Background:
Entered the AF in 2003, so Ive been in just over 14 years (all active duty). I have a wife and 2 kids (17 and 13y/o) In 2010 (age 28) I decided to retrain into a more physical demanding career-field. Physically speaking, I was very healthy prior to entering retraining. I have (or had until recently) a current class III flight physical on flight status. The end of my current enlistment is June of 2019. My current plan is to separate from AD in 2019 and switch to the Guard to finish out my career while I go back to school.
Situation:
I Injured my cervical spine during my initial Airborne training (2011), a couple hard openings and hard landings (yada, yada, yada...Airborne, Huah!) Although I didnt know it at the time, I herniated C4-C7. About 6 months after the initial incident, I started having radiculopathy (pain/pins/needles/weakness) down my left arm after starting a heavy back squat program. This was confirmed by MRI and EMG. The radiculopathy subsided about 6months after it started and hasn't been back since then. Fast forward to 2 months ago (Dec '17), We were moving offices at my squadron and by the end of the day I could not lift my right arm above shoulder level. Another MRI was done but there was never an EMG ordered and I was referred to an Ortho surgeon for a consultation (he wanted to fuse C4-7). Actually in both cases I was referred to a surgeon and in both cases I refused surgery. This go around the radiculopathy subsided in about a month. It was never recorded by an EMG but is in both my flight doc and the surgeons notes. Initially, I had a waiver for the disc herniations so I can still be on flight status but with this recent "episode" MEB is within question. My flight doc said I have a couple options: Do nothing, go through MEB and get discharged or possibly retired?? Or get the surgery and (try to) get back on status or possibly go through the MEB anyway (depending on the outcome of the surgery). He says he will support any decision I make.
Note: Every year after 2011 my neck and back have been progressively getting worse in terms of pain, stiffness/ROM but with no radiculopathy, other than the two times. I've just been dealing with it so i can keep doing my job without fear of being DNIF. This last bout of weakness has made me reevaluate my life choices and I'm not sure what path to take. As much as I love my job, I'm not sure my spine can take jumping, flying, heavy rucks, full kit, helmet with NVGs/counter weight, etc...
MRI findings from Nov 2017
C4/5 and C5/6- annular tears, disc osteophyte complex narrowing right foramen that may affect exiting right C5/6 nerve roots, respectively
C6/7- disc bulge, osteophyte complex w/o convincing MRI evidence of nerve root impingement
Impression- Straightened cervical lordosis, Multilevel DDD with associated neural foraminal stenoses and herniations
T1/2 and T4/5- small disc protrusion w/o MRI evidence of proximal thoracic cord or nerve root impingement
T9/10- small bone spur (osteophyte)
T8 through T12- Mild ligamentum flavum hypertrophy (not sure what this is exactly but this was on the 2014 MRI not 2017)
Impression- Mild central canal stenosis at T9/10 related to a small anteriorly directed osteophyte arising from right facet joint
L4/5- mild disc bulge and bilat facet arthrosis, mild right neural foraminal narrowing
L5/S1- right paracentral / foraminal disc protrusion annular tear. Right neural foraen is mildly narrowed and may contact L5 nerve root
Impression- Right paracentral / foraminal disc protrusion w/ superimposed annular tear at L5/S1 contacts and mildly displaces the descending right S1 nerve root and mildly narrows the right neural foramen. Remaining DDD at L4/5, L5/S1
The Dilemma:
My biggest complaint is my neck. Limited ROM, constant 5/10 pain. I have days that are better/worse than the normal day to day. Secondary complaint is my Lumbar Spine. Slightly limited ROM, low daily pain but unsteady lifting heavy objects. Third complaint is my mid back between my shoulder blades (constant pain/dull ache). For my entire back, in all that is going on with it, if I'm being honest with myself, I'm not really able to do whats expected of me in my job ie. many of my primary duties. Neurological problems come and go as I stated above. Currently I am managing my body the way it is as long as I dont fly, jump, wear heavy kit/ruck/helmet so I'm not interested in doing surgery. Its not ideal but its manageable if i just do normal human things. As I said earlier, my long term plan was to switch to the Guard (traditional) to finish out my career and go back to school. Kind of best of both worlds, finish out my 20 and decrease the abuse on my body to 1 weekend a month.
This is what I'm being told:
Guard or Reserve duty will most likely be out of the question if I have the surgery or not (i assume it has something to do with the flight physical?) So, that leaves me with peruse an MEB and roll the dice on retirement vs seperation or have the surgery (not a fan) and assuming everything goes well, try to get back on flight status and finish out my 20. If it does not go well, face an MEB anyway. I was also told by my doc that he could write this up in a way to limit my duties and ride a desk to finish my 20. I'm skeptical because I know that its not that easy and its not really up to him. I'm either fit for duty or not. I dont think theres such a thing as "kind of fit, but not fully" type of thing.
Dilemma 1:
Pursue MEB or not. I dont want to have 14.5 (probably closer to 15 by the time this is all over with) years of active service go to waste and leave with nothing. However, I also dont want to stay active duty until 20 and leave more broken than I am or have multiple back surgeries. I want to preserve what I have left.
Dilemma 2:
Have the surgery and get out of active duty and try to go into the Guard anyway. Secondary problem to having the surgery is that I will need to have a multilevel fusion/replacement combo. I heard a rumor that people on flight status can not have multi-level replacements or fusions or combo of the two because it is not waiverable. If that is true, if I had the surgery and got MEB'd anyway and because my condition wouldn't be waiverable, would I be screwing myself because it would most likely increase my ROM and from what I have read so far disability percentage is pretty much based on ROM. So I'd most likely be faced with severance??
Outlying Questions:
If I go through the MEB process, does Radiculopathy have to be present at the time of examination to be awarded a percentage of disability or does just have to be in my records?
Does anyone know if Radiculopathy (in the form of pain) can travel to the mid back between the shoulder blades coming from the cervical spine? is that a real thing? I was told this on 2 separate occasions.
Can anyone confirm or deny that a class III flight physical with multilevel fusion or replacement or combo is non-waiverable? Can anyone point me in the right direction of any AFI that governes this?
Is the National Guard / Reserve a possibility with this surgery? without surgery?
Can someone please give me advice on how to pursue this problem? Any and all suggestions are welcome!
Thanks! and sorry for the long post....
Entered the AF in 2003, so Ive been in just over 14 years (all active duty). I have a wife and 2 kids (17 and 13y/o) In 2010 (age 28) I decided to retrain into a more physical demanding career-field. Physically speaking, I was very healthy prior to entering retraining. I have (or had until recently) a current class III flight physical on flight status. The end of my current enlistment is June of 2019. My current plan is to separate from AD in 2019 and switch to the Guard to finish out my career while I go back to school.
Situation:
I Injured my cervical spine during my initial Airborne training (2011), a couple hard openings and hard landings (yada, yada, yada...Airborne, Huah!) Although I didnt know it at the time, I herniated C4-C7. About 6 months after the initial incident, I started having radiculopathy (pain/pins/needles/weakness) down my left arm after starting a heavy back squat program. This was confirmed by MRI and EMG. The radiculopathy subsided about 6months after it started and hasn't been back since then. Fast forward to 2 months ago (Dec '17), We were moving offices at my squadron and by the end of the day I could not lift my right arm above shoulder level. Another MRI was done but there was never an EMG ordered and I was referred to an Ortho surgeon for a consultation (he wanted to fuse C4-7). Actually in both cases I was referred to a surgeon and in both cases I refused surgery. This go around the radiculopathy subsided in about a month. It was never recorded by an EMG but is in both my flight doc and the surgeons notes. Initially, I had a waiver for the disc herniations so I can still be on flight status but with this recent "episode" MEB is within question. My flight doc said I have a couple options: Do nothing, go through MEB and get discharged or possibly retired?? Or get the surgery and (try to) get back on status or possibly go through the MEB anyway (depending on the outcome of the surgery). He says he will support any decision I make.
Note: Every year after 2011 my neck and back have been progressively getting worse in terms of pain, stiffness/ROM but with no radiculopathy, other than the two times. I've just been dealing with it so i can keep doing my job without fear of being DNIF. This last bout of weakness has made me reevaluate my life choices and I'm not sure what path to take. As much as I love my job, I'm not sure my spine can take jumping, flying, heavy rucks, full kit, helmet with NVGs/counter weight, etc...
MRI findings from Nov 2017
C4/5 and C5/6- annular tears, disc osteophyte complex narrowing right foramen that may affect exiting right C5/6 nerve roots, respectively
C6/7- disc bulge, osteophyte complex w/o convincing MRI evidence of nerve root impingement
Impression- Straightened cervical lordosis, Multilevel DDD with associated neural foraminal stenoses and herniations
T1/2 and T4/5- small disc protrusion w/o MRI evidence of proximal thoracic cord or nerve root impingement
T9/10- small bone spur (osteophyte)
T8 through T12- Mild ligamentum flavum hypertrophy (not sure what this is exactly but this was on the 2014 MRI not 2017)
Impression- Mild central canal stenosis at T9/10 related to a small anteriorly directed osteophyte arising from right facet joint
L4/5- mild disc bulge and bilat facet arthrosis, mild right neural foraminal narrowing
L5/S1- right paracentral / foraminal disc protrusion annular tear. Right neural foraen is mildly narrowed and may contact L5 nerve root
Impression- Right paracentral / foraminal disc protrusion w/ superimposed annular tear at L5/S1 contacts and mildly displaces the descending right S1 nerve root and mildly narrows the right neural foramen. Remaining DDD at L4/5, L5/S1
The Dilemma:
My biggest complaint is my neck. Limited ROM, constant 5/10 pain. I have days that are better/worse than the normal day to day. Secondary complaint is my Lumbar Spine. Slightly limited ROM, low daily pain but unsteady lifting heavy objects. Third complaint is my mid back between my shoulder blades (constant pain/dull ache). For my entire back, in all that is going on with it, if I'm being honest with myself, I'm not really able to do whats expected of me in my job ie. many of my primary duties. Neurological problems come and go as I stated above. Currently I am managing my body the way it is as long as I dont fly, jump, wear heavy kit/ruck/helmet so I'm not interested in doing surgery. Its not ideal but its manageable if i just do normal human things. As I said earlier, my long term plan was to switch to the Guard (traditional) to finish out my career and go back to school. Kind of best of both worlds, finish out my 20 and decrease the abuse on my body to 1 weekend a month.
This is what I'm being told:
Guard or Reserve duty will most likely be out of the question if I have the surgery or not (i assume it has something to do with the flight physical?) So, that leaves me with peruse an MEB and roll the dice on retirement vs seperation or have the surgery (not a fan) and assuming everything goes well, try to get back on flight status and finish out my 20. If it does not go well, face an MEB anyway. I was also told by my doc that he could write this up in a way to limit my duties and ride a desk to finish my 20. I'm skeptical because I know that its not that easy and its not really up to him. I'm either fit for duty or not. I dont think theres such a thing as "kind of fit, but not fully" type of thing.
Dilemma 1:
Pursue MEB or not. I dont want to have 14.5 (probably closer to 15 by the time this is all over with) years of active service go to waste and leave with nothing. However, I also dont want to stay active duty until 20 and leave more broken than I am or have multiple back surgeries. I want to preserve what I have left.
Dilemma 2:
Have the surgery and get out of active duty and try to go into the Guard anyway. Secondary problem to having the surgery is that I will need to have a multilevel fusion/replacement combo. I heard a rumor that people on flight status can not have multi-level replacements or fusions or combo of the two because it is not waiverable. If that is true, if I had the surgery and got MEB'd anyway and because my condition wouldn't be waiverable, would I be screwing myself because it would most likely increase my ROM and from what I have read so far disability percentage is pretty much based on ROM. So I'd most likely be faced with severance??
Outlying Questions:
If I go through the MEB process, does Radiculopathy have to be present at the time of examination to be awarded a percentage of disability or does just have to be in my records?
Does anyone know if Radiculopathy (in the form of pain) can travel to the mid back between the shoulder blades coming from the cervical spine? is that a real thing? I was told this on 2 separate occasions.
Can anyone confirm or deny that a class III flight physical with multilevel fusion or replacement or combo is non-waiverable? Can anyone point me in the right direction of any AFI that governes this?
Is the National Guard / Reserve a possibility with this surgery? without surgery?
Can someone please give me advice on how to pursue this problem? Any and all suggestions are welcome!
Thanks! and sorry for the long post....