Does my case deserve a MEB? What else do I need to do?

[chronicLBP]

I have been being seen for back pain, migraines, and sleep issues all for over a year now — all recurrent. However, the back pain is the most prevalent and most pressing issue.

I have several bulging discs, cartilage degradation, spinal canal narrowing, and nerve compression which causes pain down both legs. I have had two steroid epidurals so far, and am getting a third very soon.

Since the start of being seen, the pain has gotten worse. I see physical therapy, chiro, and an off base clinic for pain management and these epidurals. Again, this has been going on over a year and only getting worse. My PCM knows, and just wants me to “try it (the epidural) again,” “and then we’ll see if we can do more if that doesn’t help.”

The two times I got an epidural, and same
for the next time, I have to be out that entire day of work. There have been many instances where I have to stop working and lie down because the pain gets so bad. I’ve also had to leave work early or stop working more than several times as well because of migraines. The poor sleep affects my quality of work. All of this has started negatively affecting mental health, and I’ve started being seen for that as well.


From the AFI in the MEB 101:

5.3.11.8. Migraine. Manifested by disabling attacks requiring frequent absences from duty and are unrelieved by treatment

5.3.12.2.1. Conditions that are expected to have persistent duty impairment (more than 1 year despite treatment)

5.3.14.1. Congenital anomalies presenting functional impairment of a degree to preclude the satisfactory performance of duty.

 

[Provis]

I am sorry that you are going through this! Has your PCM brought up the possibility of a MEB yet? If not I would have an appointment to discuss. If your PCM says that you are not at that point I would want to know at what point do they think starting a MEB is appropriate.

Also, in the Army, the Commander can request a fit for duty exam independent of medical. I am not sure if the Air Force does it the same way. If so, I would discuss with your commander about your duty performance and how your medical issues prevent you from doing your job. Even if your commander cannot request a fit for duty exam they will be part of the process if you do go through a MEB so its best for them to be well informed and hopefully in your corner. Back issues and Migraines can easily be debilitating and a cause to be found unfit for duty. If you can't get anywhere with your PCM you may need to escalate your concerns. That may mean a 2nd opinion, communication from your leadership on your behalf or reaching out to a patient advocate.

 

[chronicLBP]

Thank you. My PCM has not even said the word MEB. I am also on my fourth PCM at this base, so that makes it difficult and frustrating. I have not asked because I felt it was not appropriate to bring it up myself, would that not be wrong? My thought would be they would be thinking I am just trying to reach for a medical retirement.

I am also unsure if the commander has that power, but I will look into that as well. I have also been thinking about the patient advocate with how bad my back has been lately, and I think I’m going to call them
this week.

 

[Provis]

Thank you. My PCM has not even said the word MEB. I am also on my fourth PCM at this base, so that makes it difficult and frustrating. I have not asked because I felt it was not appropriate to bring it up myself, would that not be wrong? My thought would be they would be thinking I am just trying to reach for a medical retirement.

I am also unsure if the commander has that power, but I will look into that as well. I have also been thinking about the patient advocate with how bad my back has been lately, and I think I’m going to call them
this week.

I am a strong believer in over communicating. I don't think your PCM will think that if you are able to communicate it in a way that logically makes sense and that you come across to them as genuine. For example... l am doing all I can and following all of my treatment recommendations but sometimes I don't fee like I will ever fully heal. I feel bad for those I work with because they have to work harder and longer to cover for me when I am unable to perform my duties. At what point do we consider a MEB? I love my job but I also understand that the mission needs to come first and I don't want to be the weak link here.

 

[chronicLBP]

Thank you, Provis, I really like that. My (third) epidural appointment has been delayed over a month and won’t happen for a couple weeks, so I will make a PCM appointment and say that.