Shell shocked...now what???

Habers

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Guys, I wish I even knew where to start...I don't even know or understand exactly where we are in the process or anything else. We really just want to make sure we do the right thing for ourselves and don't screw anything up. I don't think we have yet...but I'm sure you guys will tell us if we did.

Short background first. In August 2004, my husband was in an ATV accident on the job. He fractured his L2 vertebrae, several ribs, and the bone linking his shoulder and neck. He was life-flighted from the hospital here in town to William Beaumont in El Paso (army hospital). They put him in a turtle shell brace, monitored him for about six months and....that's it. No MEB or anything ever came out of it....

In March of 2008, enter ATV-on-the-job-accident number 2. (I should mention at this point in the story that no, he is no longer allowed to ride ATVs. :) ) In this one, he broke his left let. No biggie. Goes to hospital. They do surgery with like 18 or 19 screws/pins. However, the doctor is bad. My husband ends up with osteomyelitis from the surgery/injury. The doctor has multiple lawsuits against him. The local hospital had to file for bankruptcy due to the litigation against them. He is no longer practicing, of course. In May of the same year, after it's getting progressively worse, the bad doc is supposedly trying to make it better, but the physical therapists are petrified. In the middle of the night we drive to El Paso, per instructions, to go to William Beaumont again. He stays there for a week, before being life-flighted (AGAIN!!! LOL) to San Antonio, BAMC. Doc Hsu hooks him up with the HALO brace thing on his leg for about 5 months. He lives three of those months in San Antonio ON BAMC. He comes home that September or so. In November he gets the brace off. But guess what...no MEB. He is still having regular checkups with Doc Hsu.

What gets the MEB rolling is that he was on a profile for over a year. To give the doc here credit, he did wait as long as he possibly could until giving this to the MEB people.

He will hit 19 years this December, 20 next December and had wanted to stay in until he hits 20. Thankfully his job is a brain job, not a brawn job, so he can still be a resource to the USAF. His commander wants him, the squadron wants him....okay. So what do we do?

The paperwork came back and said 20% DOD and 30% VA. I don't even understand what that means. I am looking. I found this website. But good grief the amount of information is soooo overwhelming. LOL. But I'm trying.

So. To maximize income later, is it better to try and stay this extra year, or take a medical retirement? I think we are going to appeal the 20% DOD/30% VA thing...it sounds like something is missing but I'm not sure how all that works. I just can't see signing this paperwork and then him being retired before Christmas...it's just...wow. We have about 5-6 months salary saved, so would be okay...but it's still just like...wait a minute...I thought we'd be able to finish out the 20...

Okay. Any advice? I just don't know where to go from here. I KNOW we have to get all his med records together. I KNOW how to google and find stuff. But I'm also paranoid that the answers I think I've found are incorrect and are going to cost us dearly.

Thank you all tons. I can't imagine going thru this process without any help..

Melissa
 

firedawg225

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MEB is started after one year on profile OR in the AF when all other treatments have been exhausted. Also a MEB has to be started by a doctor but the command can ask for one. Anyone else want to chime in?

He won't get Medical retirement. He'll get severance. anything less then 30% DOD get severance. Base pay X 2 X years in is what you get. If he can stretch it for the year he could retire. OR maybe someone can answer this can he drop his retirement paperwork. you can normally drop it a year early. Wish you could have got here earlier. He should have fought along time ago for a fit finding. Since he's rated he's unfit.

hope this helps some!! If you have any other question asked. This is what we are all here for to help each other.
 

Habers

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Okay. Edit that to be 30% DOD and 20% VA. :) Although I still don't really have a handle on what it means. LOL

Thanks!
 

firedawg225

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I don't think thats right. Normally it's lower for DOD and higher for VA. The ratings are normally this

DOD - MEB condition only
VA - Everything else including MEB condition
 

anchorage70

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When he went to the board did his Commander state that he wanted to keep him and that he was capable of doing his job? That has a major impact on whether or not they find him fit or not. By far you want to hit 20 years and medical retirement but with a finding already in I am not sure what he can do other than appeal and hope it takes a long time.
 

Habers

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When the paperwork went down, the Commander did ask to keep him (and was quite adament about it!) and stated that he is capable of doing his job. From what I remember it was a great letter and we felt really confident about it. I can't believe we are sitting here with just a little over a year left to go and this is happening. If it would have happened 7 years ago or 3 years ago, I could have understood it. But to wait until the year before...literally 45 before he drops retirement paperwork...is just crazy to me (but that is my civilian brain talking) :)

Thanks everyone. I appreciate the info. It may not be what I want to hear, but at least it's *something*.
 

anchorage70

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When the paperwork went down, the Commander did ask to keep him (and was quite adament about it!) and stated that he is capable of doing his job. From what I remember it was a great letter and we felt really confident about it. I can't believe we are sitting here with just a little over a year left to go and this is happening. If it would have happened 7 years ago or 3 years ago, I could have understood it. But to wait until the year before...literally 45 before he drops retirement paperwork...is just crazy to me (but that is my civilian brain talking) :)

Thanks everyone. I appreciate the info. It may not be what I want to hear, but at least it's *something*.
It's a hard position to be in. I also had a MEB dropped due to 1 year undeployable but was lucky enough to be over 20 years at the time. Since his commander likes him so much he might want to sit down with him and the 1st Sgt and see if there is anything they can do.
 

Habers

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Thank you, Anchorage70. I will relay the message. The funny thing is, my husband's 1st Sgt was on med leave for the summer. Who do you think took her place while she was out? That's right - the commander requested my husband be the stand-in shirt. LOL. I will keep everyone updated and I will keep digging!
Melissa
 

firedawg225

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What does his profile limit? I read the beginning. What is his condition?

is it this? this is how they get the rating.


5000 Osteomyelitis, acute, subacute, or chronic:

Of the pelvis, vertebrae, or extending into major joints,
or with multiple localization or with long history of
intractability and debility, anemia, amyloid liver
changes, or other continuous constitutional symptoms.......................... 100
Frequent episodes, with constitutional symptoms.......................................... 60
With definite involucrum or sequestrum, with or without
discharging sinus............................................................................................. 30
With discharging sinus or other evidence of active infection
within the past 5 years..................................................................................... 20
Inactive, following repeated episodes, without evidence of
active infection in past 5 years....................................................................... 10

Note (1): A rating of 10 percent, as an exception to the amputation rule, is to be assigned in any case of active osteomyelitis where the amputation rating for the affected part is no percent. This 10 percent rating and the other partial ratings of 30 percent or less are to be combined with ratings for ankylosis, limited motion, nonunion or malunion, shortening, etc., subject, of course, to the amputation rule. The 60 percent rating, as it is based on constitutional symptoms, is not subject to the amputation rule. A rating for osteomyelitis will not be applied following cure by removal or radical resection of the affected bone.

Note (2): The 20 percent rating on the basis of activity within the past 5 years is not assignable following the initial infection of active osteomyelitis with no subsequent reactivation. The prerequisite for this historical rating is an established recurrent osteomyelitis. To qualify for the 10 percent rating, 2 or more episodes following the initial infection are required. This 20 percent rating or the 10 percent rating, when applicable, will be assigned once only to cover disability at all sites of previously active infection with a future ending date in the case of the 20 percent rating.

Is he world wide deployable? The deployment part is the deal breaker in the air force now. He's already got a rating so he can fight that. You'd have to ask Jason if the FPEB stuff or someone else good in that area. I'm not sure on that part. I could guess yes but he'd have to prove that he can do his job at home base and deployed. From what i've seen lately there more to kick people out then give Duty Limiting Conditions. If you fight get things ready for the FPEB. Do your homework, read the regs, think about getting a civilian lawyer over the assigned one (can be more prepared ahead of time) and so on.

you can also appeal twice if you don't get your answer. first is the FPEB then you can appeal to the SecAF. Good luck
 

Habers

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Thank you, Firedawg. I imagine I should clarify on the broken leg. It was broken in at least two places. There was a tibular plateau fracture/shatter and then I think a break lower in the leg, too. It's so hard to remember exactly, although I'm sure he does. As a result of the break AND the poor medical care received directly after, he walks with a limp. His knee is almost the size of a basketball. He cannot run. Walking long distances is extremely painful. He goes to PT and does what he can, but he is NEVER EVER going to run anywhere again. Even with the walking - he cannot do it fast - he doesn't have the range of motion, etc. I can't even tell you how many surgeries there were. There is so much scar tissue in the knee itself...ugh. You know those knee-high converse shoes - they look so dorky - but if you can imagine black ones laced from just below the middle of the shin all the way to the middle of the knee - his leg looked just like that when he got out of surgery. lol. He has come a long way. I don't know if maybe he talked to the specialist that he has been going to in San Antonio, might help. That might be an additional avenue.

I think at this point, I am probably going to turn this over to my husband. You guys have questions, and I don't have all the answers you need to inform us best. I did contact one of my lawyer friends on FB last night, but I want my husband to speak with someone who is much more informed about the rules/regs, and someone who, if needed, can go to the hearings with us.

Thank you!!
 

firedawg225

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The rating sounds low now that you mention that. Now the question is what did they write in his narsum? Narsum is the document the doctor writes on the meb condition. You should have a copy. If not I'd request a copy of your file the peblo has. Good luck
 

Habers

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Okay, I can't find anything that says Narsum exactly, so I am hoping that means narrative summary, or the remarks.."The SM's med condition, which is not likely to change over the next several years, prevents him from reasonably performing the duties of his office, grade, rank, or rating. Tibial Plateau Fracture and Osteomyelitis: SM had an ATV accident in March 2009 resulting in a left tibial fracture. He had an operative repair and developed subsequent osteomyelitis which required further surgery. He uses a can to support his gate, has chronic pain and has limited flexion and extension of the left leg. He is restricted from the timed run or walk, situps, or pushups and from lifting greater than 40 lbs or running 100 yards per the narrative. Lumbar Compression Fracture L2: This injury also occurred due to AVT {yes, that's how they spelled it - AVT} accident in March 2009. (This part is not true. This accident occurred in August 2004. I remember because I was five months pregnant and scared to death.) The SM continues to suffer back pain which limits his ability to perform his primary duties. This condition has not improved over time and he has used Percocet and Tramadol to control his pain. The commander states SM can perform supervisory duties in garrison, cannot deploy, but strong strongly favors retention. The IPEB finds the SM unfit and recommends PRDL with a disability rating of 30% IAW (don't know what that means yet) the VAS for Rating Disabilities guidelines. The conditions in Cat II do not appear to affect the SM's ability to perform his duties and are not unfitting for duty.

Okay. So for the left knee, they are eval'ing that at 10% it says "referred as tibial plateau fracture and osteomyelitis, left leg)(claimed as tibial plateau fracture left knee)" I don't understand that part. The knee is worth 10%. Which sounds really low since it was a limb salvage case in which hubby received TSGLI for. I know, I should have mentioned that earlier. Another side note, he can't feel anything that touches his leg. The nerves are completely gone. Then the osteomyelitis is rated at 0%, which I don't understand...that is permanent. I can provide documentation that the doc was dirty - the malpractice lawsuits, etc, if that matters, I think. The back is worth 20%, Upper Lib Benign Pigmented Nevus, 10%, Actinic Keratosis, 10%, Tinnitus,10%, and Essential Hypertension, 0%. Lastly is Esophageal Reflux which is a no. Lastly, "we are proposing that your total combined rating for unfitting and claimed service-connected disabilities is 50%"

It's dated the 16th of October. He received it Friday. How long does he have to appeal? I can look it up.

Opinions?
 

firedawg225

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Something doesn't sound right. What did they list in Section 4 of your NARSUM, (If it's the same as mine) Potential unfitting condition or HPI i think they call it. This section is what they use to rate the DOD section. Also if you look at the rating i posted earlier it's been within 5 years so 0% for the osteomyelitis doesn't look right. Looks like there are some errors in his file. Go talk to legal ASAP!!I'd fight looks like your missing information for a proper rating
 

firedawg225

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Oh BTW you have 10 days to sign your findings or request a review or take it to the FPEB (Formal PEB, court type case in front of 3 doctors)
 

mike762414

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Appeal, it sounds like they are purposely trying to low-ball your husbands conditions. Get attorney help, eith civilian who knows the MEB process, or the MEB counsel. I am guessing you are at Alamagordo? William Beaumont has attorneys solely dedicated to MEB patients. 915-742-2280/2131 for that office. They have been very helpful and proffesional in advocating for the patients.
 

Robert Albright

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Oh BTW you have 10 days to sign your findings or request a review or take it to the FPEB (Formal PEB, court type case in front of 3 doctors)
From my experience, its not three Doctors; I had a Colonel (he wore no medical insignia), a Lt. Col (administration specialist, and a civilian doctor (he was the medical expert for the board).

Also, in my case I was gathering more evidence, so my military attorney advocated taking the full 10 days to sign.
 

Habers

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Okay. So we will take the full nine or ten days. I don't want to cut it too close.

Category I - Unfitting conditions which are compensable and ratable:
1. S/P Compression Fracture of L2 of approximately 25-30% without paralysis, minimal thoracolumbar scoliosis secondary to back spasms, minimal narrowing of L1-L2 interspace without radiculopathy to lower extremeties and residual mild to moderate pain, stiffness, and back spasms of the thoracolumbar spine. Disability comp rating for that - 20%. VASRD code 5235.
2. Moderate tricompartmental osteoarthritis of the left knee, S/P comminuted (?) tibial plateau fracture and fracture fixation, diffuse cartilage irregularity with partial thickness cartilage loss of the femoral condyle, mild chondromalacia involving the medial patellar facet and tendinopathy of the distal patellar tendon and residual moderate pain, occasional swelling (LMAO @ occasional), and episodic effusion of the left knee Disability comp rating for that - 10%. VASRD codes 5003-5260.
3. S/P osteomyelitis and the rating for that is 0%. VASRD code is 5000.

And yes, we are at Alamogordo. :) We had a civilian PEBLO but she is gone and there is SRA here right now who has been doing this for about 5-6 months now. Poor guy, I don't think he has a clue, but in his defense, there is so much to learn, how could he have one? I will pass along the phone number at WB. After these 10 days, approximately how long until the FPEB? Just for a guess? How much notice do they give you? Do they just come in and say "Your FPEB is in two weeks?" or do they give you a little more time to prepare?
 

Kim76

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As far as a timeline for an AF FPEB, I requested a formal board on 1 Oct. I received notification on 19 Oct that my report date is 30 Oct. My PEBLO had stated that it would probably take four weeks before I would even find out my report date so my FPEB came a lot quicker than I expected. I would suggest contacting the Airman's Council - they have been a great help!
 

Kim76

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Sorry, I actually got the e-mail on 11 Oct not 19 Oct.
 
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