Unexpected MEB for RA; So confused, pleae help!!!

afwife816

Registered Member
#1
Some background on our situation: My husband is Active Duty Air Force with 9 yrs of spotless service in. Last October he began experiencing a new onset of back/hip/neck pain that he had never previously been seen for. He was referred off base to see a Rheumatologist and got MRI's done which revealed bulging discs and inflammation which his doc wrote up as being "inflammatory arthritis, likely Rheumatoid Arthritis". She told us that she could not yet determine if it was RA and prescribed him with Methotrexate and Prednisone.

His PCM informed him that he would likely be MEB'd at some point but that for the moment he could hold off on taking his meds because we were trying to have a baby (Methotrexate causes terrible birth defects) and that the MEB would take place after a couple months when we had enough time to see if his condition could be well controlled with meds. One month later we get a phone call saying the MEB process had been started even though they GAVE HIM PERMISSION to hold off on the meds, especially since we do not yet have a definitive diagnosis of RA!

Doesn't the AFI specify that a "definitive" diagnosis is needed to proceed with an MEB? He has not missed a single day of work due to his condition, and we have no documentation of him having been treated or even seen for this prior to last October. Needless to say he has started to take his meds and having a child is out of the question since our future is so uncertain. His CC has written a glowing narrative strongly supporting him being retained as an AD member but how much weight does that really carry? He has only even met his PCM twice so we have no idea what her narrative will say and feel so lost and confused about this entire situation. Does anyone have any experience writing a personal narrative? Can we submit character letters for this first stage of the process?

Sorry my post is so long but there's just so much! Any and all help would be greatly appreciated. This site has become an invaluable resource for us....
 

Jason Perry

Benevolent Leader
Site Founder
Staff Member
PEB Forum Veteran
Registered Member
#2
Welcome! I hope all works out well for your husband.

His PCM informed him that he would likely be MEB'd at some point but that for the moment he could hold off on taking his meds because we were trying to have a baby (Methotrexate causes terrible birth defects) and that the MEB would take place after a couple months when we had enough time to see if his condition could be well controlled with meds. One month later we get a phone call saying the MEB process had been started even though they GAVE HIM PERMISSION to hold off on the meds, especially since we do not yet have a definitive diagnosis of RA!
You might clarify with the PCM that he is not on methotrexate now (which may well have been the reason for the MEB starting. Maybe you can get the MEB put off.

Doesn't the AFI specify that a "definitive" diagnosis is needed to proceed with an MEB?
No...they can do it if his availability for world wide duty is questionable. Or if he is on profile (AF Form 469) for more than a year. Or if he has a 4T profile. It is very "squishy" when they can initiate MEB and there is a lot of discretion if they want to start one. Bottom line, though, they appear to have started it, so it may well be a moot point.

He has not missed a single day of work due to his condition, and we have no documentation of him having been treated or even seen for this prior to last October.
Well, this would seem to indicate fitness and a return to duty finding.

Needless to say he has started to take his meds and having a child is out of the question since our future is so uncertain.
Okay, well, this may change things, if he has started the methotrexate, that may be the reason they started the MEB.

His CC has written a glowing narrative strongly supporting him being retained as an AD member but how much weight does that really carry?
It carries a lot of weight, so long as the medical narrative or his actual limitations do not contradict it. It is not the only factor or the deciding factor, but it counts a lot.

He has only even met his PCM twice so we have no idea what her narrative will say and feel so lost and confused about this entire situation.
Though the waiting and unknown can be wrenching, you don't know what it will say, so it may be early to worry too much.

Does anyone have any experience writing a personal narrative? Can we submit character letters for this first stage of the process?
In my opinion, you only submit letters to make a point or to provide additional evidence/information that is not in the case file. So, you don't know what point you are trying to make. You can submit anything you like. However, without knowing what the MEB narrative says, it is hard to say what to put into a letter. I do not favor letters just for the sake of writing them. Anything submitted should be narrowly tailored to address specific issues. I can't tell you how many times I have seen cases where people just submit letters without a clear purpose in mind and end up writing something that hurts their case.

Sorry my post is so long but there's just so much! Any and all help would be greatly appreciated. This site has become an invaluable resource for us....
Glad to help. Like I said, I hope all goes well.
 

KiloBravoSierra

PEB Forum Regular Member
#3
Likely RA???????

Check his labs to see if they looked for Rheumatoid Factor. Something like 80% of people with RA are sero-positive for Rheumatoid Factor.

If he is a flyer, he has to be referred to Rheumatology at Wilford Hall according to the Wavier Guide.

Yes, RA is cause for referral in to the DES.
 

KiloBravoSierra

PEB Forum Regular Member
#4
I'd add that once he starts methotrexate, he has to be off the medication for 90 days for it to clear the body and reduce the risk of birth defects. Make sure to ask this question is this is still the case.

Also know that some studies show that some methotrexate is passed in semen during........... I think you know what I mean.

Also, plaqunil (sp?) should be prescribed along with methotrexate.

Makes sure he sees a rheumy for treatment. They are better versed on the disease and treatment.
 

afwife816

Registered Member
#5
You guys are fantastic, a truly supportive group of people, I thank each of you for taking the time to respond :)

We took the issue of him not being officially diagnosed up to the medical chief and his MEB has been suspended for the time being! He concluded that (obviously) the doc saying "likely RA" is not a definitive diagnosis. He did say that if my dh has to go on another profile for >90 days that the MEB would be restarted. One small victory down a long road I know, but its a start. I figure this may give him enough time to hopefully figure out a medication regime that works. His PCP has placed him on a profile just under that cutoff but we can't keep that gig up very long.

Hubs is not currently taking the methotrexate but he is on prednisone and celebrex, neither of which is helping at this point. I just wish I knew how good our odds were. Do many people actually get to return to duty if they have physical limitations, or does the board generally seek to eliminate these people? Does the VA evaluation and disability rating have any influence on the eventual outcome of the MEB process? His PEBLO says that it has no bearing on the process but how can that be true? Would the AF move to retain someone whom the VA has rated at say 50% disability? Also if he is seperated, given that RA is a progressive disease could he go back to the VA at some point in the future to be reevaluated as things get worse or is it a one time deal?

Thanks again for help everyone. This forum has been such a wealth of helpful information, unlike the AF!
 

dfinniss

PEB Forum Regular Member
#6
AFWIFE-sorry to hear about your husband and I too suffer from RA and sjogren's syndrome and understand the pain. I fought going onto methotrexate but nothing else helped me. Finally, after a year and a half I was put onto humira and came off only for a foot surgery that the IPEB process is denying even though it is medically necessary (jerks) but they just want to make us as miserable as they can I swear :mad:
He needs to get help from labs and the one that was very high for me was the anti-ccp test. It is the most sensitive one and my ANA was high too along with c-reactive protein. They wax and wane and when I was seen at Ft Sam Houston of course my labs were 'within normal limits' but still close to being over the top levels of high! Obviously I have inflammation going on....they just want to deny us our benefits.
He only needs 8 years to collect a pension if they rate him over 30% and if he is rated above 50% with the VA he will collect a concurrent check from both, provided he gets above the 30% mark from the USAF. It is tricky but that's how they roll. You can always send me a pm if you need help! It is quite frustrating, esp as a spouse. My husband is just watching me fall apart before his very eyes but the dmards do help slow the disease down whereas the celebrex won't do darn for him.
Take care and if they will only offer him a severance, APPEAL it! What can he lose? Nothing! He has a lot going on and needs to see the doc for every single ache and pain, seriously. If he can't go to work he needs to MISS work for pain. I go when I'm ill or sick and stopped going and get dr notes. I don't give a damn anymore. They treat me like a POS anyways and I'm getting kicked out, but there are days I can't drive my car or get out of bed. Plus, it involves my GI system but it doesn't meet the severity of the VA standards so I am not going to see any compensation from the USAF for it. Owell...we'll see. I'm still waiting for the IPEB results....
 

Big H

Registered Member
#7
I understand where you are coming from! I too have RA. Had it for about 1.5 years now. Metotrexate sucks! I think the side effects were worse than RA. I had a "flare" a couple months back when they were preparing my MEB file and attempting to stabalize my illness.

I was a very active person prior to RA. Kinda sucks not being able enjoy life when RA is bad. I have been taking anxiety meds for a few years and the doc up my dose and added additional meds to help the situation. This actually help a ton dealing with RA.

I also have had GI issues for years. I was told chrohns is iminent but every test under the sun says no. It is very tricky to catch it when its active. I have found motrin, steroids and any other anti inflamatory meds were killing my stomach. My last scope showed signs of deteriation in my stomach but was healing to to me cutting out motrin.

Where are you at in the process? I get my NARSUM this week. This s$it is driving me nuts! It takes forever to find out....

I just want to know if I need to find another job r not.
 

elsereno19

Registered Member
#8
Good Afternoon I have 18 years active Army and currently am stationed in Germany. For the past 4 years I have had Gastro issues that have been Documented. I was diagnosed with Ulcerative Chronic Proctitis, Gastritis, Chrohns Disease, and Encopresis not due to a substance or known physiological condition. Recently when I arrived to Germany and was sent to Gastro in Landstuhl I was told that it was doubtful I have Chrohn's Disease. I have a probable diagnosis from an off post Gastro doctor in the U.S. They performed an upper Endoscopy and Blood tests on me and used that to diagnose me. I am now being referred to the German economy to find out what's going on with my intestines. I feel like I have been getting the run around and no one is taking the time to really find out what is wrong with me. The Doctors in Landstuhl told me there is nothing they can do for me there. I saw my PCM and he said there could be 2 courses of action MEB or WTU. I have 18 years in so I do not want to MEB, I am actively working and doing my military job, but I find it real hard to take care of my medical at the same time. I have seen 5 different Gastro Doctors. I am still having the same symptoms as 4 years ago. I do not want to go to the WTU and get MEB there. I want to know what is really wrong with me before I retire and I feel an MEB would just pass the buck to the VA and that is scary. What are my options? I also have other medical conditions that would benefit from WTU but again I want to continue my service to fulfill what I set my mind to long ago 20 years... I have been deployed 3 times to Iraq 2003-04, 2005-06, 2008-09. I also have been diagnosed with Chronic PTSD, Chronic migraines with aura, GERD had surgery but now has returned, Hiatal Hernia, Degenerative Back Disc Disease with L4/L5 disc slipped, L5/S1 slipped disc infringe on nerve root, Obstructive Sleep Apnea, Gout Unspecified, Allergic Rhinitis, Essential primary hypertension, Chronic Frontal Sinusitis, Bunionectomy surgery, Radiculopathy lumbar region, Fecal smearing, Diarrhea Unspecified, Fecal Urgency, Abdominal distension, and Hallux Valgus. A whole lot of stuff. Has anyone had a positive experience in the WTU? My goal is to get fixed and taken care of medically and get back into the fight if I can. Currently I have no time to take care of "myself" medically because of my mission here. I want to put my medical aside and continue my mission but I feel as if I am neglecting a healthy future with my family when I retire. I want to be able to enjoy time with my kids and be able to play with them. Has anyone been in a similar situation to mine? Are there any other options? Thank you for all of your assistance in this matter.