In 2009 I was in a motor vehicle accident while on military duty and hurt my back, neck and shoulders in which I have an LOD for. About three months later while running I noticed my right hip started hurting. It mostly would hurt after I ran and the pain would last for a day or two. I began treatment after about a month when it didn't subside on its own. I went to my chiropractor and to my primary care doctor at San Diego VA medical center treatment. My doctor there ordered x-rays and medication.
I would run two to three times weekly in order to maintain fitness for the military. Over a significant amount of time the pain began to worsen while running. In December 2012 I was on Unit Training Assembly (UTA) status, while taking the Physical Fitness test (required by the Air Force) my hip had excruciating pain during the running portion. Afterwards, I reported my hip pain to Mr. Hecke who was the base test proctor. The next day I returned to work at my Air Reserve Technician job at March ARB and reported the injury to both my civilian supervisor and the military medical squadron with a "one hour mishap" report. This is when the Line of Duty (LOD) was initiated.
While waiting for the LOD to be approved, in January 2013 I began treatment at Loma Linda VAMC; at first with my primary doctor then consequently with the orthopedic doctor and was placed on a 'no running' profile. I had been given prescription after prescriptions for pain and inflammation. I was also given a steroid injection directly in my hip joint under x-ray with little to no relief of pain.
In July 2013 while on Annual Tour status at March ARB, my hip became re-aggravated while doing mandatory physical training at the gym while riding the stationary bike due to my ‘no running’ instructions from the doctor. I reported the injury to the Senior Master Sergeant and sought medical treatment immediately afterwards and filed another military required "one hour mishap" report with the medical squadron on March ARB.
In September 2013, the LOD was pre-approved and I began receiving medical treatment through the direction of the military. The LOD Manager at March ARB sent me to San Diego Navy Hospital for evaluation. After a few thorough medical examinations, the Navy doctor recommended that I have surgery for Femoral Acetabulum Impingement (FAI).
November 27, 2013 surgery was completed at San Diego Naval Hospital. By this time, I had already been told by my military commander (LtCol Horine) that because I reported the injury twice during Unit funded events, i.e. UTA and then again on Annual Tour, that my military unit had no funding to put me on Military Medical Orders. I was also instructed to apply for military Incapacitation pay, funding from a different military source. In order to complete the application for Incap pay, I needed an employer verification letter from my civilian employer, who also happens to be my military employer. Like I mentioned earlier, the letter was finally signed on 14 Feb 2014. As of August 2015, I have an settled EEO complaint filed that addressed that issue.
On 19 March 2014 I was notified that the LOD was not approved and the judgment was not clear, however, it said "existing prior to service (EPTS)." Please see attachment. I have always maintained that this injury was caused from extensive running which is required by the military in order to pass the annual PT test. My Navy surgeon even commented to me during one of my visits that he has seen this type of injury especially in female Marines who also do an extensive amount of running. I'm in the process of trying to get a letter from him linking the military requirement to my hip injury.
Furthermore, since this is a military injury, I am not eligible for workers comp and as a federal employee I do not have any short term disability benefits nor am I eligible for State disability. I was not paid for the period 23 October 2013 until I was able to return to work on 11 Feb 2014.
The LOD was approved by all personnel on March ARB but once it got to Air Force Reserve Command it was denied for EPTS with little to no explanation. It was suggested to me during a phone conversation with my commander (at the time) that it was denied due to fiscal budget constraints and not medical evidence.
More recently, my medical records were forwarded to the MEB to be evaluated for a medical retirement. I was informed on 26 February 2016 that because I was able to pass 3 PT tests that that LOD no longer qualifies me for the MEB process and that my case has to return to local base for a possible Fit for Duty evaluation and possible be separated from service without any compensation. I have 17 good years of Reserve service to include 3 years of active duty during Desert Storm and feel that the service is just trying to skirt any responsibility and I'd lose out on those 17 years.
I am in the process of seeing what my options are at this point. My congressman has been informed of this process along the way and has done little to help me. Please assist and put this out to the media. There is no reason the military shouldn't take care of its people. It's a shame and I'm hurt and embarrassed to admit that I was a proud member for such a large portion of my adult life.
Thank you,
Mary
First gut feeling, is APPEAL the LOD finding of EPTS immediately, and when you do, be sure to include clearly as possible the nexus between your military service and the injury.
Something key to this, even if an injury or medical condition existed prior to the service, if it was aggravated above and beyond normal wear and tear due to the service, is IS in the Line of Duty according to the standards of the regulations.
If someone hinted at the denial being for fiscal reasons, I wouldn't put too much stock in it, even if it were true no one would put that down on paper, better to stick with the medical evidence and connection to the service during your appeal.
Once the LOD is settled in your favor, don't be shy about hammering them for the INCAP pay that was wrongfully denied, but you must get the LOD worked out beforehand. I spent over a year fighting through bureaucracy and blatant ignoring of the regulations by the unit, State and NGB, but eventually was successful. So when you get to that point, if you run into issues, I will be glad to help.
As for them bumping you from the MEB process, I would work hard to get the LOD back on track ASAP, then IF you are still unable to continue your service (either due to your medical condition OR they just want to give you the bums rush) do what you have to to get back into the MEB process, whether that means letters from your Doctors or dropping out of runs and going on profile again due to the hip is your call.
Keep this last thing in mind. IF you are bumped from the reserves with 18 odd years of service you most likely will get nothing from the military and the only benefits you'll most likely get is those from the VA for disability and service connected treatment. Being a full time tech might change this.
IF you are put through the MEB to completion, as a Reservist, if you are finally rated by the military at 20% or lower, you will be given a one time severance check based on your points divided by 360 to indicate years of service, and no other military benefits or connection after that.
IF your are put through the MEB to completion, as a Reservist, if you are finally rated by the military at 30% or higher, you will be Medically Retired, which if warranted is the best option. You should warrant a meager military retirement check each month for life based on your years of service, again off the points equation, but more importantly you will be afforded Tricare medical insurance (Prime or Standard, your option), base privileges, etc... just as if you were an Active Duty Retiree. That's a big plus since medical insurance, especially if you employment is limited due to the injuries is a key part of your finances.
IF you are allowed to continue on and retire as a normal Reservist, you are NOT eligible for Tricare (other than Tricare Retired Reserve which is WORTHLESS) until you're 60, at which time you START to qualify for the regular Tricare Retiree plans. For the most part, retiring as a Reservist, the military doesn't even recognize you again until you're 60, I don't even think you get base privileges until then.
Things to keep in mind, hope this helps...