That said... I am compiling a central FAI guide for people like myself who cant find any info on the subject. If anyone has anything of value to add to this, please PM me the info and I will incorporate it into this post.
Please note: This is NOT medical advice. I am not a doctor! This is only a summary of my many hours of research into my FAI. Hopefully this will help others!
First update as of today. I called the BCAC again (beneficiaries counseling assistance coordinator) and found out that I was given the wrong information.
(A) MEDICAL PROBLEM OR DIAGNOSIS: Femoroacetabular Impingement
1. Arthroscopic surgery ("scopes" or "plastys") are not covered or to be approved by any network provider. (network meaning: civilian or outside the military medical community).
1A. Civilian or non-military surgical procedures:
NOT approvable, NOT covered.
2. Scopes (arthroscopic) and plastys (femoroplasty etc) ARE covered and approvable as long as they are performed by a military doc
OR at a MTF.
2A. Military or MTF performed surgical procedures:
approvable, covered if medically necessary.
3. If there is no doc in your area to perform the procedure, you can arrange through your BCAC to be put on TDY to the MTF that does perform these procedures.
Note: Regulations and approvals/denials change all the time, cross reference and verify accuracy.
This information can be obtained by calling the BCAC (Army) representative.
(B) SURGICAL OPTIONS FOR FAI:
1. Arthroscopic surgery (aka plastys or scope) procedures are the least invasive and "should" be very conservative.
2. Hip resurfacing (from what I have been reading) is best for younger individuals or if deemed better for you, is not the same as THR, but can be converted to THR later on if necessary. (Also known as Birmingham Hip Resurface or BHR)
3. Total Hip Replacement (THR) is best for those who are older, as the prosthetic wears out and may need to be replaced @15-20 years (also varies on individual and lifestyle). This is a "big deal" surgery.
4. There may be other procedures that I have not listed. Again, this is only what I have found so far.
5. If you have a procedure done, ask if you can have it video recorded and obtain a copy for your records!
NOTE: If you are going through the med board, or are about to be recommended for one because of FAI, and you have the option of getting the surgery while you are still in the military... Look into what is/isn't covered outside of the service!!
I cannot even begin to stress the importance of this!
(C) SURGERY INFORMATION: In progress...
(D) RECOVERY INFORMATION:
1. Most of the websites I have researched claim the recovery from the arthroscopic procedure lasts approximately 4 months give or take. (Im on 6 months. Still painful, still have catching/popping/pinching, still walk with a heavy limp, and am approved to use a cane)
2. I was on crutches for 3 1/2 months after surgery. This depends alot on the individual and the surgeon's recommendations.
3. Stick with your Physical Therapy. There are days that I want to quit because it is too painful, just do what they want and push yourself within reason.
4. Stretch and stay as flexible as you can during recovery. In my case, my leg muscles are always stiff, and I lose my range of motion from it.
5. Take your time, dont try to be a hero and be up and running too quickly. Make sure your body can heal, what you do now may make the difference between Prosthetic Hip Replacements or a normal life later on (as my surgeon put it)
6. Realize that depending on your procedure you may be at a high risk for early osteoarthritis. (I am. Because of the torn labrum, arthroscopy, and cam/pincer impingement etc)
* During the surgical recovery period you may want to consider or look into WTU as an option. The recovery timeline for these procedures is often longer than 6 months, and can have a lot of extreme ups and extreme downs. If you are considering a surgery to correct FAI, ask your PCM about WTU as a place to go while you recover (I chose to go there due to the numerous appointments, physical therapy sessions, and ease of getting seen in case "Private Murphy" shows up. Make sure you educate yourself on the options WTU offers, especially when it comes to the "return to duty" orders. WTU has many programs available for those who do not successfully recover and are forced to consider changing their MOS or entire career path for civilian employability...
Note: Dont give up on getting it fixed! Dont give in to the docs that are just pushing for the MEB/PEB without regard to your quality of life (either while you are in service or out). Remember, you have to live with this diagnosis and letting it get worse increases your chances of early osteoarthritis and prosthetic hips. I recommend reading the Patient Bill of Rights for military health care.
(E) IS FAI SURGERY COVERED AFTER I LEAVE THE MILITARY? (with or without medical benefits):
1. Even if your FAI was incurred during your military service,
it may not be covered on the outside, even if you leave with over 30% and take your health benefits with you!
2. Refer to the exclusions under tricare or VA!
3. Take the time to carefully read all applicable insurance documents to make sure you know what is fact and what is fiction. Do not take someone else's word that "you can always go back to the VA after you are out..." unless you see it in writing. There are others on this forum who have gone through hell trying to get their FAI taken care of after they were retired/seperated for it.
4. Call the BCAC or Tricare to verify the facts for after service surgical options
5. Call the VA to verify the facts for after service surgical options
(F) IF PEB/MEB IS INITIATED FOR FAI:
1. First, refer to section (E) listed above.
2. I would immediately consult with someone who knows the PEB/MEB process thoroughly. (Lawyer, PEBLO etc)
3. If you are thinking about accepting severance pay, and getting the surgery done in the final months before you lose Tricare coverage, refer to section (E) listed above. (Many service members are told they still have Tricare for approx. 3-6 months before coverage expires after exiting service)
4. Dont get in a rush due to a slow PEB/MEB process and miss the opportunity to get your condition corrected before "getting out". If this statement doesn't make sense: refer to section (E) listed above!
5. As with any PEB/MEB, make sure you have personal copies of ALL your medical records!
6. Ask for, and obtain, all of your MRI and X-RAY images. Be specific and state "
you would like a copy of all of your IMAGES." This will get you every single image ever taken (of anything) during your time in the military. Images are for any issues with the VA asking you to show proof.
Note: The cost that tricare paid for 1 single arthroplasty procedure on my hip came to $30,000.00 (I have a bilateral diagnosis, which comes to about $60,000.00 if I ever had to pay out of pocket) Severance pay isn't so attractive after seeing these numbers!
(G) KNOWN FAI/TORN LABRUM PEB/MEB/VA OUTCOMES AND RATINGS:
Keep in mind that everyone's specific diagnosis is unique, and may contain a combination of other conditions.
Forum member submitted outcomes and findings:
1. TXNVYMOM
- Here's what the VA wrote about her son's FAI: "The disability is not specifically listed in the rating schedule (VASRD); therefore, it is analogous to a disability in which not only the functions affected, but anatomical localization and symptoms are closely related".
Also: Get familiar with the VASRD! Notice that FAI has not found its way to the rating schemes... Dont be surprised when you go through arthroplasty and you are awarded a WHOPPING 10%.
(H) IMPORTANT PEOPLE TO KNOW AND HAVE PHONE NUMBERS FOR (Army):
1. BCAC (Beneficiaries counselor and assistance coordinator).
2. The supervisor of the BCAC rep.
3. Tricare
4. Patient Advocacy
5. Post I.G. (if you ever need it... Hopefully not)
6. An experienced orthopeadic doctor off post (for second opinion or initial FAI diagnosis if needed). This may or may not be at your own expense, so be aware of this. FAI is a relatively new diagnosis and not all ortho docs are familiarized with it or its diagnosis.
7. A good lawyer. (Anything that puts my career in jeopardy is reason enough for me to have an attorney on speed dial. And no, not a "barracks lawyer". Im referring to the paid kind)
(I) DENIAL OF COVERAGE APPEAL LETTER TEMPLATES, OTHER MISC. DOCUMENT TEMPLATES: In progress...
(J) GOOD WEBSITES FOR INFORMATION ON FAI, RECOVERY, OTHERS WHO HAVE HAD IT, ETC:
1. This forum. Use the "search" button.
2. Femoroacetabular Impingement (FAI)
3. Hip Chicks - Hip Dysplasia and Impingement Support Group
4. New UnderstandingFAI Forum
OP Disclaimer: And again, I am not a doctor, and none of this should be taken as medical advice. This is only to help those with FAI due to the complete lack of resources and information on it (especially within the military!)