Just failed Asthma Test

ibucki

PEB Forum Regular Member
PEB Forum Veteran
I just walked in the door from a methylcolin challenge test and found out that I failed.

Had a 40% decrease of FeV1 after the fifth dose of the medicine, I was at %20 after dose four.

My head has been spinning since I walked out of the office, but would like to hear from others that have been diagnosed with asthma and hear what I am likely facing here. I guess I need to know if I should start preparing for a civilian job or not. Obviously they are going to start a MEB on me, says they have to in the AFI. But what factors will determine my fit for duty status?

Thanks for any help in advance.
 
What's your job? and how long have you been in?

I'm an imagery analyst... Intel

I will be in 11 years in February!

Do these play into the determination? If so, I don't have much chance of staying in. A buddy of mine was diagnosed a couple years ago with asthma with the same TIS and AFSC and they booted him.
 
I know when I was MEB'd for Asthma last year my package wnet to the IPEB because of AFSC and time in. However I have a co-worker who is in the same job and same tim in and his was fast tracked. From what you describe from your methylcolin challenge test it sounds like your Asthma isn't as bad as either of ours. We're both Comm folks, but we work in the Intel building with the intel folks. We were both returned to duty. I'm coded C-1 and he's C-2. The only difference between our packages is I was not on an inhailer at the time of my MEB and he was. I did hear about an Asthma case that went in the same time as mine that was seperation....but that's because he only had 1 year in. My advice is plan for the worst...hope for the best...but I don't think you have anything to worry about. It should be a return to duty with asignment limitation code probably C-1 or C-2.
 
I know it’s difficult not to, but comparing yourself to others can be very inaccurate.

Fitness for duty is based specifically on your conditions impact on the duties and expectations of your rank and AFSC. There are some AFSCs where it may be disqualifying based on their needs and there are AFSCs where it is acceptable and managed with an assignment limitation code.

TIS can factor into it but it is more dependent on the patient's rank and position (an 11 year SSgt wouldn’t really be looked at differently than a 19 year SSgt). But to make a usable comparison your conditions would have to be identical in severity and impact.
 
A C-1 places me on a non worldwide deployable status correct?

It is my understanding that my PCM will likely start a MEB after my follow up in a few weeks, sound about right?

From there what happens? I'm a little confused as to how this whole process will go!
 
A C-1 places me on a non worldwide deployable status correct?
Not quite

ALC-C1 Deployable/Assignable to Global DoD fixed installations with intrinsic Medical Treatment Facilities (MTF). This code will be used primarily to identify individuals with temporary or mild conditions requiring medical follow-up but whose condition is clinically quiescent or unlikely to cause serious impact if untreated or treatment is limited to primary care during periods of deployment or assignment.

ALC-C2 Deployable/Assignable to CONUS installations with intrinsic fixed MTFs (Tricare Network availability assumed). This ALC-C will be used for medical conditions for which specialist medical care and referral within one year is likely but who could be deployed or reassigned OCONUS or to non-fixed environments if appropriate specialty care is available, or for short periods of time.

ALC-C3 Non-Deployable/Assignment limited to specific CONUS installations based on medical need. This ALC-C stratification designates members who should not be deployed or assigned away from specialty medical capability required to manage their unique medical condition.

It is my understanding that my PCM will likely start a MEB after my follow up in a few weeks, sound about right?

Sounds normal.

From there what happens? I'm a little confused as to how this whole process will go!

Someone from your MTF's Patient Admin or TRICARE flights should get intouch with you to set up your inital breifings.
 
Thanks for the info...

I'll keep the forum posted as to how the process rolls.

I guess I can kiss the orders to Korea bye-bye!
 
Question....

According to a post by Jason on the boards a 40% decrease in FeV1 is grounds for a 30% finding at a PEB.

FEV-1 of 56- to 70-percent predicted, or; FEV-1/FVC of 56 to 70
percent, or; daily inhalational or oral bronchodilator therapy,
or; inhalational anti-inflammatory medication............................................. 30

Mine dropped 40% and I'm on Xopenex right now as an emergency inhaler. I have to be honest and say that after experiencing what I did in the test, I realized that I've had more asthma attacks than I ever thought I have. I knew I've experienced them after rigorous exercise, that's what started this whole thing rolling, but I thought my other boughts with breathing issues were from years of smoking and not actual asthma attacks.

I realized that what I thought was just poor breathing from smoking were actually asthma attacks when my symptoms started worsening after the 3rd dose during the PFT.

Now I realize that the use of daily steroids goes a long way towards a 30% rating, but I was never prescribed a daily because I didn't realize that the problems I was experiencing were asthma issues, so I never mentioned my almost daily episodes with shortness of breath with my PCM. I fully intend to describe what I've been going through over the last couple years with him at my follow up. If he prescribes a daily inhaler to help control the problem, I assume that will be taken into consideration by the MEB and PEB boards?

A few of the replies to my thread have indicated that the MEB simply came back with a "fit for duty" determination and moved on. If the above excerpt is correct, how can they do that? Seems to me that in a case where FeV1 drops by 40% from expected, they would be required to refer it to a iPEB? Do commander letters have that much impact on the MEB findings?

Additionally, I have been on profiles for almost a year for an issue with my neck... I have two bulging discs that are pinching nerves and causing me numbness in my left arm and extreme pain after moderate exercise. My PCM was intending to begin a MEB on this issue in January if the last cortizone injection didn't benefit me. Now it looks like a MEB will be initiated due to the failure of the PFT. Can these issues be included in the MEB as well?

Personally, I have no intentions of re-enlisting when my two years are up. Now that this is presenting itself, I want to be sure that everything is taken into consideration when the MEB is initiated and that I get as much out of this as is possible. If they are going to seperate me, I want to be sure I get the 30%. May sound selfish, but I've learned in the last 11 years that you have to look out for yourself cause the military isn't going to do it. They would gladly tell me to exit stage left with nothing. Knowing that I am looking for an unfit and 30% going in, what steps should I take to prepare for achieving that end? Should I have letters from supervisors and items like that for the MEB or are those more appropriate for the PEB?
 
In my previous post indicating that my board and that of my co-worker came back RTD with C code limitations, both cases did go to AFPC. Mine went to the IPEB and his was fast tracked. I’m not sure which board the fast track cases go to. However, as AFPEBLO mentioned above, my opinion was purely conjecture and speculation as to the possible outcome of your case.

As far as your own health and well-being is concerned, If you feel that you would benefit from the use of a daily inhaler than you should definitely talk to your PCM about that as soon as possible. You should be sure that you are undergoing the proper treatment for your conditions before they start your MEB to ensure you get the correct rating by the board.

As to your question about your other conditions, it is my understanding that an MEB is an MEB. The Asthma may be the trigger that gets the ball rolling, but all of your conditions should come out in your narrative summery. Once the MEB is initiated it is no longer just about Asthma, it is about your total fitness and your ability to perform your job as a member of the military at your grade. If you are still undergoing treatment for a condition that you feel should be included in this package talk it over with your PCM and your PEBLO. Make sure you express your concerns with them and let them know your position. In most cases, your case is just a job to them, it’s your life/future to you…..you must be your own advocate. I’m not saying that there are not some terrific PEBLO’s and PCM’s out there just that they sadly seem the exception not the rule.
 
Okay here goes... They initiated the MEB last week. Basically my PCM put me on a non-deployable profile for three months and started a MEB. He told me that if in three months my asthma is not "controlled" (meaning I'm still using my albuteral more than twice a week) I will be seperated. He said if it is "controlled" I will get a "fit for duty".

In the mean time the pulmonoligist wants to do a sleep study for possible sleep apnea. We'll see how that goes next week.

Now according to a document I downloaded from this site, a drop of 40% FEV1 and use of the corticosteroids qualifies me at the 30% disability level. Question: is this pretty cut and dry or are they likely to play a game with me and drop a number like 20% then make me request a formal PEB? Also, is there anyone out there with experience in this that could give an indication as to wether (if an un-fit is returned) it will be on a TDRL or PDRL?

I'm really trying to get all my ducks in a row for worst case scenario as I will need to start looking for a job if the ball drops on my AF career.

Thanks for the info....
 
oh how I love the military....So I'm thinking (because my doctor told me, big mistake) that my MEB will be started in March so I will have time to see if the meds they have me on get the asthma under control. I get a call from the MEB office saying my MEB is underway. I'm confused but let it go... Then a call from personnel office telling me that my orders (RNLTD 10 FEB) will not be cancelled because my code expires on 10 MAR and I'm still eligible for assignment. At this point I'm thoroughly confused so I decide to stop in and ask my Doc, "what's up Doc?". I am told that my MEB will be completed by March and I should be fine. At this point I walk upstairs to the MEB office where I am greeted by a nice young lady that knows exactly who I am before I walk through the door.

Seems that AFPC has contacted her and requested that she do a RILO in leu of a full MEB so they can get me processed and off to Korea before 10 MAR... She was in the process of obliging their request until I walked in the door and she looked more closely at my file. She then discovers that there are restrictions in my profile completely unassociated with asthma, such as the ones involving two bulging discs in my neck and then discovers the pulmonologist will be testing me for sleep apnea in February. Things my PCM knew and did not include in the MEB request.

Additionally, she proceeds to pull up all documentation scanned by the doctors (non-military) that have been dealing with my neck. (something my PCM must have never done)... Orthopedic Doc examined my MRI and diagnosed degeneterive disc disease and referred me to a shoulder specialist thinking I may have a torn rotator cuff. All things my PCM failed to report to me or include in the MEB request.

The kind young lady at the MEB office assured me that the orders will be cancelled because this will have to be a standard MEB and we will have to wait for all appointments and issues to be fully diagnosed before we submit. THANK THE LORD!!!!!!

Needless to say, I'm pretty ticked that

1. AFPC is trying to meddle in my MEB so they can fill a stinking billet! How ridiculous... they are willing to NOT look into an airman's full health so they don't have to go short on a billet. Then instead of being straight forward about it, (i spoke to an AFPC rep twice who informed me that they were working to get the assignment cancelled so the MEB could run it's course), they go and request a fast track paper push so they can get me there and if I have another attack I guess MEB me from there or my follow on. This just angers me to no end!

2. My PCM didn't allow the time needed to fully look into ALL the issues that need to be addressed. He told me a month ago that if I returned to him in february with neck pain he would MEB me for that. Now he doesn't even include it in the MEB, I'm still be treated for the pain by an outside doctor!

I really don't know how to proceed now. It seemed that this was going to be smooth and they were going to look out for me, it looks now like the only one the AF is looking out for is themselves and I'm going to need to do my homework to make sure I don't get screwed. Any words of advice would be more than welcome and greatly appreciated.

Thanks!
 
ibucki,
DOCUMENT EVERYTHING!!! I got quite the run around for my MEB. Definitely exercise your right to write a letter and explain all of this. Start gathering as much info as possible on the process. Learn the regulations because you are your own advocate, as you've seen so far... Do not let them pull BS on you. If you know the regulations you can ensure that your case is processed properly.
 
Thanks! I'm trying to learn all this, but there is so much and it's so confusing.

I called my PCM's office today and spoke with his nurse. I asked why I was told I would have three months to try and manage the asthma before a MEB was initiated and he got frustrated with me and just told that this is the way they do things and I have to talk to my PEBLO from now on. WHAT????? The man specifically told me that I would get a chance to get it under control prior to them even initiating the MEB, now they are trying to push through a determination without even looking at all the facts of my situation AND giving me an attitude about it!

Fact of the matter is, we DON'T have ALL the information! If they fast track now, deem me fit, send me to Korea and then my follow-on, there is a CHANCE that this could be un-controlled and I'll be MEB'd out at my next assignment. In the mean time, I've sold my house, moved my kids, and rearranged my entire life all because some glorified physicians assistant didn't feel like waiting a couple months for all the information.

If they continue to push this through, do I have a legal recourse that I can pursue to force their hand at taking into consideration all the problems associated with my case?
 
ibucki,

In my experience, most asthma cases that result in retirement end up on the TDRL. Much depends on how long you have had condition, how it has responded to treatment, and the doctor's input on stability.

If they continue to push this through, do I have a legal recourse that I can pursue to force their hand at taking into consideration all the problems associated with my case?
You can raise issues at the MEB level, both informally and by requesting an impartial health care provider review your MEB and rebutting the findings. After the fact, the recourse is likely through the BCMR's initially and finally in the courts.

I hope all goes well for you and you get the outcome you want.
 
ibucki,
I sent you an e-mail via your profile. If you didn't get it let me know. I just finished a USAF MEB/PEB a month ago.
 
Jason, thanks for the input...

My biggest concern is that AFPC is requesting a RILO and NOT a MEB! They want to push through a RILO prior to all the facts coming in and being looked at because they want me in Korea in February. I was just diagnosed last month and haven't been on my treatments for more than 2 weeks. How do I stop the RILO until it can be truly determined if this is controllable or not?
 
poison... I didn't get it, seems I don't have access to private messages or something...

I'm trying to get the profile updated so you can email directly to my home email.
 
Try again, my account now has my home email is in the system...

Thanks...
 
Top