AD Dentist/Ankylosing Spondylitis

A

ArmyDDS

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I'm currently AD Army at Fort Hood, TX. I'm a dentist and in year 3 of serving back my 4 year HPSP scholarship. I become a commissioned officer in May of 2015 before I started dental school. While in my first year of school I started having major low back pain and was later diagnosed with Ankylosing Spondylitis in July of 2016. I included the diagnosis in my annual PHA's and the Army never said anything about it. Fast forward to 2020 when I started my AD service. I let my PCM know about my situation and they just prescribed me what I was taking the last 5 years (Dicofenac and Protonix). They tested me for HLAB-27 (I'm +) took x-rays in 2021 and an MRI in April of 2022 due to the fact I started having major back spasms. The MRI report confirmed what I have said to them for 2 years while on AD and I am now getting referred to Rheumatology for a consult based on the MRI report. I'm guessing they will diagnose me with Ankylosing Spondylitis (or non-rx axial spondyloarthritis) officially when I see Rhuematology. I can perform dentistry fine, I just can't do all the field work/wear gear without major complications/pain in my back. I'm in a dental field unit so that's how I've come to learn that.

My question is: does an official diagnosis of AnkSpon automatically start a MEB/PEB? and if so, do you think they could deem me fit for duty with a profile since I'm a dental provider as I can perform dentistry but need to be on a profile for back? Also how would it work if in my record I told them I have this condition in 2016 but they never officially diagnosed me until now? And I never had back spasms until AD which triggered the MRI to be ordered.

Thank you for your time.
 
ArmyDDS said:
I'm currently AD Army at Fort Hood, TX. I'm a dentist and in year 3 of serving back my 4 year HPSP scholarship. I become a commissioned officer in May of 2015 before I started dental school. While in my first year of school I started having major low back pain and was later diagnosed with Ankylosing Spondylitis in July of 2016. I included the diagnosis in my annual PHA's and the Army never said anything about it. Fast forward to 2020 when I started my AD service. I let my PCM know about my situation and they just prescribed me what I was taking the last 5 years (Dicofenac and Protonix). They tested me for HLAB-27 (I'm +) took x-rays in 2021 and an MRI in April of 2022 due to the fact I started having major back spasms. The MRI report confirmed what I have said to them for 2 years while on AD and I am now getting referred to Rheumatology for a consult based on the MRI report. I'm guessing they will diagnose me with Ankylosing Spondylitis (or non-rx axial spondyloarthritis) officially when I see Rhuematology. I can perform dentistry fine, I just can't do all the field work/wear gear without major complications/pain in my back. I'm in a dental field unit so that's how I've come to learn that.

My question is: does an official diagnosis of AnkSpon automatically start a MEB/PEB? and if so, do you think they could deem me fit for duty with a profile since I'm a dental provider as I can perform dentistry but need to be on a profile for back? Also how would it work if in my record I told them I have this condition in 2016 but they never officially diagnosed me until now? And I never had back spasms until AD which triggered the MRI to be ordered.

Thank you for your time.
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Chances are you will be found fit if you can preform dentistry and will get a permanent profile for no field work etc. Dentist, Medical Doctors, & Chaplains are in short supply so they typically don't kick out those professions if they can do their core duties even if that means no field work, PT, or deployments.
 
Provis said:
Chances are you will be found fit if you can preform dentistry and will get a permanent profile for no field work etc. Dentist, Medical Doctors, & Chaplains are in short supply so they typically don't kick out those professions if they can do their core duties even if that means no field work, PT, or deployments.
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Thank you for your reply. That's what I kind of figured but wasn't sure. Just wondering if diagnosis will trigger MEB or if they will just put me on permanent profile.
 
Provis said:
Chances are you will be found fit if you can preform dentistry and will get a permanent profile for no field work etc. Dentist, Medical Doctors, & Chaplains are in short supply so they typically don't kick out those professions if they can do their core duties even if that means no field work, PT, or deployments.
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Hey Provis, so I had my Rheumatology appointment today and doctor is thinking of going the Humira route based on active disease progression. Do you know if Humira is prescribed on AD that it will be covered by VA once I'm out? Not sure on status of IDES yet as I'll have to relay information from today's appointment to my PA once everything is finalized on Rheumatology side. Does Humira almost automatically make me unfit by the PEB as well then from your experience on here? Any information helps. Thank you!
 
ArmyDDS said:
Hey Provis, so I had my Rheumatology appointment today and doctor is thinking of going the Humira route based on active disease progression. Do you know if Humira is prescribed on AD that it will be covered by VA once I'm out? Not sure on status of IDES yet as I'll have to relay information from today's appointment to my PA once everything is finalized on Rheumatology side. Does Humira almost automatically make me unfit by the PEB as well then from your experience on here? Any information helps. Thank you!
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Does it make you unfit? It depends. You are a dentist - the Army will make many exceptions for you. I was a microbiologist, so I'm familiar with how the Army goes out of its way to retain physicians and dentists. Humira makes you non-deployable because the therapy requires refrigeration and a proper cold chain. Thus, you cannot reasonably deploy to austere environments. I started taking Humira for psoriasis because no other treatment was working. I couldn't deploy and as it stood microbiologists were already overstrengthed even though there was 90 of us. So, I was medboarded. I don't see that happening in your case just because the Army is hurting for dentists.

And yes, the VA covers it, but it depends on a lot of things. What your rating is with the VA...whether it is service-connected or not...your priority group. The VA covers it all for me, which I'm grateful cause it's expensive. Without it, my skin would be bleeding constantly from all the scratching.
 
Simple answer- under Section 3-30(g)(1) of AR 40-501, your AS would meet the definition of a disqualifying condition and will likely start the MEB/PEB process. While the Army needs dentists, you should expect to be processed through the PEB, and it will be unlikely that you will be retained due to the significant profile limitations that would go hand in hand with the diagnoses and the need for TNF Inhibitors like Humira or Remicade as opposed to simple NSAIDs and other lesser medications. Thus, you should prepare for this possibility and not downplay any symptomatology if you are processed through the IDES.
 
johnbgately said:
Simple answer- under Section 3-30(g)(1) of AR 40-501, your AS would meet the definition of a disqualifying condition and will likely start the MEB/PEB process. While the Army needs dentists, you should expect to be processed through the PEB, and it will be unlikely that you will be retained due to the significant profile limitations that would go hand in hand with the diagnoses and the need for TNF Inhibitors like Humira or Remicade as opposed to simple NSAIDs and other lesser medications. Thus, you should prepare for this possibility and not downplay any symptomatology if you are processed through the IDES.
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Roger, thanks for shooting it straight. I figured the IDES would be triggered eventually and I will be prepared for either fit/unfit decision. Just like @Oxalate was saying, all I’ve heard is that it will be tough to get an unfit decision from PEB as long as I can do dentistry. I just didn’t quite know if that still applied now that Humira is involved.
 
PCM said I still don’t meet criteria for a IDES referral even with diagnosis and Humira use.
 
Well looks like they finally referred me to IDES after talking to BD Surgeon and MEB office. Will keep everyone posted on journey going forward.
 
1 DEC- P3 Initiated, IDES Referral
5 DEC- IDES Accepted, MEB Initiated
6 DEC- PEBLO Breif
 
1 DEC- P3 Initiated, IDES Referral
5 DEC- IDES Accepted, MEB Initiated
6 DEC- PEBLO Breif
10 JAN- MSC/VA Claims
13 JAN- QTC Appointments scheduled
18 JAN- 1st QTC Appointment
26 JAN- Last QTC Appointment
 
1 DEC- P3 Initiated, IDES Referral
5 DEC- IDES Accepted, MEB Initiated
6 DEC- PEBLO Breif
10 JAN- MSC/VA Claims
13 JAN- QTC Appointments scheduled
18 JAN- 1st QTC Appointment
26 JAN- Last QTC Appointment
10 FEB- DBQs uploaded
15 FEB- NARSUM received and signed (4 conditions that do not meet standards/45 meet standards)
 
1 DEC- P3 Initiated, IDES Referral
5 DEC- IDES Accepted, MEB Initiated
6 DEC- PEBLO Breif
10 JAN- MSC/VA Claims
13 JAN- QTC Appointments scheduled
18 JAN- 1st QTC Appointment
26 JAN- Last QTC Appointment
10 FEB- DBQs uploaded
15 FEB- NARSUM received and signed (4 conditions that do not meet standards/45 meet standards)
8 MAR- Found UNFIT by PEB. VA assigned a rater.
 
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