Hello,
TL/DR: Is there any chance for a reevaluation of my low-back rating of 10% being increased after being diagnosed with Ankylosing Spondylitis (AS), despite how much range of motion i had during the test during IDES?
I am active military with over 8 years of service and have appealed an informal PEB where I was offered an Army disability rating of 10% for low back pain (combat related), with severance, and a VA rating of 80%. Sounds great, so whats the problem? Well, the issue is that I have been diagnosed by a rheumatologist with Ankylosing Spondylitis (X-rays show fusion of the sacroiliac joints) as well as Fybromyalgia. I am currently taking an immunosuppressive biologic called Humira (just started the first dose) to treat the diseases. I am told they are chronic and incurable, but some people can go into remission.
The MEB was initiated for low back pain after receiving back surgery for a compressed disk. During IDES, the range of motion test resulted in a rating of 10% for my back. The test was not during a flate-up or incapacitating episode. I appealed the informal PEB, stating that the unfitting condition is wrong, and they should delay the board because I was seeking diagnosis and treatment for a host of systemic issues including chronically fatigued, plagued by nightly back and hip pain (with horrible, incapacitating pain occuring at night and resolving in the day), among other issues, that has continually increased in severity over the last 6 years without diagnosis or successful treatment. I argued in my rebuttal that my health issues were not correctly identified and that the PEB did not have accurate information to base a decision. My appeal was denied, and I was offered the same ratings again. I then requested a formal hearing.
I continued to work with my PCM throughout the IDES process, and was eventually referred to a rheumatologist. However because of scheduling, I wasn't able to see the rheumatologist until after i had already received the results of the informal PEB. I tested positive for a genetic marker called HLA-B27, and the X-Rays and MRIs showed fusion in my sacroiliac joints, as well as degeneterative arthritis in my entire spine, pelvis, and hips, but with the worst cases being in my L and S spine.
My lawyer states that the highest rating I will likely receive for for AS is 10%, as that rating is already captured by my P3 condition for low back pain. This doesn't seem right to me, as I am taking Humira, so it should be treated as an active disease process (DC 5009) due to AS being an auto-immune system disease.
Any advice on if I can get my low back rating higher than 10%? Or am I just stuck with that rating now? For the record, the test was done at around 11am, and was not during a flare-up or incapacitating episode.
Additionally, I am told that the MEB will not be restarted, and that I will need to be prepared at the formal PEB with all the new P3 conditions and evidence. Is this right? I thought the MEB process required injuries to be stable, but I have an active disease that I am just now receiving treatment for.
For the record, I am kinda just glad to finally gave a diagnosis and treatment options, because I thought I was losing my mind with how much pain I was in and to be told it was only worth 10% disability.
Any advice, past experience, or anything to enlighten me would be helpful. Thanks!!
TL/DR: Is there any chance for a reevaluation of my low-back rating of 10% being increased after being diagnosed with Ankylosing Spondylitis (AS), despite how much range of motion i had during the test during IDES?
I am active military with over 8 years of service and have appealed an informal PEB where I was offered an Army disability rating of 10% for low back pain (combat related), with severance, and a VA rating of 80%. Sounds great, so whats the problem? Well, the issue is that I have been diagnosed by a rheumatologist with Ankylosing Spondylitis (X-rays show fusion of the sacroiliac joints) as well as Fybromyalgia. I am currently taking an immunosuppressive biologic called Humira (just started the first dose) to treat the diseases. I am told they are chronic and incurable, but some people can go into remission.
The MEB was initiated for low back pain after receiving back surgery for a compressed disk. During IDES, the range of motion test resulted in a rating of 10% for my back. The test was not during a flate-up or incapacitating episode. I appealed the informal PEB, stating that the unfitting condition is wrong, and they should delay the board because I was seeking diagnosis and treatment for a host of systemic issues including chronically fatigued, plagued by nightly back and hip pain (with horrible, incapacitating pain occuring at night and resolving in the day), among other issues, that has continually increased in severity over the last 6 years without diagnosis or successful treatment. I argued in my rebuttal that my health issues were not correctly identified and that the PEB did not have accurate information to base a decision. My appeal was denied, and I was offered the same ratings again. I then requested a formal hearing.
I continued to work with my PCM throughout the IDES process, and was eventually referred to a rheumatologist. However because of scheduling, I wasn't able to see the rheumatologist until after i had already received the results of the informal PEB. I tested positive for a genetic marker called HLA-B27, and the X-Rays and MRIs showed fusion in my sacroiliac joints, as well as degeneterative arthritis in my entire spine, pelvis, and hips, but with the worst cases being in my L and S spine.
My lawyer states that the highest rating I will likely receive for for AS is 10%, as that rating is already captured by my P3 condition for low back pain. This doesn't seem right to me, as I am taking Humira, so it should be treated as an active disease process (DC 5009) due to AS being an auto-immune system disease.
Any advice on if I can get my low back rating higher than 10%? Or am I just stuck with that rating now? For the record, the test was done at around 11am, and was not during a flare-up or incapacitating episode.
Additionally, I am told that the MEB will not be restarted, and that I will need to be prepared at the formal PEB with all the new P3 conditions and evidence. Is this right? I thought the MEB process required injuries to be stable, but I have an active disease that I am just now receiving treatment for.
For the record, I am kinda just glad to finally gave a diagnosis and treatment options, because I thought I was losing my mind with how much pain I was in and to be told it was only worth 10% disability.
Any advice, past experience, or anything to enlighten me would be helpful. Thanks!!
