Type 1 Diabetes Deployment related?

ron.corleone

PEB Forum Regular Member
Hi long story shot, I am currently in the MEB process. Diagnosed with TYPE 1 diabetes that was brought out with my use of SEROQUEL that I was prescribed as part of my PTSD treatment which I am also being MEB'd for.

this article by a VA Dept head out for Washington State suggests a link to PTSD. and there has been numerous research on seroquel-diabetes connection.
Risk of Diabetes in U.S. Military Service Members in Relation to Combat Deployment and Mental Health

I am trying to figure out if my Diabetes would be considered Deployment related as it was in my opinion by the seroquel. MED Narsum Doc says its a stretch and knows nothing about any PTSD/Seroquel relation to Diabetes.

Im not sure if it would be worth fighting for to be Deployment connected or just letting letting things fall where they may. What are the benefits of it being deployment connected? my MEB is very complicated as it is I also have spinal conditions and has been in the process for over 120 days.

thx
 
Type 1 one is an autoimmune disease and autoimmune diseases are tied to anthrax innoculations.

Deployment related could be an issue if the condition began or was aggravated in a combat zone and you were medically separated vice retired. This would make you military severance pay not subject to offset by VA comp.

If medically retired, combat related status (to include an instrumentality of war) would make your disability retiremnt tax free and make you eligible for CRSC.

Mike
 
A more important question would seem to be : Was it present prior to deployment ie, was it a pre-existing condition... I have never heard of them saying this percentage is tax free and that percentage is taxable. Your PTSD diagnosis covers all that. I think your NARSOM Doc is right... It's a stretch and not necessary. I was on Seroquel and it was horrible for me so I'm trying other drugs now. Talk to your Ombudsman and ask your primary care Doc for a second opinion if your not satisfied. Go through the down loads here and on the net and get up to speed.... this is a long journey especially on PTSD. Just my thoughts check with other here too. Good Luck.
 
As an active duty member, it will be covered unless their is clear and unmistakable evidence the condition existed prior to service and there is clear and unmistakable evidence the condition, if it preexisted service, was not aggravated by service. If you have eight years of active duty, it would be compensated by DoD even if it preexisted service and was not aggravated by service.

So again, "deployment related" is not a DES term of significance that I know of but combat related and incurred/aggravated in a combat zone are important DES determinations as discussed in my previous post.

mike
 
I am going through the same issues. Right now I am in traditional status with the ANG. However back in Nov 2009 I did a 7 month tour to Al Udeid, Qatar. Came home with some weight loss, 6 months later went to the clinic on Jan 25 with an A1C of 18.3%. I am 39 years old.
Before deployment I normally weighed 210, January I weighed 150.
April 24 I filed for a rating with the VA, and I am still waiting for the rating to come in. I filed it with the help of AMVETS.
I am currently under going a MEB board with the Guard, told them in Feb of 2011, and still waiting to hear back from them.
Went to a retirement dinner for a fellow member, and ran into an old friend who was having blood clot issues, out of a crowd of 80 I spoke to two people that had the issue, and they believed it was from the Anthrax vaccination.
One of them told me to look up VERS and report it to them http://www.vhcinfo.org/. I did, and got a hold of a nurse from Lackland AFB, and she told me that she will look up my blood samples that I gave before and after going. I asked the guard in the beginning if they had the samples but they were clueless. She also asked for my medical records from the VA, so I mailed her them yesterday.
So the VA doesn’t communicate well with Guard, the guard does not communicate with the Active Duty, so in short I am finding my self having to put all the pieces together to solve the mystery of my Type 1 diabetes or to prove my case. From which no one in my family has the disease.
 
Hey all, I did training at Ft Mclellan Alabama. There was a PCB, Dioxin, and Nuke contamination issue that has come up for everyone that trained there. 4 months after I got out of service (31 yrs old, 13 yrs of service) I was diagnosed with type 1 diabetes. I never took seroquel though. I had been put on Selexa for PTSD. I dont know if any of this helps. I also was put on Gabapentin (Neurotin) and Celebrex for ortho injuries.
 
I posted to this thread yesterday, but for some reason its not there now. Any how I was diagnosed at the age of 39. I was deployed three times to the Middle East between the years of 2005 to 2010. I received more than one shot of the anthrax, and six months later I went to the clinic at the VA, and had a fasting blood sugar of 300, and A1C of 18.3 percent. I went on insulin that day. I filed a disability claim with the VA late April, still waiting for results. I ran into an old buddy who had blood clotting problems because of the anthrax shot and he told me to register the complaint with VERS a system to track anthrax vaccination. In short make sure you do the leg work, agencies do not talk to each other, Air National Guard, VA, and VERS.
 
"ANG_NV, post: 40701, member: 15287

I am going through the same issues. Right now I am in traditional status with the ANG. However back in Nov 2009 I did a 7 month tour to Al Udeid, Qatar. Came home with some weight loss, 6 months later went to the clinic on Jan 25 with an A1C of 18.3%. I am 39 years old.
Before deployment I normally weighed 210, January I weighed 150.
April 24 I filed for a rating with the VA, and I am still waiting for the rating to come in. I filed it with the help of AMVETS.
I am currently under going a MEB board with the Guard, told them in Feb of 2011, and still waiting to hear back from them.
Went to a retirement dinner for a fellow member, and ran into an old friend who was having blood clot issues, out of a crowd of 80 I spoke to two people that had the issue, and they believed it was from the Anthrax vaccination.
One of them told me to look up VERS and report it to them http://www.vhcinfo.org/. I did, and got a hold of a nurse from Lackland AFB, and she told me that she will look up my blood samples that I gave before and after going. I asked the guard in the beginning if they had the samples but they were clueless. She also asked for my medical records from the VA, so I mailed her them yesterday.
So the VA doesn’t communicate well with Guard, the guard does not communicate with the Active Duty, so in short I am finding my self having to put all the pieces together to solve the mystery of my Type 1 diabetes or to prove my case. From which no one in my family has the disease.

Update June 2013, VA rated me at 80%, 60% for diabetes, and other %20 is the diabetic peripheral neuropathy
 
"ANG_NV, post: 40701, member: 15287

I am going through the same issues. Right now I am in traditional status with the ANG. However back in Nov 2009 I did a 7 month tour to Al Udeid, Qatar. Came home with some weight loss, 6 months later went to the clinic on Jan 25 with an A1C of 18.3%. I am 39 years old.
Before deployment I normally weighed 210, January I weighed 150.
April 24 I filed for a rating with the VA, and I am still waiting for the rating to come in. I filed it with the help of AMVETS.
I am currently under going a MEB board with the Guard, told them in Feb of 2011, and still waiting to hear back from them.
Went to a retirement dinner for a fellow member, and ran into an old friend who was having blood clot issues, out of a crowd of 80 I spoke to two people that had the issue, and they believed it was from the Anthrax vaccination.
One of them told me to look up VERS and report it to them http://www.vhcinfo.org/. I did, and got a hold of a nurse from Lackland AFB, and she told me that she will look up my blood samples that I gave before and after going. I asked the guard in the beginning if they had the samples but they were clueless. She also asked for my medical records from the VA, so I mailed her them yesterday.
So the VA doesn’t communicate well with Guard, the guard does not communicate with the Active Duty, so in short I am finding my self having to put all the pieces together to solve the mystery of my Type 1 diabetes or to prove my case. From which no one in my family has the disease.


Update June 2013, VA rated me at 80%, 60% for diabetes, and other %20 is the diabetic peripheral neuropathy

Welcome to the PEB Forum! :)

Congratulations on receipt of your DoVA ratings!

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer."

Best Wishes!
 
My husband has 14+ years in the AF. Deployed to Iraq in 2005, returned in June of that year and was diagnosed with type 1 diabetes in December. He noticed that while in Iraq, he had the tell tale sign of diabetes--unquenchable thirst and weight loss (though not as drastic as some cases). He attributed this to the extreme heat and 20# weight loss that many service members experience while deployed.

He is a LADA diabetic, so initially, was controlled by oral meds alone. Found fit for duty that year. Then, when he went on insulin in 2009, he faced another FPEB, and was again found fit for duty.

But last year, his RILO came back with two "major changes": his transition to an insulin pump (which the AF is saying is irrefutable evidence that his health was declining, despite the fact that his medical record clearly says he is a good candidate for a pump because of his active lifestyle, no end-organ damage, well controlled patient, etc.) and the development of retinopathy--which he does not have. So he was kicked back into the system on false pretenses.

Long story short is after a long-hard battle, we lost our ultimate appeal to SAF/PC to remain on active duty. I believe this not to really be health related, but because he is in a highly deployable career field (Civil Engineering). However, the entire findings were based on an erroneous lab result (A1c score was completely inaccurate), so we were allowed the opportunity to write a reconsideration letter. I was feeling optimistic about our chances because virtually everything in their findings was inaccurate or misleading, but then last night I came across AFI 48-123 (Medical Examinations and Standards), dated 5 Nov 2013, that states that retention standards also require members to be fit for mobility status. Another AFI that governs this process (DoDI 1332.18--Separation or Retirement for Physical Disability) says that deployability can not be the only consideration for discharge, but this new AFI seems to contradict, and possibly override that. An interesting timing issue is that our second hearing was held just days after this new AFI went into effect--making me wonder if they waited intentionally so they could apply this new policy to his case.

Because he had Lt Col Keryl Green on his panel, he was hesitant to put forth any evidence that could make them point out that the military was a risk to his health, so he never mentioned the fact that he think he got diabetes during his deployment to Iraq. So that information never got figured into his rating. After fighting so hard to prove (and we truly believe his condition does not affect his ability to do anything work related, aside from the Assignment Limitation Code) that he is a fit and vital member of the AF, is it too late at this point to try to say we deserve a retirement instead of severance because he could have gotten it due to his service? The other issue is we don't know how to definitively prove it, we just know he showed the signs and symptoms after being there--though he did not have the anthrax shot. Would this be an issue for the BCMR or is there any legal recourse?
 
Whether the condition is related to deployment or not would not affect the rating. For a 40% rating, he needs to demonstrate he has to regulate both social and occupation activities due to diabetes. How far is he from 15 years? Can he apply for a TERA retirement?

Mike
 
Thank you for your quick response. His career field is critically manned so CE is not eligible for TERA as far as I know. He has 14 years, 2 months.
 
Yes, the most recent PEB found him unfit, based on his transition to an insulin pump (3 years ago, not recently), which they say is a clear sign his health was in decline, all evidence to the contrary. In fact, the findings from his first PEB even noted he would soon begin insulin pump therapy as a means to be better suited for military service, and he did crossover 2 months later (though he could go back to using multiple daily injections at any time). Plus, using a pump is simply a new way to get medication, akin to switching from oral to liquid prescription. Nothing has changed in his health since being found fit by the first PEB.

We think they just tried to find "something" to kick him back into the DES since there is now (since Nov 5, 2013) a new policy that requires every airman to be able able to serve in austere conditions for 179 days without healthcare (AFI 48-123 11.1)-- which basically means all type-1s are ineligible. My question is why even do a PEB if this is the case with this policy in place? Is that truly full and fair to even say you can try? What is the difference between "fitness for duty" and "retention standards?" And dodi 1332.28 mentions that the inability to serve in every conceivable contingency and every possible location cannot be the sole means for a determination of unfitness. Does a DoDi carry more weight than an AFI? I've read through so many it's hard to tell if policy even matters because these two completely contradict one another. This PEB has dragged on so long the new policy didn't even apply when we first started all this. Not to mention they talk out of both sides of their mouth all the time, to include in our findings: "even though his command says he would not likely have to deploy in the foreseeable future, the high demand in his career field would inevitably affect Major M at some point." So...even though he won't have to deploy anytime soon, he will have to deploy soon? Isn't that (prohibited) speculation, not to mention a contradiction? Really, what is the point of having people testify if they don't take their input into account?
 
DoD put out a DTM in 2007 modifying DoDI 1332.38 allowing the Services to use non deployability as the sole reason for unfitness.

Does he have the need to regulate recreational and occupation activities? If so, that would get him to a 40% rating and retirement.

I do agree he is getting screwed by this new policy which is probably being driven by a the reduction in force requirements.

Has he applied for Continuation on Active Duty (COAD)? COAD is the Army term but the policy allows those found unfit to continue on active duty despite being unfit.

Retention standards are used to screen who needs to undergo DES evaluation and are generic in nature. Fitness standards are based on individual factors such as specific duties, rank and other factors.

When is he due to separate?

Mike
 
He got a discharge in January but there were so many errors they had to allow a reconsideration. Given this new policy regarding deployment, though, it sounds like they'll probably just correct their errors and reissue a discharge.

I think coad might be equivalent to limited assignment status in the AF, but you have to have 15 years-20 years in to apply as far as I know. He's 10 months shy.

I have tried to make sense of when a sm with an alc can be sent back into the des and can't quite understand, other than if there is a major change in their health. They said in his Rilo he had an eye condition he does not have. His PCM said as much and they said "it doesn't matter, he's not world wide qualified so he needs to do a full fpeb." Sounds a little fishy to me...creating changes in health just to kick him back into the des?

He is too well controlled to be considered for 40% according to his endo, and he runs marathons so it's difficult to say he has restriction of activities. Yet the AF says he's an out-of-control patient and used that as the basis for their findings.
 
I think the change in policy is driven by the requirement to reduce the AF's overall end strength and that is why suddenly it matters. Certainly not fair to end ones career after two fit findings and no increase in severity. Have you sought support from your Congressman/Senators?

I know of a AF officer who retired around 2007 with 20 years as a Lt Col. He was diagnosed with DMI as a young 2nd Lt and was deemed unfit. His family was close to Senator Strom Thurman who pulled strings and got him back on active duty as a personnel officer.

Certainly Congress needs to know of this issue to prevent abuse during the drawdown.

Mike
 
I have suspected what you say about reducing total end-strength all along, but of course they can't say that in their findings so they have littered his write-up with a bunch of basic filler like "DM1 could cause complications," "his glucose is elevated" (ummm, the definition of diabetes...he's "well controlled" per doctor), "he is dependent on insulin." All true but a little misleading and also not a change since his last fit finding. Sigh.

We will write a Congressional just to see if anything positive comes of it, at the very least to help those down the road facing the same issue. Appreciate the input.

Do you happen to know if there have been any other changes to DoDi 1338.38 aside from the DTM from 2007? Want to make sure I'm working from the most up-to-date copy. Also, I am fixated on this "preponderance of evidence" issue--they make mention of all this filler stuff in their findings, and even wrote a few very erroneous statements (misquoted his lab results--to our detriment--saying his A1C was 8.4 instead of 6.4, to a diabetic, is like saying he weighs 250 vs 150) but virtually NONE of the support we had got any mention. I know it says quality not quantity, but having gone through this process not once, no twice, but three times, we have a lot of evidence in our favor. And even though he was found fit twice before, I believe at this PEB we had the most viable evidence--personal letters of support from the PACAF Surgeon General, two Brigadier Generals (+5x06, 5x05, several chiefs, etc) vouching for his exemplary performance and that his condition has never affected his ability to do his job, his endocrinologist saying his diabetes is well controlled (and they took that and turned it around, saying he is too poorly controlled to remain on AD, which is completely unsubstantiated). Even though his dr. note from before he transitioned to a pump says he is a good candidate because he's well controlled, has a good understanding of the condition and has no end-organ damage, and then they turned that around and painted a picture that he was in such ill health that he had to use a pump as a last-ditch effort to get his diabetes under control. I just don't know how people in good faith can write such unsubstantiated or misleading facts, given the leverage they have over an Airman's life. Ok, I'm whining now, but I'm sure many people on this PEB forum can empathize.

Very appreciative of your timely replies!
 
So it's been quite a while...so a little update for any other type-1s fighting the good fight.

So after our (I say "our" because I'm as much invested in this as my husband--but he's got other things to do, like look for a job) first discharge memorandum came back with a litany of notable errors, my husband's reconsideration request took another 6 months to respond to. So, in that timeframe, we wrote a very detailed Congressional Inquiry that pointed to the numerous errors/inconsistencies throughout our specific case (though I'm sure you all have similar issues with your own cases).

I think the only thing that the Congressional did was speed up the discharge, truthfully, because magically after the inquiry was in the que, our reconsideration came back within a few days.

The lowdown of the reconsideration was a bunch of b.s. akin to this: 3 pages of them applauding themselves for even permitting a reconsideration and attaching some AFI policy to prove how magnanimous they were for even allowing it. Then, they acknowledged their errors, but said they didn't use the information they wrote in their previous findings--those were only put in there for "illustrative purposes." Then, after saying they didn't use that information to render a decision, their new discharge has virtually nothing in common with their first discharge memorandum--mostly because we called them out for just about everything they wrote, so they couldn't very well repeat those mistakes again. And, like in our previous 3 sets of findings, they simply ignored anything in our favor (which is the majority of it). Ultimately, the reason my husband's diabetes is considered unfitting is because he poses too much of a risk to himself, or so they say--funny, he has had it for 10 years and nothing has changed...so why did that risk increase exponentially between January and July, the timeframe in which they drafted an entirely new discharge memo? Seems a little suspicious to us...

The response from the Congressional Inquiry was laughable. We had posed about 20 questions. They answered one: we implied that the MEB process is being used as a RIF tool--based on senior leaders telling us there was pressure on the PEB to lower the return to duty rate, and friends of ours with a variety of medical conditions who were also suddenly in similar situations as us. Of course, since it is not permissible to use the MEB in such a manner, the official response is that the MEB is completely unrelated to the Force-shaping process. So in order to prove to our Senator just how legit their response is, they said "we've been consistent in rendering decisions about type-1 diabetics. To prove this, every type-1 diabetic who met the board in fiscal years 2011, 2012 and 2013 were found unfit for duty." Hmmmm...then please explain to me where my husband fits in with that statistic, since he was found fit for duty in fiscal year 2011 when insulin-therapy began. Oh, and two of our friends who were returned to duty in 2012 upon initial diagnosis. Our Senator's (Patty Murray) assistant allowed us to rebut to their response due to this blatant lie. So the Legislative Liaison team responded and just repeated verbatim their initial response--but removed their incorrect statistic. They never responded to any of our other questions and simply said "we have closed this case, the only recourse is to apply to the AFBCMR." His 30 day out processing began and he is officially off active duty as of late January 2015, 13 days shy of 15 years.

He did apply to the VA to see if they would reconsider retiring him. While we didn't really think anything would come of it, what we were sort of hoping would happen is that the lengthy time frame in which they consider those cases would take him over the 15-year mark and allow him to apply for certain programs like LAS or TERA. We are completely firm in our belief that my husband's diabetes has no affect on his duties--to support this, he was just selected for promotion to Lieutenant Colonel (quite coincidentally, he was informed of his promotion on the same day he received his discharge orders). And if he had not been caught up in this MEB, would have gone to IDE and been one of a handful of Majors in CE to be considered for Command (typically, LtCol slots). We were not trying to seem inconsistent and try to take an entirely new path by saying that after he got discharged that he was falling apart so he could get retired. All he did was say while I contend that I am a fit and vital diabetic, here are a few things to consider about my day/diet. But don't take my word for it, take the AF's word for it--and he quoted all the things the previous Boards had written in previous findings about how bad diabetes is. But it was a lost cause, as the VA found that they couldn't retire him because he is clearly a well controlled diabetic who is fully capable of enduring physical strenuous activities. Hmmm...that's funny. That is the argument we've been making these past 21 months, and yet the AF translates his case as he is a poorly controlled patient who isn't capable of handling the strenuous military environment. Wow...same medical record and evidence before both panels, and this is how incongruous the decision-making is? Unfortunately, our response to the Legislative Liaison's lie sped up our VA processing--somehow, given the enormous backlog at the VA, our case was processed some 4 months quicker than everyone else--likely because we had a Congressional in the que and they had to act on it in some capacity. So rather than give a valid response, their action was a quicker discharge.

So, after leaving Hawaii and getting our case together, we just submitted our AFBCMR appeal, for whatever that is worth. Now the wait begins. However, after reading over so many sad stories on this forum, it's difficult to get our hopes up.
 
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So it's been quite a while...so a little update for any other type-1s fighting the good fight.

So after our (I say "our" because I'm as much invested in this as my husband--but he's got other things to do, like look for a job) first discharge memorandum came back with a litany of notable errors, my husband's reconsideration request took another 6 months to respond to. So, in that timeframe, we wrote a very detailed Congressional Inquiry that pointed to the numerous errors/inconsistencies throughout our specific case (though I'm sure you all have similar issues with your own cases).

I think the only thing that the Congressional did was speed up the discharge, truthfully, because magically after the inquiry was in the que, our reconsideration came back within a few days.

The lowdown of the reconsideration was a bunch of b.s. akin to this: 3 pages of them applauding themselves for even permitting a reconsideration and attaching some AFI policy to prove how magnanimous they were for even allowing it. Then, they acknowledged their errors, but said they didn't use the information they wrote in their previous findings--those were only put in there for "illustrative purposes." Then, after saying they didn't use that information to render a decision, their new discharge has virtually nothing in common with their first discharge memorandum--mostly because we called them out for just about everything they wrote, so they couldn't very well repeat those mistakes again. And, like in our previous 3 sets of findings, they simply ignored anything in our favor (which is the majority of it). Ultimately, the reason my husband's diabetes is considered unfitting is because he poses too much of a risk to himself, or so they say--funny, he has had it for 10 years and nothing has changed...so why did that risk increase exponentially between January and July, the timeframe in which they drafted an entirely new discharge memo? Seems a little suspicious to us...

The response from the Congressional Inquiry was laughable. We had posed about 20 questions. They answered one: we implied that the MEB process is being used as a RIF tool--based on senior leaders telling us there was pressure on the PEB to lower the return to duty rate, and friends of ours with a variety of medical conditions who were also suddenly in similar situations as us. Of course, since it is not permissible to use the MEB in such a manner, the official response is that the MEB is completely unrelated to the Force-shaping process. So in order to prove to our Senator just how legit their response is, they said "we've been consistent in rendering decisions about type-1 diabetics. To prove this, every type-1 diabetic who met the board in fiscal years 2011, 2012 and 2013 were found unfit for duty." Hmmmm...then please explain to me where my husband fits in with that statistic, since he was found fit for duty in fiscal year 2011 when insulin-therapy began. Oh, and two of our friends who were returned to duty in 2012 upon initial diagnosis. Our Senator's (Patty Murray) assistant allowed us to rebut to their response due to this blatant lie. So the Legislative Liaison team responded and just repeated verbatim their initial response--but removed their incorrect statistic. They never responded to any of our other questions and simply said "we have closed this case, the only recourse is to apply to the AFBCMR." His 30 day out processing began and he is officially off active duty as of late January 2015, 13 days shy of 15 years.

He did apply to the VA to see if they would reconsider retiring him. While we didn't really think anything would come of it, what we were sort of hoping would happen is that the lengthy time frame in which they consider those cases would take him over the 15-year mark and allow him to apply for certain programs like LAS or TERA. We are completely firm in our belief that my husband's diabetes has no affect on his duties--to support this, he was just selected for promotion to Lieutenant Colonel (quite coincidentally, he was informed of his promotion on the same day he received his discharge orders). And if he had not been caught up in this MEB, would have gone to IDE and been one of a handful of Majors in CE to be considered for Command (typically, LtCol slots). We were not trying to seem inconsistent and try to take an entirely new path by saying that after he got discharged that he was falling apart so he could get retired. All he did was say while I contend that I am a fit and vital diabetic, here are a few things to consider about my day/diet. But don't take my word for it, take the AF's word for it--and he quoted all the things the previous Boards had written in previous findings about how bad diabetes is. But it was a lost cause, as the VA found that they couldn't retire him because he is clearly a well controlled diabetic who is fully capable of enduring physical strenuous activities. Hmmm...that's funny. That is the argument we've been making these past 21 months, and yet the AF translates his case as he is a poorly controlled patient who isn't capable of handling the strenuous military environment. Wow...same medical record and evidence before both panels, and this is how incongruous the decision-making is? Unfortunately, our response to the Legislative Liaison's lie sped up our VA processing--somehow, given the enormous backlog at the VA, our case was processed some 4 months quicker than everyone else--likely because we had a Congressional in the que and they had to act on it in some capacity. So rather than give a valid response, their action was a quicker discharge.

So, after leaving Hawaii and getting our case together, we just submitted our AFBCMR appeal, for whatever that is worth. Now the wait begins. However, after reading over so many sad stories on this forum, it's difficult to get our hopes up.
What was the outcome of the AFBCMR? I was a medically discharged type 1 diabetic at 20% and am looking for evidence to prove I met the 40% rating for a medical retirement.
 
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