Psoriasis / Psoriatic Arthritis / Humira MEB; RAF Lakenheath

Bwit43

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Actually, I injured the same thumb 3-4 times over the last 6-7 years. This is capped off by a really bad walleyball instance this year where I went to spike the ball and a guy on the other side spiked my thumb with his hand at the same time. My thumb wasn’t even rated for psa, just constant pain from multiple injuries.

I would recommend making sure each joint that’s affected is documented specifically in your medical records. The more consistent and specific your actual medical notes are the better. I feel if I had a military rheum instead of UK, the notes would have been more detailed and would have resulted in multiple other joints getting rated. My British rheum is still awesome though.
 

Bwit43

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Had my Formal PEB this week and found out their recommendations yesterday.

They are keeping the same findings from the IPEB. So at this point, my best bet will be asking for the VA Reconsideration and hope they bump up the Humira use from 30%-60%. Figure at this point, there is not much more opportunity to drag out the process any more. There is a paragraph in AFI 36-3212 (5.16.4.3) for hardship exception to extend the retirement date. I figure I am going to draft up an MFR with some supporting docs to request this extension from AFPC. At this point, I don't expect it to actually get approved.

I'm thinking at this point, sometime in middle-late January or early Feb would have retirement orders and figure out my terminal/PTDY dates to see when I will be actually be out of the Air Force. Now, I'm just trying to find a definitive answer if I can remain overseas during my terminal leave or not.


Timeline.JPG
 

Mayhem2007

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I was put on Code 37 on Dec 15 2019. Im on continuous Weekly methotrexate for last 15 months and weekly Enbrel for 2 months at this point. I haven't even heard from a PEBLO yet...just saw that code 37 activated when checking IMR today. I'm curios on them notifying you of full MEB within 5 days. When did you get assigned a PEBLO? who sets up the VA MSC meeting? That seems so fast (1 day turn time).

thanks for your detailed posts!
 

Bwit43

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I was first put on the Code 37 and IRILO start 21MAY19 and notified of the full 15AUG19. I was actually in the IRILO process for a few months. If I remember right, I met with the PEBLO the same week as the notification to start filling out forms and required paperwork. The PEBLO setup the meeting with the VA MSC for the very next Monday.

From what I understand, you will be in the IRILO/Code 37 until the DAWG meets at your respective medical unit. Your PEBLO should give you a few handouts that will provide more information, but I think most of it is available online anyways.
 

19yrMEB

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Thank you for sharing the time line. I've been notified I'll be going through an MEB at 19 years in. Not gonna lie I'm a bit nervous and hoping I can drag it out to July 6 to hit my 20 year mark. I'm at RAF Mildenhall.
 

Bwit43

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Any updates on your case that you can share?
I requested an appeal of the FPEB to the SAFPC, but I don't see any changes coming from it. It was emphasized that I needed to submit new medical evidence to justify the appeal, which I submitted my most recent Rheum comments for justification. I requested the VA Reconsideration at the same time as the FPEB Appeal and will submit docs right after the SAFPC appeal, but I don't really see anything positive coming from it. Anything's worth a shot though.

At this point, I'm thinking I will be signing the disposition sometime early/mid January...then orders sometime at the end of January to mid-February (just a complete guess). Talk to MPF and seems I should be able to stay at RAF Lakenheath while on terminal leave, which will be my plan. My commander will authorize the 30 day PTDY and I am at 71 days of leave and trying not to spend any more.

I've requested the PEBLO ask about Paragraph 5.16.4.3 within AFI 36-3212 (Medical Eval AFI) which reads:

5.16.4.3. Hardship. AFPC/DPFD may approve limited extensions, normally not to exceed 30 calendar days, in cases where the service member is facing an unusual personal hardship over and above that encountered by other service members being retired or discharged for disability. The member may submit requests for extension via memorandum through the PEBLO.

I'm putting together an memorandum with a couple hardship extension justifications to see if I can get extended for a couple months.

Timeline.JPG
 

Bwit43

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Thank you for sharing the time line. I've been notified I'll be going through an MEB at 19 years in. Not gonna lie I'm a bit nervous and hoping I can drag it out to July 6 to hit my 20 year mark. I'm at RAF Mildenhall.
If you are just starting the IRILO process, I think you should easily make it to July 6th. I'd just make sure to take as much time as allowed with deadlines placed on you by medical/PEBLO. Unless something's changed, they still are sending people back to the states for the C&P exams. Hopefully the process goes smooth and beneficial for you, it has definitely been some of the most stressful times for myself this last ~9 months.
 

eerf123

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Bwit43,

What is the basis of your appeal to SAFPC? Are you still trying for an RTD?
 

Bwit43

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Just a quick status update....

I did appeal to add additional joints to my Psoriatic Arthritis as unfitting conditions and asking to get them re-evaluated as the VA said I did not have joint pain in several of my joints contrary to medical evidence supplied. I actually submitted my rebuttal letter to the AOC the week after Christmas and was sent up from his office to SAFPC the first full week of January. I received confirmation that SAFPC received my appeal on January 10, 2019.

Currently, I am waiting on their decision, but since it has been 14 days, I assume they are actually going to review it. I initially figured they would not even take a look at it. I'm still going to request a VA Reconsideration after to bump my Humira use up, but think I'll still have to pursue this avenue after I get out and hit my 12 months of constant use at the end of March 2020.
 

eerf123

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Thanks for the update. Do you know from a procedural standpoint what actually would happen if the SAFPC sided wth you on your appeal? Would the whole thing have to be kicked back to the MEB stage?
 

Bwit43

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Thanks for the update. Do you know from a procedural standpoint what actually would happen if the SAFPC sided wth you on your appeal? Would the whole thing have to be kicked back to the MEB stage?
I was told new C&P Exams could be ordered for the specific issues and provide correct ratings for the additional joints. I don't fully understand/know what exactly the process would be, but it sounds like they would re-rate the joints and provide any new findings to be added to the unfit findings. I believe whatever would come from it would be final and then I could do a VA Reconsideration either way. I don't think there would be any more FPEB's/MEB paperwork or other appeals.

Will see what happens though, I think they will keep the same findings as the PEB though.
 

Bwit43

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Well...it's been a long time coming...

I found out on 24 April 2020 that the SAPC denied my request for appeal. The justification is the appeal did not meet the criteria of new and compelling evidence that was not available to the FPEB. It is definitely not a surprising finding, but it at least extended my time significantly and will hopefully allow me to medically retire this summer and get my kids through a whole school year. For reference, the SAFPC signed the letter on 24 March 2020 and the PEBLO received an e-mail from them on 7 April 2020. With everything going on and turnover, I think I could have been notified a couple weeks earlier, but I'm more than ok with how things went down.

I did submit my VA Rating Reconsideration on 4 May 2020 through my representation at the Office of the Airman's Council. The legal council made the whole process super simple for me, I just had to supply some medical records, my statement and what part I disagreed with ratings wise. I think it is a straight forward win for me at this point, but will see what happens.

I am thinking sometime late this month I will get the reconsideration back and then waiting on retirement orders from there. I have 81 days of leave currently and have been told I would get 30 days PTDY (overseas) so hoping to start terminal relatively quickly.

Timeline.JPG
 

Bwit43

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The VARR approved my appeal and my Psoriasis w/Humira use was bumped from 30% to 60%, putting me at 60% DoD and 80% VA. So that's cool to get it resolved before separating. The VA approved it on the 13th/14th of May, and my attorney from the OAC emailed me on the 2nd that it was approved. Then my PEBLO reached out/searched through files and found the results and then I submitted my pre-separation docs.

Right now, I have a new Date of Separation of 30 September and awaiting Finance to provide me a terminal leave date. I've got 83+ days of leave and permissive so I think it will be starting pretty soon. I am expecting to be on terminal by the end of the month I think.

Timeline.JPG
 

Bwit43

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Thanks!!
I am planning on starting my terminal leave on 11 July and getting settled back in America. I also accepted a tentative offer working at a VA hospital and hoping to start work early August. It’s all coming together finally, but still super stressful moving to a brand new area and trying to find the right spot to live for the family.
 

Zeeky12

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Hey there fellow engineer!
I was just informed last week I am now going through this process, and it’s interesting to see how rapid Lakenheath is moving cases...do you have any specific advice for Lakenheath? From what I can tell I’m currently in IRILO and they are putting together the documents, and I have made contact with the PEBLO.
Thanks!
Z
 
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