Neuromuscular disorder (min 30% VA) and undermanned career field

vtaf10

PEB Forum Regular Member
Registered Member
Good Afternoon all,

First, this forum is a gold mine! I appreciate the awareness and help that people provide on here. With this in mind, I post my story. I am a pilot with 9 years in. I have been recently diagnosed with MG (VARSD min 30% 8029) with constant diplopia which is connected and renders me incapable (let alone I feel unsafe) to do my job. I'm getting a second opinion, but I don't know that I actually disagree. Medicine is helping. With this in mind, I have a few questions-
If my condition is a guaranteed MINIMUM of 30% on the VA scale, is medical retirement a guarantee?
There is a pilot shortage AF wide. If I desire to military retire, can they force me to stay in despite the rating?
Do they have the option to re-train me? If they do, is there no choice in the matter?
With a cut and dry diagnosis and VA rating, will this help the MEB/PEB process move forward quicker? Is ~270 days a standard?

Thanks!
 

tony292

PEB Forum Regular Member
PEB Forum Veteran
If you have a MG diagnosis and found unfit for it (likely) you’ll be medically retired. They may grant you TDRL if they think it could improve or PDRL. I was granted PDRL and for my MG ratings I was rated 40% per leg plus 10% bilateral factor for thigh atrophy and leg weakness. I was also rated 60% for pulmonary residuals of MG. And finally o was rated 0% for ocular (diplopia and ptosis because the examiner checked the box next to symptoms being “occasional” vs “constant”. Has he checked the constant box I’d have some sort of percentage for ocular too, but I don’t need it as I’m 100% PT when all things are combined.

Make sure you don’t take meds and are tired for your Va CP exams. You need to show them your symptoms at their worst. And if you’re having trouble breathing at all ask for a pulmonary function test. I wasn’t scheduled for one but the examiner for general medical noticed that I had labored breathing and sent me for a PFT, they just happened to have an opening right then and so I lucked out and was seen and rated for pulmonary residuals as well.

One question. Is your myasthenia Gravis ocular only, or is it generalized? If ocular only you may be able to stay at a desk job. If generalized not likely to stay at all.
 

vtaf10

PEB Forum Regular Member
Registered Member
Tony thanks for taking the time to reply. Right now it is ocular but I essentially can’t reliably work starting mid afternoon due to my ptosis and Diplopia, and it is only improved in a minor way with Mestenon. I have Diplopia that can happen all hours of the day (even right after waking) I just have my energy give out fighting it around then. I think I have a case for “constant.” You mention a desk - so even though I can’t do my primary rate, they can find me fit to sit a desk, when I can’t look at computer screens to long? Maybe that’s what the NARSUM is for?
 

tony292

PEB Forum Regular Member
PEB Forum Veteran
If the PEB finds you fit then you’ll have to request a formal PEB where you can make your case against a desk job. If your commanders statement says you can’t perform a desk job that would help too.
 

tony292

PEB Forum Regular Member
PEB Forum Veteran
I what the VA DBQ for ocular doesn’t quantify well is the fact that with MG, symptoms are always constant. My vision literally changes all the time but normally within a set “window”. When I get extremely tired though I get bad double vision. But when asked is your double vision and ptosis constant? I said no. Most of the time it isn’t double vision, it’s some degree of blurred vision. And my ptosis is nearly constant to some degree, but it varies as well. I. Fact, I once was told by an optometrist to stop coming back to get glasses, I had 3 different prescriptions in a 5 month period of time. The third time he grew frustrated and said your vision should not be changing this quickly, you need to see a neurologist..

Had I known more about how ocular symptoms are rated going into the exam I would have said yes it’s constant.
 

vtaf10

PEB Forum Regular Member
Registered Member
Tony it is great to get your perspective as someone who has gone through this because I completely understand and agree. MG is called “snowflake” (hate that term, oh well) disease because everyone’s is different and inconsistency tends to be a hallmark. Just like you detail my ocular symptoms are borderline unsafe driving home after a normal day at work. Are they that way at 0730? Not necessarily, but does that mean they’re not constant? They are to me because if I don’t take my meds on time they’re sure constant. I also notice that your signature summary detailed 21% for MG. Isn’t th min 30?
 
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