Getting the Surgery or MEDBOARD answer from Ortho.

[k8l8]

Hello all - 10 year TIS (however, with an ETS of next year) Army Enlisted with multiple injuries, but constant right ankle instability is leading with high possibility of MEDBOARD -

To keep it short,

Three years ago I destroyed my right ankle during a PLF. I was diagnosed with both a high and low ankle sprain. The x-rays of the ankle left the specialists describing that I only have one ligament left intact in my right ankle.

I was referred to PT and orthopedics for this injury. As this is one of a few injuries I have and I am in the NCR, so it's a minimum of an hour to drive to any treatment facility, I did end up neglecting to finish my prescribed PT treatment.

Follow on with routine re-aggravation of the injury from rolling the ankle while walking down stairs or on flat surfaces to collapsing during sprint-drag-carry and the deadlift fitness test events.

The point of contention is that my Ortho PA says surgery is the solution to "tighten up" my ankle. Due to life events/family planning and high skepticism in the results post-surgery, I do not have interest in electing to the surgery.

Will not electing for the surgery sink my MEB case? Should I seek second opinion for further documentation?

 

[Winnie11b]

In order for your PA to initiate your MEB, your Ortho need to conclude your injury as MRDP. During IDES/LDES (Medical Board process) you are still able to do surgery as long as you coordinate with C&P exams and SKILLBRIDGE. I hope this help.

 

[Almostthere86]

Hello all - 10 year TIS (however, with an ETS of next year) Army Enlisted with multiple injuries, but constant right ankle instability is leading with high possibility of MEDBOARD -

To keep it short,

Three years ago I destroyed my right ankle during a PLF. I was diagnosed with both a high and low ankle sprain. The x-rays of the ankle left the specialists describing that I only have one ligament left intact in my right ankle.

I was referred to PT and orthopedics for this injury. As this is one of a few injuries I have and I am in the NCR, so it's a minimum of an hour to drive to any treatment facility, I did end up neglecting to finish my prescribed PT treatment.

Follow on with routine re-aggravation of the injury from rolling the ankle while walking down stairs or on flat surfaces to collapsing during sprint-drag-carry and the deadlift fitness test events.

The point of contention is that my Ortho PA says surgery is the solution to "tighten up" my ankle. Due to life events/family planning and high skepticism in the results post-surgery, I do not have interest in electing to the surgery.

Will not electing for the surgery sink my MEB case? Should I seek second opinion for further documentation?

While it won’t sink the MEB you will need that provider or a second opinion from a like provider to refer you for an MEB. My ortho kept pushing for surgery hard and I told him no, as my two other conditions I have didn’t meet retention standards anymore. Surgery will tie things up if you push for an MEB as surgery will delay the whole process. Had a fellow soldier whose shoulder was messed up bad and he wanted an MEB but instead let them do surgery and it took the MEB off the table entirely until he was completely healed and did PT.

 

[k8l8]

In order for your PA to initiate your MEB, your Ortho need to conclude your injury as MRDP. During IDES/LDES (Medical Board process) you are still able to do surgery as long as you coordinate with C&P exams and SKILLBRIDGE. I hope this help.

Sincerely appreciate the insight! For some clarification, I want to avoid the surgery completely. I'm mostly worried about letting the Ortho PA initiate the MEB process after telling that same Ortho PA that I don't want the surgery that would (in theory) fix the ankle instability.

I read some older posts on here where individuals described that they refused surgery, that was reflected in their MEB case, and ended up with low ratings.

All in all, more so wondering how or if refusing surgery will impact MEB rating.

 

[k8l8]

While it won’t sink the MEB you will need that provider or a second opinion from a like provider to refer you for an MEB. My ortho kept pushing for surgery hard and I told him no, as my two other conditions I have didn’t meet retention standards anymore. Surgery will tie things up if you push for an MEB as surgery will delay the whole process. Had a fellow soldier whose shoulder was messed up bad and he wanted an MEB but instead let them do surgery and it took the MEB off the table entirely until he was completely healed and did PT.

Sincerely appreciate the insight!

For some clarification, I want to avoid the surgery completely and the Ortho PA is willing to begin the MEDBOARD process.

I'm mostly worried about letting the Ortho PA initiate the MEB process after telling that same Ortho PA that I don't want the surgery that would (in theory) fix the ankle instability.

I read some older posts on here where individuals described that they refused surgery, that was reflected in their MEB case, and ended up with low ratings.

All in all, more so wondering how or if refusing surgery will impact MEB rating.

 

[Almostthere86]

Once mine finishes out I will let you know since I refused surgery myself, but like posted above the VA is the decider on the rating side and the DOD follows suit usually with the same percentage. The biggest hurdle will be getting referred for an MEB and the MEB board Doctor finding you not meeting standards and then the PEB voting that you are unfit. Surgery can be a crapshoot. A good friend of mine had surgery and his shoulder is still not back to normal and he has been doing physical therapy for over a year. Luckily he is retiring normally soon.

 

[Winnie11b]

without surgery will might affect your dod rating, cuz they look at whatever trigger your meb, really talk to your ortho about both legs and make sure PA understand both your legs are fk, have both legs mri xray.. all that good stuff for bilateral factor. I only got 10% from dod site cuz only got surgery for my right leg and nothing done (including mri) for my left. but I'm happy with my 100va. Just tell your ortho straight up u don't want surgery.. I did for my left cuz my right leg got worse (compartment syndrome)

 

[k8l8]

Once mine finishes out I will let you know since I refused surgery myself, but like posted above the VA is the decider on the rating side and the DOD follows suit usually with the same percentage. The biggest hurdle will be getting referred for an MEB and the MEB board Doctor finding you not meeting standards and then the PEB voting that you are unfit. Surgery can be a crapshoot. A good friend of mine had surgery and his shoulder is still not back to normal and he has been doing physical therapy for over a year. Luckily he is retiring normally soon.

Will keep an ear to the ground for your update!

I am meeting with PCM to request second opinion. The Ortho PA writes incredibly weak clinical notes and only ever describes the issue as "ankle instability". I'll also take the recommendation to request imaging on both legs to have solid documentation.

 

[k8l8]

without surgery will might affect your dod rating, cuz they look at whatever trigger your meb, really talk to your ortho about both legs and make sure PA understand both your legs are fk, have both legs mri xray.. all that good stuff for bilateral factor. I only got 10% from dod site cuz only got surgery for my right leg and nothing done (including mri) for my left. but I'm happy with my 100va. Just tell your ortho straight up u don't want surgery.. I did for my left cuz my right leg got worse (compartment syndrome)

Imaging both legs is a good recommendation. I'll pursue that! When you say that the DOD side looks for what triggered the MEB, could you elaborate further? With the injuries I have (and in this economy), I would like to achieve PDRL with 100% VA. I've been working for the last two year to pursue every specialist I can manage and document as much as possible. In short, the last 10 years really ate my lunch and it would be nice to have a strong case.

 

[Winnie11b]

Imaging both legs is a good recommendation. I'll pursue that! When you say that the DOD side looks for what triggered the MEB, could you elaborate further? With the injuries I have (and in this economy), I would like to achieve PDRL with 100% VA. I've been working for the last two year to pursue every specialist I can manage and document as much as possible. In short, the last 10 years really ate my lunch and it would be nice to have a strong case.

DOD % only rate you the condition that cause you unfit for duty, pretty what your PA write down refer you to Medical board (ex: lower right extremity). after C&P exam, everything is sent to Dod, they will decide if you fit or unfit, if unfit, case sent to va for va proposal rating, then sent back to dod for dod rating.