Chronic Kidney Disease Rating

I

ike7cc

PEB Forum Regular Member
Registered Member
Greetings everyone. First, let me thank you all for the myriad of information that you have provided on this site. It has been invaluable to me as I have been going through my MEB. In order to better frame my case, I'm active duty Air Force with just under 8 years of service (8 years in November).

Here's a brief synopsis of my situation. Roughly 14 months ago I was diagnosed with Chronic Kidney Disease. My course of treatment for those 14 months has been an immunosuppressive (cyclophosphamide) and a corticosteroid (prednisone). I have been taking both of these daily and continue to do so. My IPEB came back with a recommendation of retire with a disability rating of 30%. I appealed to the FPEB to be retained, and they came back with the same retirement recommendation. My case is currently being appealed to SecAF, which I anticipate will take 3 or 4 more months.

I anticipate that I won't be retained, so my question has to do with my rating. I know that there are several conditions that 12+ months use of immunosuppressives and corticosteroids warrant a minimum rating of 60%. My initial rating did not include the long term use in any way, shape, or form simply because it's not explicitly spelled out in the rating tables. My question is if there is anyway to claim the long term use of immunosuppresives and corticosteroids if it is not explicitly tied to your condition in the ratings table?

Thank you for all the help.

Jake
 
What are the conditions that warrant a higher rating? The CFR appears to associated kidney disfunction ratings with BUN or creatine.
 
The initial rating stated that I didn't have any definite loss of kidney function and because of that couldn't be rated at a higher percentage. I've been diagnosed with membranous nephropathy, it has no cure, but can go into remission. However, there is also the chance that the treatment I am currently on won't be effective once I stop, and I will have to begin a new course of treatment with different medication. After receiving the 30% rating, I spoke with my nephrologist who said that while it may appear that my condition has improved/stabilized, all of that has occurred while I've been on medication (on meds since April '17). He compared me to someone with high blood pressure that has it under control due to medication. While I may appear normal, it's only because of the medication.

Additionally, my GFR has never been above 90. My understanding is that 90-120 is the normal range, but a lower number is acceptable if there are no other indicators of kidney problems, which I have.

My original question stems from ratings on other conditions, such as eczema:

"More than 40 percent of the entire body or more than 40 percent of exposed areas affected, or; constant or near-constant systemic therapy such as corticosteroids or other immunosuppressive drugs required during the past 12-month period"

The above condition receives a 60% rating. I understand that comparing a kidney condition with eczema is apples and oranges, but the fact that the rating says "or" rather than "and" when it comes to the constant or near constant use of the medication makes it appear that the rating is because of the treatment rather than the condition. There are other conditions, asthma being one of them, that have a similar rating with the use of the word "or." I'm taking both a corticosteroid and a immunosuppressive.

Am I out of luck because the ratings table does not specifically spell out my condition and the treatment?

Thanks for the help.
 
When the rating tables do not specifically spell out a condition it is ratable. Usually using a disease closely related by symptoms.
 
The link below is the DBQ for kidney disease. It does ask about chronic medications and additional diagnoses.
https://www.vba.va.gov/pubs/forms/VBA-21-0960J-1-ARE.pdf

I would review my answers and ensure I got everything correct on the form. Then I would get a copy of what the doc reported on the form.
 
This will help a lot when it comes time for my rating recon. Thanks for your insight!
 
You are welcome.

Best wishes for a great outcome.
Mike
 
ike7cc said:
Greetings everyone. First, let me thank you all for the myriad of information that you have provided on this site. It has been invaluable to me as I have been going through my MEB. In order to better frame my case, I'm active duty Air Force with just under 8 years of service (8 years in November).

Here's a brief synopsis of my situation. Roughly 14 months ago I was diagnosed with Chronic Kidney Disease. My course of treatment for those 14 months has been an immunosuppressive (cyclophosphamide) and a corticosteroid (prednisone). I have been taking both of these daily and continue to do so. My IPEB came back with a recommendation of retire with a disability rating of 30%. I appealed to the FPEB to be retained, and they came back with the same retirement recommendation. My case is currently being appealed to SecAF, which I anticipate will take 3 or 4 more months.

I anticipate that I won't be retained, so my question has to do with my rating. I know that there are several conditions that 12+ months use of immunosuppressives and corticosteroids warrant a minimum rating of 60%. My initial rating did not include the long term use in any way, shape, or form simply because it's not explicitly spelled out in the rating tables. My question is if there is anyway to claim the long term use of immunosuppresives and corticosteroids if it is not explicitly tied to your condition in the ratings table?

Thank you for all the help.

Jake
Click to expand...
Sorry to semi hijack your post but when did your MEB begin in relation to your diagnosis? I was recently diagnosed with Membranous Nephropathy in June and started the same treatment plan as you but I fear that a MEB is looming. I have almost 13 years in AD Air force.
 
No worries, I'm glad that I can help you out a bit.

I was diagnosed in April of 2017, and they tried to start my MEB a few months after. However, my condition wasn't stable at the time, so they recommended a return to duty and took a look at it 6 months later. That's when my MEB began. I received the results of my IFEB around the end of May/start of June 2018 (retirement w/30% disability). I contacted an attorney who recommended appealing to the formal board, which took a few weeks. They agreed with the decision of the IFEB, and now my case has been with SECAF on appeal since mid-June. My attorney said that the timeline for the case to be reviewed would be around 4-6 months.

Hope this info helps a bit. Feel free to shoot me any questions you have.
 
I just wanted to give a quick update on my situation. My appeal to the SAFPC was approved, and I was returned to duty, which is the good news. The bad news is that my ability to deploy still needs to be determined, and if I'm unable to obtain a flying waiver (13B is my primary AFSC) or my condition worsens then the RTD memo stated that a new MEB may be required.

Does anyone have any information on flying waivers and chronic kidney disease? I'm not even sure if that's what the waiver is needed for. I'm geographically separated from my nearest flight doc and haven't received much info since being RTD 2 weeks ago. Any input would be greatly appreciated.

Thanks
 
ike7cc said:
I just wanted to give a quick update on my situation. My appeal to the SAFPC was approved, and I was returned to duty, which is the good news. The bad news is that my ability to deploy still needs to be determined, and if I'm unable to obtain a flying waiver (13B is my primary AFSC) or my condition worsens then the RTD memo stated that a new MEB may be required.

Does anyone have any information on flying waivers and chronic kidney disease? I'm not even sure if that's what the waiver is needed for. I'm geographically separated from my nearest flight doc and haven't received much info since being RTD 2 weeks ago. Any input would be greatly appreciated.

Thanks
Click to expand...
Congrats on being RTD. Now get ready to fight the next MEB if you remain non-deployable. Get a hold of the MSD (medical standards directory). It’s the quick view of whether conditions meet the criteria for Retention/FC1/2/3/GBC standards etc. There a link somewhere on this forum with it.

Also the aeromedical waiver guide. Basically lists every condition that has been waived or that the AF has physio data on. If your condition is in there it’ll have the tolerances that led to an approved/denied waiver.

Send a DM if you have more questions.
 
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