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Seeking information #101581 12/13/05 08:13 PM
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nick10m Offline OP
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Hello, this is the fist post that I have made to this site, so forgive me for being long winded, however I have so many questions and cannot seem to find any answers. As of 18 Nov, I have 11 years of Active Duty service in the Army and I am a SFC currenlty assigned as a Healthcare Recruiter, which given my situation seems now somewhat ironic. A bit of background on my current situation, I started my career as a 14T Patriot Missile Systems, and did 2 tours at Ft. Bliss and 1 tour in Germany, then I came down on orders for recruiting in Chicago. Prior to receiving my orders and about 8 months after returning to Ft. Bliss from Germany I became ill, I was so exhausted and it didn't seem to matter how much I slept and I had a constant horrible ear and jaw ache that would not subside. Finally after about 3 months of agony my CSM, (I was BN OPS NCOIC) ordered me to sick call, and they diagnosed me with Mono and acute sinusitus. So I was placed on conv. leave for 3 weeks with a weekly follow up required. After the 3 weeks had passed I was still testing positive for mono and now was experiencing this bizarre joint pain and swelling in my hands, elbows, knees, wrists, neck and lower back. The put me on prednisone and another 2 weeks of convl. leave. I still didn't feel right when I went back to work, however I chalked it up to being lazy form having not been at work. After PCSing to Chicago, I was having joint issues again and after repeated visits to the Great Lakes Naval base was referred to a Rheumatologist, after about 2 years he finally diagnosed me with Psoriatic Arthritis, I think the pitting of all my nails, fingers and toes were the final pieace to the puzzle for him, as I had tested positive for the HLA B27, and negative for RA factor. So he treated me with prednisone and more prednisone and more and more. Then I PCS'd to Indianapolis, where I am currenlty stationed and I am enrolled in Prime Remote, so I see a civilian primary care and again a civilian Rheumatologist, who is excellent by the way. He changed my treatment to Enbrel and I had a great almost year, I began to have some minor flare ups over the summer, however nothing I couldn't handle. Then after attending the AMEDD (Army Medical Department) recruiting course in October I got a steph infection and I had to go on an antibotic and off the Enbrel, the infection was caused by a burst cyst (on my left groin) and I had to have it surgically removed, the surgeon prescribed no activity for 2 weeks, until he could remove the external stitches. However 4 days after the procedure my Battalion Commander decided that I needed to report back to work, as the surgeon who did the procedure was not an Army Dr. and didn't know what he was talking about, so back to work I went and ended up ripping the stitches apart and having to go back and having them removed a week early, and remaining on the antibotics for an additional 3 weeks to fight off the infection that came back as a result of the improper healing. So I am now in the middle of a severe flare up and cannot take my Enbrel again until after I have completed this last round of antibotic and I am supposed to be starting on Remicade at the end of December. I have loved the Army and being an NCO for many years, I have had a bright and excellent career, however I fear now that my medical condition is going to reuin that and I do not want to destroy my exemplary service by being seen as a sick call rider, or some one who is trying to evade work through medical excuses. I don't know what to do, or what not to do, however I know that I cannot continue to function with this kind of pain. Anyone who might be able to offer some guidance, I would be forever greatful. Sorry for the lenght and excessive spelling errors, and thank you for your time. confused

Re: Seeking information #101582 12/14/05 11:28 AM
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Welcome to the board! Lots of good info here on not only the disease, but on military and veteran aspects as well. I will get back in the near future to address your specific issues.

BTW, I too, was a duck hunter! I spent four years with the 1-62 ADA Bn (25th ID) working with Vulcans and Stingers. The good old days!

Re: Seeking information #101583 12/14/05 06:48 PM
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Nick10m,

Your biggest issue is making sure you get a retirement out of your service. Being at the 11 year point puts a lot at risk with many years to go. Having spondylitis and being
on TNFs will make getting to 20 years very problematic, but not impossible. But if 20 years is not in the cards, get a retirement out of the deal. One thing you got going for you is your current job and location is probably drawing less attention to your condition than being in a deployable unit. If you make it to fifteen years before a MEB/PEB, your chances of being allowed to stay until 20 on the Continuation on Active Duty (COAD) program go up dramatically. There is another Army SFC on this board who was COAD who may chime in with more details on the program. He recently retired so he may be out fishing!

One of the things going for you is that you have psoriatic arthritis. DoD/VA has confused the hell out of ratings for AS resulting in many being screwed over. We are trying to fix that but sometimes it’s like talking to a wall. Good progress lately, though.

Get smart on how the Army will rate your condition should you ever go through a MEB/PEB. If they rate you less than 30% you will be screwed. You need to understand the criteria Code 5002 of the VASRD so you can ensure your condition is documented in these terms as you medical file builds. A 30% rating will lead to life time retirement and benefits. Sometimes, it just a matter of documenting the truth correctly. A word or two could make all the difference. The whole MEB/PEB thing is like watching sausage being made, you will lose your appetite.

I could go on and on about lessons learned and issues raised in the recent past but you can capture the lion’s share by reading some of the threads on this page. Make sure you toggle to see all posts to reach back further.

Welcome to the group and keep in touch. We are here for you.

LTC P.

Re: Seeking information #101584 12/15/05 02:41 AM
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Sir, thank you so much for the information. I honestly have a lot to learn about the ratings systems ect. I had never pictured being in the Army one day less than 20 years, however it is starting to seem less likely. I am on quarters today, tomorrow and Friday, my flare up as gotten to a high in the pain level department and I went to my Rheumatologist this morning who was going to start me on Remicade, surprisingly enough the insurance portion had been approved however I didn't have the proper referrals in the system to have the infusion done today. They are hoping the referral will come back by Friday so I can have the infusion done then. They put me on I think it's Azarvin? It's a morphin and sulfate pain killer, so hopefully it's assist until this flare up is under control. I am certain that because of my current assignment it is far easier to be not MEB/PEB as of yet, however I think that my Battalion Commander is going to ensure that it becomes a reality, sooner than later. Thank you again for the information and I will be reading everything I can. It's nice to know that I am not the only soldier who is in this position. Again thanks for your time and feedback.

Re: Seeking information #101585 12/19/05 05:21 PM
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Sir, thank you so much for the information that you emailed to me. I am starting to at least become somewhat familiar with some of the processes. I did however receive a blow this morning I was notified that tomorrow I will go to Ft. Knox and undergo a fit for duty physical. The Battalion Commander made the appointment and it will be conducted at Ireland Army Medical Center, I did not know that you set up these types of things with a specific physician, my appointment is with a specific doc. I have no idea what this physical is supposed to entail nor am I aware of the physician is required to do/not to do confused , my concern is that this is done properly and in accordance with regulations. If there's anything that anyone might know about this that I should know, I would love to have the knowledge. Thanks again.

Re: Seeking information #101586 12/19/05 05:37 PM
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Step one : http://ecfrback.access.gpo.gov/otcgi/cfr...M=1#Sec.%204.45
MThis is a link to the VASRD. Get familiar with the criteris in code 5002. See para 4,71a. Describe you condition in these terms as much as possible.

Make sure you address all the manifisations of your disease to include residual effects.


Make sure if it Psoriatic Arthritis, thats what he puts down. No 5240 issues again. Cover other medical conditions as well.

My physical was done by a Doc who focuses on MEB physicals so that is why a specific Doc. I guess.

I am leaving for an appointment right now. I will think on it and pile on later.

Keep us informed. Your the first we had we cuaght this early in the process.

Email me your phone #. We may want to talk tonite.


Mike

Re: Seeking information #101587 12/29/05 12:03 PM
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nick10m Offline OP
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I have been having some email difficulties as of late, however did want to update my situation and ask that if anyone has some input I'd love to hear it. They found me unfit for duty at my "physical" which I wouldn't even rate as an exam. (more on that later) I have to go back to Ft. Knox for an MEB on 5 Jan. 06, I'm trying to get everything in order. Any pointers?

Re: Seeking information #101588 12/29/05 02:54 PM
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First, the physical nor the MEB can deem you “fit”or “unfit”. They can state you don’t meet retention standards under 40-501 Chapter 3. This will lead to a PEB. The PEB will determine if you are fit or not and that finding will be heavily influenced on your duties and job performance.

Do you know which PEB will be handling your case? (Walter Reed, Sam Houston, Ft. Lewis).

I was found medically unacceptable on two AR 40-502 issues by the MEB. Spondyloarthropathy, Para 3-40 l-2 (Reiter’s) and for Migraines, Para 3-3- G. The PEB then found me fit without addressing any of the medical issues or impacts (non-deployable) related to these diseases to include the use of Enbrel in mt DA 199. As far as they were concerned, adequate performance reports and the fact I passed my PT test was good enough to find me fit. Bear in mind I am over twenty years of service and the Army may have had to pay me more on a disability retirement versus a length of service retirement. This may have influenced their decision as other PEB’s have found service member’s use of Enbrel a reason for unfitness it to itself and this lead to separation without retirement.

Make sure you document all of your medical issues on your MEB physical as this will aid in the MEB/PEB as well as in you VA benefits and compensation for both unfit and unfitting conditions.

If the PEB finds you unfit, they should rate psoriatic arthritis under VASRD code 5002. Make sure you physical, NATSUM and MEB documentation stake the impact of your condition in terms that are used in the 5002 criteria. Specifically the number of exacerbations you have and their impact – incapacitating, severely incapacitating, totally incapacitating. Make sure they address how the disease and your medicines impact your overall health – definite impairment to health, severe impairment to health. These are terms used in 5002. Become very familiar with 5002 as a word can make the difference between separation and retirement.

Do not concur with MEB/PEB findings unless you absolutely concur. Take time to respond rebut these findings even if it to clarify and expand on the points they have made.

Keep in touch.

Re: Seeking information #101589 01/06/06 08:33 AM
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Jamnry Offline
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Sorry to hear they are going to start the medical board process on you. Take from me and the mistakes I made when doing my board. Do not just assume that the Army will get it right. Never rush any step. In fact my advise would be if you can stall at every step do so, so that you have plenty of time to review everything and get the best understanding possible.

Part of the reason I am having problems getting rated is because I did not do this. My case seemed so obvious to me that the Army aggrivated my condition at the very least that I let small wording go through on my narsum I knew where not 100% factual just because I wanted the process over so I could move on to the next phase of my life.

Anyway I hope your board goes well. LTC Parker I am sure has given you lots of information to help you out, he has been a great help to many of us.

Jim


James Wollman
Re: Seeking information #101590 01/07/06 04:15 AM
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nick10m Offline OP
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thank you for your kind words. I am still trying to get myself educated on the process, and I find it frustrating that it is not an easily researched topic. I really had no idea of the complicated nature of these types of situations and I only hope that I can draw from everyone else's experiences and perhaps not have to endure all of the nightmarish things that some many have. Good luck to you in getting your situation rectified. And thank you for sharing your information

Nicole


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