thinking about requesting surgery

Hello all, I am waiting on IPEB results and i am thinking about requesting to the MTF commander to have the wrist fusion i need. I wanted to make sure i knew all of my options.

#1 if my request was granted would it cause this process to take longer/restart?

#2 could i wait until after i signed my ratings and still have it done ?

#3 could i get it done while on terminal leave @ home?

#4 could i get it done during the 6 months i'll still have tricare after im seperated?

I just don't want to end up getting out and having to wait another year of appointments to get surgery because i think if i recover successfully i will be much more likely to find a decent job. I'm not afraid of working hard i was considering postal service to buy into retirement with the 12 years active duty i have but the recovery time for the fusion is up to a year. At the same time i'm ready to move on ( somewhat depending on IPEB results ). I dont want to end up not being able to bring enough money home because of the situation im in, if i get temporary retirement until im fully recovered its different but just trying to get a plan for different possible outcomes. Im going to see my hand doc in a couple days and im sure he could put some convincing notes in my records that i should get the surgery now im just nervous about it backfiring on me. Thanks all
 
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#1 - 3 would probably result in a delay. #4 would not. It would be one of the rare surgeries that would probably increase your ratings. Normal surgery is done to restore movement, but a fusion would reduce movement. ROM therefore would probably decrease significantly.
 
Yes but its a partial fusion I know I will most likely have to get a full fusion someday because I'm 33 and its usually people twice my age that have my condition. The full fusion or ankylosis is the only thing I can find with a higher rating than what I'll probably get. I'm hoping they group some of my other conditions so I can still retire. I'm thinking of asking for temp retirement at fpeb to get surgery if I dont agree with IPEB could that work? Or would I have to be rated at 50% already?
 
What condition(s) were you found unfit for by the AF? You mentioned that you claimed 19 with the VA.
 
gsfowler said:
What condition(s) were you found unfit for by the AF? You mentioned that you claimed 19 with the VA.
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left wrist injury with failed reconstruction, my scalphoid/lunate ligament is beyond repair, had the soft tissue reconstruction to try to keep my scalphoid bone in place but that came apart so next is partial fusion. i found out about the failed surgery right after my RILO came back unfit and MEB started. hand doc said if i dont do anything i'll have very painful arthritis within 10 years. i also have carpal and cubital tunnel ( mild neuralgia ) in the same hand
 
Your rating will more than likely be derived from range of motion as listed in the VASRD, here is the criteria listed. The number on the left is major, right minor.

5214 Wrist, ankylosis of:
Unfavorable, in any degree of palmar flexion, or with
ulnar or radial deviation......................................................................... 50......... 40
Any other position, except favorable........................................................40......... 30
Favorable in 20º to 30º dorsiflexion.........................................................30......... 20

Note: Extremely unfavorable ankylosis will be rated as loss of use of hands under diagnostic code 5125.

5215 Wrist, limitation of motion of:
Dorsiflexion less than 15º.....................................................................10.......... 10
Palmar flexion limited in line with forearm..............................................10.......... 10
 
chaplaincharlie said:
#1 - 3 would probably result in a delay. #4 would not. It would be one of the rare surgeries that would probably increase your ratings. Normal surgery is done to restore movement, but a fusion would reduce movement. ROM therefore would probably decrease significantly.
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gsfowler said:
Your rating will more than likely be derived from range of motion as listed in the VASRD, here is the criteria listed. The number on the left is major, right minor.

5214 Wrist, ankylosis of:
Unfavorable, in any degree of palmar flexion, or with
ulnar or radial deviation......................................................................... 50......... 40
Any other position, except favorable........................................................40......... 30
Favorable in 20º to 30º dorsiflexion.........................................................30......... 20

Note: Extremely unfavorable ankylosis will be rated as loss of use of hands under diagnostic code 5125.

5215 Wrist, limitation of motion of:
Dorsiflexion less than 15º.....................................................................10.......... 10
Palmar flexion limited in line with forearm..............................................10.......... 10
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i hope i do get in the ankylosis system but right now i have a max of about 30' dorsal/palmer so unlikely. but as far as work goes it's damn near useless because of pain. I think i am going to go with getting it approved. lets say the VA decides i don't qualify for any ratings but its still unfit even though it says in my records i need the fusion ( its already been forwarded to the VA ). could i still disagree after i get IPEB results and fight to have the surgery to be rated more accurately? I feel like i'm in a unusual situation, no one disagree's i have a major injury but its also not like i broke all the bones in my wrist/hand. Is it worth waiting for IPEB and giving them the benefit of the doubt or do i get surgery ASAP and possibly be sitting here for months in recovery still not being able to do my job, fly to McClellan CA again for another C&P ( im in okinawa ) ect. its been a big internal battle for me to figure this out. who knows they might just tell me its not going to benefit the air force to give me surgery so it looks like i have to find that out first. I wish i could deal with the tail end of this at home with the rest of my family but we will see if they force my hand. going to talk to the hand doc in a couple hours gonna get some sleep thanks for the support guys i would have even more anxiety about this without you all.
 
Out of curiosity, do you think if you have the surgery, there may be the possibility of returning to duty?

This could be somthing that you could possibly pitch to the AF. It may be a bit too late since you have already completed C&P exams and your fate may have already been decided.

Does the Air Force have something similar to a WTU in which you can rehabilitate after surgery with the goal of return to duty?

I do not know the AF rules, but in the Army, they are not to keen on approving elective surgery while yu are undergoing a MEB.
 
Same here on surgery
gsfowler said:
Out of curiosity, do you think if you have the surgery, there may be the possibility of returning to duty?

This could be somthing that you could possibly pitch to the AF. It may be a bit too late since you have already completed C&P exams and your fate may have already been decided.

Does the Air Force have something similar to a WTU in which you can rehabilitate after surgery with the goal of return to duty?

I do not know the AF rules, but in the Army, they are not to keen on approving elective surgery while yu are undergoing a MEB.
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I don't want to return to duty its more about pain relief and getting rated properly I'm gonna find out today what my ROM will be after the surgery
 
Good news, kind of. talked to my hand doc, i'll probably have the same ROM i have now after the fusion so there is no rush since it wont affect my ratings, might even lower them with having less pain/more strength

also even though my EMG or whatever it is for cubital tunnel came back negative he still diagnosed me with non-nerve cubital tunnel or something i forgot what he called it. I'll have to make another claim for that at some point unless i do FPEB because the C&P doc just had that he could not find enough evidence of my RH cubital tunnel at this time.

My unfit condition rating is still up in the air but at least now i dont have to worry about the rating changing after i get the fusion.
 
Same ROM after a fusion is an interesting conclusion. Do you know more?
 
chaplaincharlie said:
Same ROM after a fusion is an interesting conclusion. Do you know more?
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he explained it today that he takes out the scalphoid bone and fuses 4 other bones together in my wrist/hand but not to my arm bones. he said someday i'll have to have those 4 bones fused to my arm and thats when i wont be able to move my wrist at all any direction
 
also ive already lost over half of my ROM in my wrist i dont have much right now but i should keep roughly what i have now. i'll find out somewhat soon i hope. leaning more towards waiting until im out for the surgery though.
 
Thanks for the explanation. Whatever you decide, I wish you the best.
 
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