Hello,
I joined this forum a couple years ago when things started getting shakey and uncertain. I decided I would document this odyssey so that others in my type of limbo land of what set of rules to follow may gain help and insight.
I have 19.5 years of total service. An initial tour of duty as active duty infantry, followed by a few months IRR, then joined CA ARNG, as a regular MDay soldier for about three years, then went into ADSW (Active Duty Special Work) while still assiged to my MDay unit. I have a total of about 16 years AD.
Though my readings of this forum, not many folks appear to be in this situation where I am AD by some regs and NG by others. So hopefully if there are others in this situation they may gain some insight.
Note: If I am posting in the wrong place please jump in and let me know. I would hate to start off by making a mess of things. I know Jason has gone through a lot of work to set this up and keep it organized.
Background of injury:
In May 2005 while on ADSW, I was in a bicycle accident in which I broke my left wrist requiring four surgeries over a period of three years. The last surgeon stated that while it will never be back 100%, it's as good as it will get. Status: I get by. Some issues, but for the most part all is good.
During the same accident I ruptured my right femoral artery and incurred major nerve damage in the right hip/groin area. Initially I was told that my hip/groin area was going to hurt for quite some time. It did. Not wanting to whine about it, I just let it go. After about a year, I still had a lot of pain accompanied by popping. I decided to go back to see an ortho doc. It was then that I found out that I had a labral tear. I was also told that I had tendonitis and bursitis in the psoas muscle group and something called piriformis syndrome.
In 2008, as I notified my command that I would be undergoing various surgeries the "new command" inquired about the LOD. Initially after the accident I was sent a number of documents to be filled out for the LOD, which I did and promptly returned. Appearently, it was never done. Commands changed again and this time I was told I didn't need an LOD because the dates of the medical treatment clearly showed it happened while on orders. Fast forward to the latest command; they want an LOD. So an LOD was prepared. NOTE TO ALL: Be obnoxious if need be! Get your LOD ASAP.
Current medical standing:
The surgery in 2008 repaired the labral tear and for the most part stopped the popping and locking. However, the tendonitis/bursitis of the psoas group along with the piriformis issue has continued. I was referred to pain management where I have been receiving botox injections into both muscle groups. The concept being that if we could get them to relax maybe the constant spasms would cease. Medically, they cannot inject botox more frequently than three months apart. Unfortunately, the injections only last about six weeks at best while providing about 30-50% relief. The latest MRI as of two weeks ago shows a boney growth on the head of the femor which according to ortho changes the axis.. blah, blah, blah, 75%, rotation impeaded, blah, etc. Referral to surgeon for another hip surgery. Physical therapy and PCM (primary care mgr) recommended looking into having the pirifomis muscle removed as piriformis syndrome causes the pinching of the sciatic nerve and the muscle itself is a contradictory muscle to the psoas group. So if one spasms, the other starts to spasm. However, ortho rejected the idea.
My opinion:
Although I have hoped for a one shot, one kill fix for my hip issues, it appears that it is simply not possible. The intelligent guy that I am just recently realized that there really isn't a cure for tendonitis or bursitis. The treatment for tendonitis is isolation and rest. How does one isolate and rest the psoas group? When it spasms while driving I switch to driving with my left foot and pray to find my way to the side of the road. It is completely debilitating. Long story short, there is no fix. I can't run, I can't walk very far if I rush, I am afraid to swim because if it spasms I'm afraid I'll drown. I may be able to do the bicycle if the regs don't preclude the use of a recumbent bicycle. (Does anyone know if a recumbent bicycle is allowed? Also, is there a requirement of resistance on a stationary bicycle?) Additionally, I cannot do situps. Fortunately, I can knock out the pushups fast enough to avoid the psoas from spasming or cramping. I don't think the majority realizes how much the psoas is involved in our every movement. A primer for those unfamiliar: The psoas and iliopsoas attach at the bottom of the spine, connecting to the first four or five vertabrea then travel through the pelvis and attach to the upper end of the femor. There is not much that the body does that doesn't include use of the psoas group. From standing, walking, using the toilet, etc. If you move your hips, you're using the psoas group.
Now the regs:
My command has directed me to start getting the paperwork together for a medical evaluation. Now the talk is a permenent profile, however the discussions behind my back are directed towards seperation. Last week I received a letter from the state surgeons office. According to the letter from the state, I will be removed from active duty while on the MND list (Medically Non-Deployable). Last I heard, a soldier cannot be involuntarily removed from active duty while injured. So this is one of those limbo areas. Does this not apply to all active duty. The fear is without my job I don't have medical coverage, without medical coverage I cannot bring this to an end or get fixed.
Below is the letter from the state and an email caption from my ADSW medical NCO. 07AUG I attended a unit PHA event. I told the LTC doc that I saw for PHA that my unit wanted me to go to Ft. Irwin for an ortho consult regarding the issue for MND. He told me I didn't have to go to Ft. Irwin, actually he told me to avoid them if possible because they are difficult to deal with. He said I could go anywhere. I told him I was about an hour and a half from Edwards, AFB. He said that would be better but even a civilian doc would do as long as I provided that doc with all the neccessary paperwork.
After informing our medical NCO of what the LTC doc from the PHA said about "going anywhere to get it done", this is what I received from our ADSW Medical NCO, dated 09AUG10:
I kindly refer you to AR 40-400 Patient Administration, Chapter 7-16, Triservice medical evaluation board coordination.
b. MEB proceedings completed by another Uniformed Service may include recommendations regarding the member's disposition. However, "referral of the proceedings to the Service reviewing authority" is the only official disposition that can be used. This is required since Service physical standards vary and could result in different dispositions. Also, one Uniformed Service will not commit another Uniformed Service to a specific disposition.
Medical Evaluation Board proceedings are branch specific, so the end state is a final medical determination at FT Irwin. Once you get your referral tomorrow for FT Irwin from your PCM, please schedule the follow on appointment with FT Irwin Ortho as soon as possible. What we need is either a perm profile or a MEB determination from FT Irwin.
As you direct medical chain, please forward both LT XXXXXX and myself all Medical Documentation for review. We will continue to work both with the State Surgeon's Office and your BDE on your behalf.
Also, please forward the referrals you were given from your PHA's. If you have any further questions, do not hesitate to call.
-----End pasted email-----
From the State Surgeons Office I received:
View attachment Ltr from state surgeon.pdf
And here is the current profile that I am on:
View attachment Profile 20100807-20101105 blacked out.pdf
What a coincidence... The doc at the PHA wanted to update my profile because it was going to expire 26AUG, so he wrote a new one to carry from AUG to NOV. I just noticed while scanning the profile. The doc that said I could go anywhere, that was corrected by our Medical NCO, was the same doc from the state surgeons office that sent the paperwork!!
Okay, some of you are reading this and wondering how this has gone on for so long. My MDay command has kinda kept this on the downlow. They know I don't want out. My ADSW command (we've gone through multiple) for the most part also know I don't want out. While going to Ft. Irwin for PHAs (Periodic Health Assessments) and profiles, the docs there have been helpful as to not do anything to get me flagged. It's not until now with this new command that things are getting rushed through. Making me even more nervous is the fact that they are letting people go that are inside of months before retirement. They say it's about funding, yet they are hiring to replace those they are releasing from AD.
I know this is a lot of rambling but I do hope it helps someone like me who is stuck between active duty and active duty and are unsure of which active duty they belong to. Certainly there will be more to come, especially the circus of what regs pertain to active duty vs NG vs active duty.
I joined this forum a couple years ago when things started getting shakey and uncertain. I decided I would document this odyssey so that others in my type of limbo land of what set of rules to follow may gain help and insight.
I have 19.5 years of total service. An initial tour of duty as active duty infantry, followed by a few months IRR, then joined CA ARNG, as a regular MDay soldier for about three years, then went into ADSW (Active Duty Special Work) while still assiged to my MDay unit. I have a total of about 16 years AD.
Though my readings of this forum, not many folks appear to be in this situation where I am AD by some regs and NG by others. So hopefully if there are others in this situation they may gain some insight.
Note: If I am posting in the wrong place please jump in and let me know. I would hate to start off by making a mess of things. I know Jason has gone through a lot of work to set this up and keep it organized.
Background of injury:
In May 2005 while on ADSW, I was in a bicycle accident in which I broke my left wrist requiring four surgeries over a period of three years. The last surgeon stated that while it will never be back 100%, it's as good as it will get. Status: I get by. Some issues, but for the most part all is good.
During the same accident I ruptured my right femoral artery and incurred major nerve damage in the right hip/groin area. Initially I was told that my hip/groin area was going to hurt for quite some time. It did. Not wanting to whine about it, I just let it go. After about a year, I still had a lot of pain accompanied by popping. I decided to go back to see an ortho doc. It was then that I found out that I had a labral tear. I was also told that I had tendonitis and bursitis in the psoas muscle group and something called piriformis syndrome.
In 2008, as I notified my command that I would be undergoing various surgeries the "new command" inquired about the LOD. Initially after the accident I was sent a number of documents to be filled out for the LOD, which I did and promptly returned. Appearently, it was never done. Commands changed again and this time I was told I didn't need an LOD because the dates of the medical treatment clearly showed it happened while on orders. Fast forward to the latest command; they want an LOD. So an LOD was prepared. NOTE TO ALL: Be obnoxious if need be! Get your LOD ASAP.
Current medical standing:
The surgery in 2008 repaired the labral tear and for the most part stopped the popping and locking. However, the tendonitis/bursitis of the psoas group along with the piriformis issue has continued. I was referred to pain management where I have been receiving botox injections into both muscle groups. The concept being that if we could get them to relax maybe the constant spasms would cease. Medically, they cannot inject botox more frequently than three months apart. Unfortunately, the injections only last about six weeks at best while providing about 30-50% relief. The latest MRI as of two weeks ago shows a boney growth on the head of the femor which according to ortho changes the axis.. blah, blah, blah, 75%, rotation impeaded, blah, etc. Referral to surgeon for another hip surgery. Physical therapy and PCM (primary care mgr) recommended looking into having the pirifomis muscle removed as piriformis syndrome causes the pinching of the sciatic nerve and the muscle itself is a contradictory muscle to the psoas group. So if one spasms, the other starts to spasm. However, ortho rejected the idea.
My opinion:
Although I have hoped for a one shot, one kill fix for my hip issues, it appears that it is simply not possible. The intelligent guy that I am just recently realized that there really isn't a cure for tendonitis or bursitis. The treatment for tendonitis is isolation and rest. How does one isolate and rest the psoas group? When it spasms while driving I switch to driving with my left foot and pray to find my way to the side of the road. It is completely debilitating. Long story short, there is no fix. I can't run, I can't walk very far if I rush, I am afraid to swim because if it spasms I'm afraid I'll drown. I may be able to do the bicycle if the regs don't preclude the use of a recumbent bicycle. (Does anyone know if a recumbent bicycle is allowed? Also, is there a requirement of resistance on a stationary bicycle?) Additionally, I cannot do situps. Fortunately, I can knock out the pushups fast enough to avoid the psoas from spasming or cramping. I don't think the majority realizes how much the psoas is involved in our every movement. A primer for those unfamiliar: The psoas and iliopsoas attach at the bottom of the spine, connecting to the first four or five vertabrea then travel through the pelvis and attach to the upper end of the femor. There is not much that the body does that doesn't include use of the psoas group. From standing, walking, using the toilet, etc. If you move your hips, you're using the psoas group.
Now the regs:
My command has directed me to start getting the paperwork together for a medical evaluation. Now the talk is a permenent profile, however the discussions behind my back are directed towards seperation. Last week I received a letter from the state surgeons office. According to the letter from the state, I will be removed from active duty while on the MND list (Medically Non-Deployable). Last I heard, a soldier cannot be involuntarily removed from active duty while injured. So this is one of those limbo areas. Does this not apply to all active duty. The fear is without my job I don't have medical coverage, without medical coverage I cannot bring this to an end or get fixed.
Below is the letter from the state and an email caption from my ADSW medical NCO. 07AUG I attended a unit PHA event. I told the LTC doc that I saw for PHA that my unit wanted me to go to Ft. Irwin for an ortho consult regarding the issue for MND. He told me I didn't have to go to Ft. Irwin, actually he told me to avoid them if possible because they are difficult to deal with. He said I could go anywhere. I told him I was about an hour and a half from Edwards, AFB. He said that would be better but even a civilian doc would do as long as I provided that doc with all the neccessary paperwork.
After informing our medical NCO of what the LTC doc from the PHA said about "going anywhere to get it done", this is what I received from our ADSW Medical NCO, dated 09AUG10:
I kindly refer you to AR 40-400 Patient Administration, Chapter 7-16, Triservice medical evaluation board coordination.
b. MEB proceedings completed by another Uniformed Service may include recommendations regarding the member's disposition. However, "referral of the proceedings to the Service reviewing authority" is the only official disposition that can be used. This is required since Service physical standards vary and could result in different dispositions. Also, one Uniformed Service will not commit another Uniformed Service to a specific disposition.
Medical Evaluation Board proceedings are branch specific, so the end state is a final medical determination at FT Irwin. Once you get your referral tomorrow for FT Irwin from your PCM, please schedule the follow on appointment with FT Irwin Ortho as soon as possible. What we need is either a perm profile or a MEB determination from FT Irwin.
As you direct medical chain, please forward both LT XXXXXX and myself all Medical Documentation for review. We will continue to work both with the State Surgeon's Office and your BDE on your behalf.
Also, please forward the referrals you were given from your PHA's. If you have any further questions, do not hesitate to call.
-----End pasted email-----
From the State Surgeons Office I received:
View attachment Ltr from state surgeon.pdf
And here is the current profile that I am on:
View attachment Profile 20100807-20101105 blacked out.pdf
What a coincidence... The doc at the PHA wanted to update my profile because it was going to expire 26AUG, so he wrote a new one to carry from AUG to NOV. I just noticed while scanning the profile. The doc that said I could go anywhere, that was corrected by our Medical NCO, was the same doc from the state surgeons office that sent the paperwork!!
Okay, some of you are reading this and wondering how this has gone on for so long. My MDay command has kinda kept this on the downlow. They know I don't want out. My ADSW command (we've gone through multiple) for the most part also know I don't want out. While going to Ft. Irwin for PHAs (Periodic Health Assessments) and profiles, the docs there have been helpful as to not do anything to get me flagged. It's not until now with this new command that things are getting rushed through. Making me even more nervous is the fact that they are letting people go that are inside of months before retirement. They say it's about funding, yet they are hiring to replace those they are releasing from AD.
I know this is a lot of rambling but I do hope it helps someone like me who is stuck between active duty and active duty and are unsure of which active duty they belong to. Certainly there will be more to come, especially the circus of what regs pertain to active duty vs NG vs active duty.
