mike- I understand that I need to decide how to pursue this. If I down play my condition in hopes to be allowed to finish my career, yes that could impact me negatively.
There are many additional items documented that I have medically. None of which are anything significant but the mass of them add up. You mentioned something about mental fatigue. I have been fighting that for almost 5 years. The best way I explain it to my PCM is that when I wake up, regardless of how many hours I sleep, I wake up feeling severely "hungover". Feels like I only had 2 hours of sleep. For someone who also suffers from AS, would that best describe your " mental fatigue "? If so, I would love to know what treatment or medication best helped to alleviate that.

Once the ball starts rolling with my appointments, I will keep everyone posted with what they tell me. Like I said, I want nothing more than to finish my career proudly. I have my previous commands full support and utmost recommendation to remain in the military. I was also told any statements I can obtain from previous supervisors or commanders in regards to my performance is also welcome to submit correct?

I'm on mobile now so I will have to view the attached later when I'm home on PC. Thank you again everyone for your information and consideration to take the time to read. Like I said, there is so much more to the story that displays what they did wrong. It's been a very rough path. With my first child due this August also makes the unknown very scary.

~Salute
 

maparker

Moderator
PEB Forum Veteran
Registered Member
Much of the fatigue can be attributed to the inflammatory process. Control the inflammatory process and that helps. The inflammatory process can be controlled by medicines like Enbrel and Humira although I see you had a bad experience on Humira. Provigil also helps with the mental fatigue. I described it as a mental fog. What is your current SED rate?

Mike
 

italia289

Member
Registered Member
Mike:

I would have to look into that to find out what my current SED rate is.
I have a random question that you may or may not know the answer to. Since I just started the entire process, I've been told that my verdict of FIT/UNFIT can take anywhere from 6--9 months from current date (give or take). If found UNFIT, I plan to contest/challenge. How much additional time would you say is added onto the process to allow for that?

I was told that I can contest an UNFIT finding and if still found UNFIT, I then can request PLD (permanant Limited Duty). Would requesting PLD also add on more time to the process? Just trying to get a general idea of the timeline if I plan to challenge an UNFIT finding then request PLD if still found unfit.

Thank you.
 

ChefShifty

New Member
Registered Member
Good Morning,
I came across this post and it is very similar to what I am going through right now.

I am a Senior Chief in the Navy with 14 years in. About 14 months ago I had my S-1 through L-4 Fused, through tests to find out why my disks went so quickly (I am 34) HLA- B27 and ultimately diagnosed with Ankylosing Spondylitis. Right now I am on my last LIMDU and will be headed to my MEB and PEB September timeframe. Since being put on Humira 5 months ago I am doing pretty good but still having bad days. Pain in my back, hips, rib cage and major fatigue. It is defiantly better than it was. I can at least swim or run 2-4 x's a week and just passed my last Physical Fitness test with no waiver. I would love to stay in the Navy to finish my 20 however, as stated above I don't want to hurt myself on a lower rating and still having to get out. My worry is I still have really bad days with pain, was just in ER last week due to uncontrollable pain.

Wondering if you had any luck with Permanent LIMDU Tim? Any lessons learned? Thanks for your help everyone

-Chad
[email protected]
 

ChefShifty

New Member
Registered Member
Mike:

I would have to look into that to find out what my current SED rate is.
I have a random question that you may or may not know the answer to. Since I just started the entire process, I've been told that my verdict of FIT/UNFIT can take anywhere from 6--9 months from current date (give or take). If found UNFIT, I plan to contest/challenge. How much additional time would you say is added onto the process to allow for that?

I was told that I can contest an UNFIT finding and if still found UNFIT, I then can request PLD (permanant Limited Duty). Would requesting PLD also add on more time to the process? Just trying to get a general idea of the timeline if I plan to challenge an UNFIT finding then request PLD if still found unfit.

Thank you.
Good Morning,
I came across this post and it is very similar to what I am going through right now.

I am a Senior Chief in the Navy with 14 years in. About 14 months ago I had my S-1 through L-4 Fused, through tests to find out why my disks went so quickly (I am 34) HLA- B27 and ultimately diagnosed with Ankylosing Spondylitis. Right now I am on my last LIMDU and will be headed to my MEB and PEB September timeframe. Since being put on Humira 5 months ago I am doing pretty good but still having bad days. Pain in my back, hips, rib cage and major fatigue. It is defiantly better than it was. I can at least swim or run 2-4 x's a week and just passed my last Physical Fitness test with no waiver. I would love to stay in the Navy to finish my 20 however, as stated above I don't want to hurt myself on a lower rating and still having to get out. My worry is I still have really bad days with pain, was just in ER last week due to uncontrollable pain.

Wondering if you had any luck with Permanent LIMDU Tim? Any lessons learned? Thanks for your help everyone

-Chad
[email protected]
 
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