I am early in the MEB process and have read a lot about how important specificity and consistency is in the commander's letter. The CC has not spoken with my PCM yet as suggested by the questionnaire, how important is that portion? My MEB is for Chronic Instability of the Knee Joint (following traumatic injury, surgery, and multiple rounds of physical therapy), Idiopathic Hypersomnia (diagnosed by 2 sleep studies with MSLT), and chronic pain (being further evaluated by rheumatologist this week for pending dx of Fibromyalgia). Currently the doctor and I are both convinced the best outcome would be an unfit rating and retirement. The following is what has currently been prepared, and I would really appreciate any feedback!
Effect on Unit Mission
1. Explain how the member’s medical condition affects his/her ability to perform all duties related to their primary AFSC.
As a computer programmer, the member is expected to sit for prolonged periods at a desk and focus on cognition-intensive tasks. Cognitive impairment due to ongoing fatigue is negatively impacting the member’s ability to concentrate, requiring detailed lists and extensive note-taking to accomplish primary duties. Significant sleep issues have serious impact on the severity of her daily symptoms, as her hypersomnia causes brief episodes of sleep throughout each day in spite of medication. She experiences sporadic extreme noise and light sensitivity, which severely affects her ability to work in the vicinity of aircraft, servers, and fluorescent lights. Additionally, chronic pain from the damage to the member’s knee causes further distraction, and prolonged sitting exacerbates this pain and causes stiffness in the joint.
2. Detail any duty-related restrictions, limitations, “work-around” or schedule modifications that are in effect and for how long they have been in effect. If the member is currently assigned to desk or administrative duties, was the medical condition a factor in selecting this duty?
Member has been on profile repeatedly since the knee injury first occurred, cumulatively it has been over 3 years. Member is unable to complete the AF Physical Fitness Assessment and is unable to deploy based on her inability to run due to knee instability and chronic pain. Member is currently allowed by her NATO supervisor to depart the duty location before the end of the duty day as needed to manage the fatigue/pain as well as possible, and to avoid falling asleep while driving due to the hypersomnia.
3. Describe the specific duties the member is unable to perform because of his/her medical condition.
Member cannot run, stand, walk or perform physically demanding tasks for prolonged periods of time, due to pain and fatigue resulting from her hypersomnia and instability/degeneration in her left knee. This precludes member from successfully completing the Physical Fitness Assessment and from routinely participating in formations or ceremonies as expected of an Air Force NCO.
4. Other than medical appointments, approximately how many days of work has the member missed over the past 90 days due to this condition? How many days were 1) appointments? 2) Formal quarters or convalescent leave? 3) Other days off due to condition?
Member has missed approximately 5 days of work due to pain and fatigue resulting from hypersomnia/chronic pain. 2 were days granted by the supervisor without formal quarters. The rest is accumulated time from arriving to work later than scheduled or leaving prior to official end of duty day, ranging from 30 minutes to 3 hours at each occurrence.
Additionally, the member has missed 3 days to travel for medical appointments at Landstuhl Regional Medical Center.
5. You are encouraged to speak with the Primary Care Manager (PCM) regarding the member’s medical condition (including profile recommendation/restrictions, if required). Have you spoken with the PCM and do you agree with the PCM’s assessment of the member’s condition(s)? If not, why?
6. How will the member’s condition(s) affect his/her ability to serve in their primary AFSC in future assignments?
Due to the fatigue caused by her hypersomnia, the member would not be able to adequately perform as a computer programmer or a supervisor in future assignments. Cognitive impairment due to the fatigue will severely impact problem solving abilities, which are central to the career field.
7. How will the member’s condition affect his or her ability to perform his/her primary AFSC duties in an OCONUS deployed environment?
The member requires medication with a controlled substance for the hypersomnia, precluding deployment to operating environments without medical facilities capable of prescribing the stimulant. The inability to remain awake in spite of medication is dangerous in a deployed environment. The pain and instability in the member’s knee prevent her from completing pre-deployment training, and would also prove a danger to her and others in a deployed environment.
8. How does the member’s medical condition impact your ability to perform your in-garrison/deployed mission?
Currently the member has managed her time such that the conditions described have not negatively impacted the mission at her current assignment. This is largely possible due to the slow pace of her current office environment, and is not likely to remain possible due to recent organizational changes and increased severity of the member’s symptoms. Member has been sacrificing quality of life during non-duty hours to ensure the mission is completed, however the chronic pain and the fatigue from her hypersomnia have recently made completing a full duty day of work extremely difficult, and sometimes impossible.
Effect on Unit Mission
1. Explain how the member’s medical condition affects his/her ability to perform all duties related to their primary AFSC.
As a computer programmer, the member is expected to sit for prolonged periods at a desk and focus on cognition-intensive tasks. Cognitive impairment due to ongoing fatigue is negatively impacting the member’s ability to concentrate, requiring detailed lists and extensive note-taking to accomplish primary duties. Significant sleep issues have serious impact on the severity of her daily symptoms, as her hypersomnia causes brief episodes of sleep throughout each day in spite of medication. She experiences sporadic extreme noise and light sensitivity, which severely affects her ability to work in the vicinity of aircraft, servers, and fluorescent lights. Additionally, chronic pain from the damage to the member’s knee causes further distraction, and prolonged sitting exacerbates this pain and causes stiffness in the joint.
2. Detail any duty-related restrictions, limitations, “work-around” or schedule modifications that are in effect and for how long they have been in effect. If the member is currently assigned to desk or administrative duties, was the medical condition a factor in selecting this duty?
Member has been on profile repeatedly since the knee injury first occurred, cumulatively it has been over 3 years. Member is unable to complete the AF Physical Fitness Assessment and is unable to deploy based on her inability to run due to knee instability and chronic pain. Member is currently allowed by her NATO supervisor to depart the duty location before the end of the duty day as needed to manage the fatigue/pain as well as possible, and to avoid falling asleep while driving due to the hypersomnia.
3. Describe the specific duties the member is unable to perform because of his/her medical condition.
Member cannot run, stand, walk or perform physically demanding tasks for prolonged periods of time, due to pain and fatigue resulting from her hypersomnia and instability/degeneration in her left knee. This precludes member from successfully completing the Physical Fitness Assessment and from routinely participating in formations or ceremonies as expected of an Air Force NCO.
4. Other than medical appointments, approximately how many days of work has the member missed over the past 90 days due to this condition? How many days were 1) appointments? 2) Formal quarters or convalescent leave? 3) Other days off due to condition?
Member has missed approximately 5 days of work due to pain and fatigue resulting from hypersomnia/chronic pain. 2 were days granted by the supervisor without formal quarters. The rest is accumulated time from arriving to work later than scheduled or leaving prior to official end of duty day, ranging from 30 minutes to 3 hours at each occurrence.
Additionally, the member has missed 3 days to travel for medical appointments at Landstuhl Regional Medical Center.
5. You are encouraged to speak with the Primary Care Manager (PCM) regarding the member’s medical condition (including profile recommendation/restrictions, if required). Have you spoken with the PCM and do you agree with the PCM’s assessment of the member’s condition(s)? If not, why?
6. How will the member’s condition(s) affect his/her ability to serve in their primary AFSC in future assignments?
Due to the fatigue caused by her hypersomnia, the member would not be able to adequately perform as a computer programmer or a supervisor in future assignments. Cognitive impairment due to the fatigue will severely impact problem solving abilities, which are central to the career field.
7. How will the member’s condition affect his or her ability to perform his/her primary AFSC duties in an OCONUS deployed environment?
The member requires medication with a controlled substance for the hypersomnia, precluding deployment to operating environments without medical facilities capable of prescribing the stimulant. The inability to remain awake in spite of medication is dangerous in a deployed environment. The pain and instability in the member’s knee prevent her from completing pre-deployment training, and would also prove a danger to her and others in a deployed environment.
8. How does the member’s medical condition impact your ability to perform your in-garrison/deployed mission?
Currently the member has managed her time such that the conditions described have not negatively impacted the mission at her current assignment. This is largely possible due to the slow pace of her current office environment, and is not likely to remain possible due to recent organizational changes and increased severity of the member’s symptoms. Member has been sacrificing quality of life during non-duty hours to ensure the mission is completed, however the chronic pain and the fatigue from her hypersomnia have recently made completing a full duty day of work extremely difficult, and sometimes impossible.
