Admin vs Medical

My husband joined the navy four years ago and has 11 months left on his five year contract. He was recently diagnosed with Crohn's Disease. He has a PEB scheduled for some time in September. He would like to make a career out of the Navy however we were told by the doctor that the board usually says no way.
He has also found out by the famous rumor mill (which may or may not be accurate) that most sailor's diagnosed with Crohn's are given an Administrative Separation rather than a Medical Discharge. I read the post here:
http://www.pebforum.com/physical-evaluation-board-system-overview/3024-lost-already.html
and I am afraid this is exactly what is going to happen to my husband. He will be found fit for duty but not world wide deployable. Is there anything we can do about this? What are our options if any?
Thanks
 
Click to expand...
There are different parts of the process you are asking about and you need to address each separately.

First, as far as the MEB/PEB, you can certainly look at others results with the same condition, but the fact of the matter is that it is your husbands specific facts they will look at. If he wants a fit finding, he needs to gather evidence that his condition does not significantly impact his duty performance.

The admin separation would come after a fit finding. So, if that happens, he may have to fight that out separately. However, it is my view that this whole process of admin separation after fit finding is illegal. I think it is smart to demand a PEB if being admin separated. This is not in the regulations, but I think it bolsters a later appeal (administrative or judicial law suit) and there is some interesting case law on this point (but probably too complicated to go into here).

I hope your husband has success with his case.
 
Thanks for your help. And thanks Jason for the Chapter 19 link, that answered a lot of questions. Ive spent the last two days trying to track down every bit of information I can about this whole royal mess and this site has been a HUGE help.
The problem is, he has Crohn's Disease. He wants to stay in the military and because his symptoms are very mild and the one flare he had resolved with no medical intervention he will probably be found "fit for duty" That being said because he might have a flare in the middle of the Pacific Ocean he will probably be determined unable to be deployed. He has asked around and the others who have crohn's have been given an Administrative Separation rather than a Medical. I did ask what someone is supposed to do now regarding the Administrative Separation due to medical reason on the Wounded Warrior Transition Brigade Webhall - Wounded Warrior Transition Brigade Webhall and am hoping for an answer.
We are hoping and praying that he can go back to active duty but are afraid if he pushes too hard to be declared fit and depoyable that they will find him fit and give him the administrative separation rather than finding him medically unfit.
 
Aphelps,
My case is currently at the PEB. Similiar to your husband I have GI isssues. The doctors have called my issue many different things but I think that we have finally settled on "Chronic Colitis". Unfortunatley somewhere in the process my issue was also refered to as chrons so they caveat the Chronic Colitis with "indicative of Crohn's disease or atypical Ulcerative colitis.

Despite the fact that my issue is limited to the tranverse colon, has not required surgery, is controlled by medicine, has been in complete remission for over 15 months now, has not caused me to miss a single day of work and that I have scored outstanding on the 4 PRTs since my diagnosis, that caveat has complicated things for me. Long and short, the flight physical guys would not consider a waiver until I went to a PEB hence why I am here today.

Now the good news: I personally know 2 helicopter pilots who have the same diagnosis as I who were still able to fly. I also know, through friends, of another 4 in the navy helo community of about 3500 people with similar diagnosis. (For perspective crohn's supposedly effects 6:100000 in the US)

Now the Bad news: All of the people I know with these GI issues were officers and all ended up with deployment restrictions. As Maparker has pointed out this is the potential show stopper/career ender. I can't find the instruction in the pile on my desk but the admin seperation decision rests at a different place for Officers and Enlisted.

The catalyst for this is the suitability screening which happens after the PEB finds fit. (within 15 days)

I have researched pretty extensively and think that in my case I can make a good argument that I am deployable however, a question like "Are there any chronic or recurrent medical conditions that might materially increase the probablity that the service member would not successfully complete an operational or overseas assignment?" on the suitabilty screening form opens up a lot of subjectivity.

Make no bones about it, right or wrong, there is definite risk in pushing for a fit determination with this condition. As someone who just went past 15 years I can empathise with your position. You and your husband need to carefull weigh the consequences of both courses of action before you decide upon a way forward. Regardless of you decision the people on this board will be able to assist you in making the best presentation of your case to adhieve the desired results.

V/R
OB
 
If anybody is or hears about anybody else being administratively separated for a medical condition that incurred or was aggravated while entitled to basic pay, let me know. I would like to take such cases direct to Dr. Casscells, Assitant Secretary of Defense for Health Affairds. He and I have had recent conversations about this problem and I would like to give him fresh, ongoing examples as they scrub through the issue.



Mike
 
3am epiphany?
I remembered reading something a few weeks ago before we sat down with the doctor for the official diagnosis. He thought he was fine because his flare went away with no medication, its the only flare hes ever had and it didn't cause too many issues. Then the doctor told us quite prettily that his career was as good as over.
I googled "can you enlist with crohn's) I found this:
http://www.army.mil/usapa/epubs/pdf/r40_501.pdf
Its army, is there a similar document for the navy? I was able to find the Manual of the Medical Department, however, I was unable to find detail about re-enlistment, just enlistment.
In the section listing the conditions which a soldier must be evaluated by the MEB. Page 22 of the document (33 of the PDF) says: "Possession of one or more of the conditions in this chapter does not mean automatic retirement or separation from the service." (and continues on)
Crohn's Disease is listed on the following page: "Crohn's Disease/Ileitis, regional, except when responding well to treatment."
If the regulation is the same for the Navy, how do we find out what the official definition of "responding well to treatment is" and how do we find out what information and records the MEB needs to come to a determination regarding my what husband's level of control is? Would the doctor who diagnosed us know? We don't want to spend the next year (thats how long the doctor said he had on limited duty before he had to go through the process) working towards a goal and find out we were given the wrong information. I believe that my husbands crohn's is well controlled, my mother has the disease and hers is not at all well controlled the difference is quite marked. In addition, if we know before he goes through the MEB what the official definition of well controlled is, if his next year proves to be difficult medically for him and he has more flares of crohn's then at least we know he was treated fairly rather than arbitrarily given the boot.
Also, are we "permitted" to request/insist on further testing in order to assist the MEB with coming to the correct conclusion regarding my husband's control of the disease and how mild/sever his case is? For example, one of the common tests to diagnose Crohn's disease is an upper GI, he never received it. Crohn's can be diagnosed without an upper GI, however you cannot determine how far the crohn's extends in the GI tract without it.
We are not familiar enough with the process yet to know if he has the ability to go before the MEB and ask them what the definition of well controlled is and whether or not they found him to meet this definition.
Thanks again for your help. Its going to be a long year, we are hoping something is done about the issue of Administratively Separating someone who has been deemed fit but not deployable due to medical reasons however we are painfully aware of how long this usually takes. [FONT=&quot] [/FONT]
 
Aphelps

Rules for enlistment and retention are differenet hence the need for MEB/PEB. The MANMED you reference is the correct one. Chapter 15 and 18 are both pertinent. Para 15-6 deals with people already on active duty.

http://navymedicine.med.navy.mil/Files/Media/mmd/MMDChapter15.pdf

On a seperate note I am curious as to how your husband received this diagnosis without a colonsocopy. There are several different diseases of the GI tract with similar presentations. (colitis, Ulcerative colitis, IBS, etc..) Blood tests and Biopsies are generally inconclusive, CT scans can show inflamation, fistulas, wall thickening etc.. but are also not always conclusive, making visual inspection the most reliable. The fact that you husband did not require any medication is also unsusual for crohn's. I will assume you are seeing a GI and not a General surgeon. If not have your husband ask for a referal to the appropriate specialist.
 
My husband did receive a colonoscopy however he did not receive an upper GI which is used to diagnose and determine how far up the GI tract the disease spreads. His blood work was in fact normal.
My mother has Crohn's and while she also uses no medication she had a RAST test 25 years ago to find out what foods she is allergic too. It literally saved her life. She was 5'6 and weighed 79lbs. Because she religiously avoids the foods she is allergic to her Crohn’s doesn't flare very often. However, her level of "control" isn't anywhere near my husbands. My husband's Chron's has only affected his life once, for a period of three weeks, and the flare went away without medication. He lost 8lbs in 3 weeks mostly due to fear of eating because he was afraid of the inevitable results. We have NO idea what caused his flare, and when I suggested the RAST test to the doctor he laughed out right, saying there was no coloration between Crohn’s and allergies. I do find it funny that no one knows what causes Crohn’s to flare in every patient and it’s different in every patient, but it can’t possibly be allergies. Even though my mother is living proof (literally) that allergies can flare Crohn’s. My husband is going to be speaking with his doctor today (who is a GI, and apparently the only CI the navy has here) Hopefully he will be willing to help us out with additional testing if necessary. We are also hoping that he will write the order for a RAST test and let us go to a private lab where we can pay for it ourselves, since he doesn't believe in it.

Also, an additional question. If he is actually determined fit and able to return to active duty, can he then, because of the Crohn's be unable to re-enlist? Or if his re-enlistment comes up while he is in the middle of the PEB (which it probably will) Will/can the navy just choose not to let him re-enlist? How does this work if he is in the middle of a PEB when his contract is up? His contract up May 31st 2009 and the doctor said he had 12 months (two six month limited duty assignments) which will be up on May 27th 2009.

I have looked at the MMD. And I may just be missing it but I don't see anything like the list army has regarding re-enlistment, just initial enlistment. Does that mean if you have Crohn's you cannot re-enlist even if it is well controlled?
 
Aphelps,

If found fit, he will be able to re-enlist. The problem, as discussed earlier, is the potential for administrative separation.

Chapter 15 of the Navy Manual of the Medical Department covers enlistment or commissioning standards only. The standards for disqualification for retention and referral to the MEB are contained in Enclosure 8 of SECNAVINST 1850.4E .

I wish your husband the best in his MEB/PEB process.
 
You must log in or register to reply here.
Top