Pulmonary Embolism requiring indefinite Anticoagulation

calaway0203

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Hello! I am an active duty army officer (36A, finance kfficer with over 11yrs of active service. I had an unprovoked pulmonary embolism in January 2020 and during my 6mo follow up appointment it was discovered that I have a genetic clotting disorder (Factor II, heterozygous). The hematologist recommended indefinite therapeutic anticoagulation, which I know is a disqualified for service under AR 40-501 Ch 3-25f. I now face a MEB and I have a few questions.

-I am assuming that most of the cases like mine result in the PEB recommendation for discharge. Is that a correct assumption? Has anyone had a waver approved for indefinite anticoagulation? Trying to gauge whether or not I should fight this.

-For disability, are most pulmonary embolism cases rated under the respiratory code 6817 for pulmonary vascular diseases? If so, have most folks been medically retired for this condition?

Thank you for the help and accepting me into the fold.
 
Hello! I am an active duty army officer (36A, finance kfficer with over 11yrs of active service. I had an unprovoked pulmonary embolism in January 2020 and during my 6mo follow up appointment it was discovered that I have a genetic clotting disorder (Factor II, heterozygous). The hematologist recommended indefinite therapeutic anticoagulation, which I know is a disqualified for service under AR 40-501 Ch 3-25f. I now face a MEB and I have a few questions.

-I am assuming that most of the cases like mine result in the PEB recommendation for discharge. Is that a correct assumption? Has anyone had a waver approved for indefinite anticoagulation? Trying to gauge whether or not I should fight this.

-For disability, are most pulmonary embolism cases rated under the respiratory code 6817 for pulmonary vascular diseases? If so, have most folks been medically retired for this condition?

Thank you for the help and accepting me into the fold.

Digging a bit deep, so may or may not be value added.

I underwent two consecutive MEBs, first I endured unprovoked DVT wil bilateral PEs. The doctor allowed me a trial period to come off of the blood thinners, this helped keep me active duty.

Second MEB due to other medical issues, though the DVT/PE was thrown back on the list. I now take Apixiban for life.

Medical retirement, as i recall they combined my sleep apnea and DVT/PE for a 60% combined rating. I wasn't expecting that, i anticipated separate ratings for each condition but was told because they were both applicable to the lungs it would be considering pyramidal to have individual ratings.
 
Digging a bit deep, so may or may not be value added.

I underwent two consecutive MEBs, first I endured unprovoked DVT wil bilateral PEs. The doctor allowed me a trial period to come off of the blood thinners, this helped keep me active duty.

Second MEB due to other medical issues, though the DVT/PE was thrown back on the list. I now take Apixiban for life.

Medical retirement, as i recall they combined my sleep apnea and DVT/PE for a 60% combined rating. I wasn't expecting that, i anticipated separate ratings for each condition but was told because they were both applicable to the lungs it would be considering pyramidal to have individual ratings.
I also take apixiban for life. 1st PEs I was given xeralto and it stopped working had PEs again 3 months later have been on apixiban/Eliquis since/ for life. Have you had an RFE appointment for rating yet. I was TDRL 60 to PDRL 60 for PEs /6817 then had RFE and VA is suggesting a reduction from 60- 30
 
I also take apixiban for life. 1st PEs I was given xeralto and it stopped working had PEs again 3 months later have been on apixiban/Eliquis since/ for life. Have you had an RFE appointment for rating yet. I was TDRL 60 to PDRL 60 for PEs /6817 then had RFE and VA is suggesting a reduction from 60- 30

I was medically retired in August, 100% VA/100% DoD PTRL. The DVT/PE rating stayed @ 60%, and still on Apixiban for life.
 
I was medically retired in August, 100% VA/100% DoD PTRL. The DVT/PE rating stayed @ 60%, and still on Apixiban for life.
@sinasasin, Were you active duty or reserve/guard? I'm a guard member that is currently DNIC/F currently on apixiban (recommended for life since it's my second episode and it was unprovoked; unlike my first one where an ankle injury was the suspected source of clots)
 
@sinasasin, Were you active duty or reserve/guard? I'm a guard member that is currently DNIC/F currently on apixiban (recommended for life since it's my second episode and it was unprovoked; unlike my first one where an ankle injury was the suspected source of clots)

I was AD.
 
Not to pry but did you make it to 20 yrs active duty and medically retired?
Thankfully yes, but it was more of a Lady Luck & God Willing sort of thing. The process timeframes are what saw me through, but you will find others who were not as fortunate.

My understanding is that medications like Apixiban/Riveroxiban are considered a bit safer these days. If i recall, when I was in the ICU the first time I was put on heprin, then my pulmonologist put me on riveroxiban. We switched later to Apixiban, which is what i still take today. Anyway, back then I was told that these medications were not compatible with service and that the medications carried a high risk because if i were injured they wouldn't have a means to get my blood to coagulate in an injury. Though I believe I've heard that Emergency personnel/ERs now have a means to coagulate blood if needed to stop bleeding...this might make these medications more compatible with service.

Separate and aside, is the cause of the DVT/PEs. Some folks have a blood disorder, whereas I do not but they are not sure why I had multiple "unprovoked" incidents. I know these things are all considered in depth during an MEB.
 
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