New here! Could use some advise

N

nick7

PEB Forum Regular Member
Hello everyone,

First I would like to thank all of you all who have helped me just by reading some of the other threads.

Here is a little back round on me and my situtation. I am 23 years old E5 US Army. In June 2009 I fell off a trailer in Iraq when I landed we all heard a large pop and my ankle instantly swelled up. The Doc in Iraq told me it was just a bad sprain take a few weeks off and back to work. I had a MRI done back in October 2009. I PCSed before I could get seen by Ortho back in the states. I am in Stuttgart Germany now and have been to Ortho up in Laundstuhle a few times. The Doc read my MRI and told me i have 7 tears in my cartlidge wich is causing Arthritis. The Doc said he would not operate on it because he would not be able to fix it. He gave me a shot of cortisone that only lasted about a week and a half. I am going back next week to talk long term solutions and to get a shot of something else.

With all of that being said I am trying to find out likly solutions. I cannot run, bike, swim, or walk. I walk about a 1/4 of a mile to work every day. I am the operations NCOIC so I spend most of my time behind the desk. But everyday my ankle is killing me just by walking maybe a mile a day. The Doc seems to be keeping some info from me. I just want to know from your alls past experiances what you all think will happen.

Thanks for all the help!

Nick
 
One of my friends, has a simular situation. He was running durning the PT test and tore the tendons and cartlage in his foot. he has had three surgeries to try to fix the problem. The Air Force has said they are going to start the medical board process as soon as he is stable. Which in his case is another nine months. He was told by our medical group that he will most likely get 40% and a medical retirement. Now he has talked to the VA and they are saying that he will most likely get closer to 60%, becouse his quality of life is effected. He has a hard time walking even short distances.
 
Thanks for the help! The wife and I were planning on spending at least 20 years in the military. I honestly love the Army but just cannot preform as needed due to not being able to walk far distances. My fear is that they are going to kick me out with out any benifits. All I really want out of this is my blue id card. I really dont care about the money (dont get me wrong it will be nice to have) but I wanted to do my time and retire.
 
nick,

Welcome to the forum!

Let me first state that the Army cannot discharge you due to your medical conditions without benefits unless they can prove that the condition existed prior to service and was not aggravated by service (your injury obviously incurred while in service, so it is compensable).

What is your MOS? This plays a big part in what will happen with you. Hard to state without more information from your doctor, but here is what I believe to be the applicable entry from AR 40-501 for your condition:

3-14 Miscellaneous Conditions of the Extremities
b. Arthritis due to trauma, when surgical treatment fails or is contraindicated and there is functional impairment of the involved joints so as to preclude the satisfactory performance of duty.
Click to expand...

AR 40-501 Chapter 3 outlines the retention standards - i.e. if you fall below the retention standards, you are referred to a MEB. You are not quite there yet, but like I said earlier, how this all plays out has much to do with your MOS and ability to perform the duties thereof.
 
Carnelli,

Thanks for the welcome and for the help! It seems like all i have been doing is reading AR's. I am an 88M. I am currently assigned to a PSD team here in Germany. I can do the driving part and shooting part but not able to do any cardio or take a APFT. If i was in a line unit there is no way I could lead troops they way they should be leaded, or be able to preform most 88M duty's. Is there a requlation that breaks down the standard by MOS? If so I have yet to find it. I wont lie I am a very impatient person and this not knowing anything and the doc telling me very little is killing me and stressing me out. I was also wondering if they do press forward with the MEB will they also consider the fact that in my first deployment I was ejected out of a 1114 and diginosed with mild TBI? Thanks for any information!!
 
There is no regulation that breaks down the retention standards by MOS. The retention standards are used by the MEB to determine what conditions fail (and yes, they must evaluate all conditions - even the mild TBI). Once the MEB has determined what conditions have failed retention standards, your package is sent off to the Physical Evaluation Board who determine if the conditions are unfitting and what disability rating will be assigned for each.

Whether or not a condition makes you unfit for duty is contingent on your rank and MOS. The classic example given is a case where two soldiers, one an airborne infantryman the other a human resource specialist, both sustain serious permanent injury to their right leg at Airborne School, neither can no longer perform jumps nor perform any strenuous physical activity. The human resource specialist who spends his days typing away at the keyboard in an office can still perform his duties despite the injury. The airborne infantryman, on the other hand, is not going to be able to perform his duties at all. So here you have two soldiers with the same injury and one is able to continue their duties while the other is now unfit for duty.

Hope that was somewhat clear - the general principle here is that the PEB determines if you are fit/unfit for duty based on the degree of the disability and your job description.

What is your desired outcome here? Do you want to stay in?
 
Jason,

Thanks for the help. Orginally when this all happened I was dead set on staying in. After talking to my DET SGT (great leader by the way) he sugested that I get due to the fact that he cannot see me back in a line unit doing my job. When I heard that I have been thinking a lot about this situtation. To be honest right now I really dont care what happens to me and all I want is a long term solustion to help my ankle. Another question and sorry for all the question just kinda stressing out about all of this. So who gathers all my medical records and is there a physical before the board that will look over me from head to toe? And the other 2 question I have learded from reading here that no one has the answers to.... % and time. Thanks again for all the helps guys and gals its really taking a lot of the stress off me and they wife just getting these answers.
 
I'm not Jason, he's the site administrator - but you can feel free to call me Dennis.

The Medical Evaluation Board (MEB) is responsible for evaluating you from head to toe, performing whatever tests are necessary. If referred to a MEB (which it sounds like you will) you will undergo a MEB physical very similar to the one you received at MEPS prior to joining the service (except there is no duck walk nor is there other people half-naked in the room). You will be asked what medical conditions you have/had while in service - state everything that has ever happened to you. The MEB provides a snapshot of your medical history and conditions for the Physical Evaluation Board (PEB), the body responsible for the final adjudication of your case. As you can imagine, much of what is recorded at the MEB level has a tremendous effect on the final outcome of your case - so if you disagree with any of the findings at the MEB level, you can request an Independent Medical Assessment (IMA) and be examined by another doctor (essentially getting a 2nd opinion).

The PEB draws justification for their percentages from the Veterans Affairs Schedule for Rating Disabilities (http://www.warms.vba.va.gov/bookc.html) - just as a preliminary guess, you can get an idea for your ankle by taking a look at 4.71a:

5270 Ankle, ankylosis of:

In plantar flexion at more than 40º, or in dorsiflexion at more
than 10° or with abduction, adduction, inversion or eversion
deformity............................................................................................................. 40
In plantar flexion, between 30º and 40º, or in dorsiflexion,
between 0º and 10º.......................................................................................... 30
In plantar flexion, less than 30º.......................................................................... 20

5271 Ankle, limited motion of:

Marked.................................................................................................................... 20
Moderate ................................................................................................................ 10

5272 Subastragalar or tarsal joint, ankylosis of:

In poor weight-bearing position ......................................................................... 20
In good weight-bearing position ........................................................................ 10

5273 Os calcis or astragalus, malunion of:

Marked deformity................................................................................................... 20
Moderate deformity............................................................................................... 10

5274 Astragalectomy............................................................................................................ 20
Click to expand...
You may also be rated under degenerative arthritis (arthritis due to trauma is rated under degenerative arthritis), but hard to say at this point.

The time line is impossible to predict, especially since you have not even been referred to a MEB yet. It can take, at best, 4 months and at worst, the better part of a year (there have been cases that take longer).
 
Dennis,

First I would like to appologize for calling you the wrong name. I have been reading so much here latly because the Doc told me not to plan on a long career in the Army but will not give me any long term plan. So it is time to let my wife loose on him come tuesday. Thanks for all the great info. I should have started asking questions on here a few weeks ago after the Doc said he could not fix me. It would have relieved so much stress from my life. Thanks again for all the help and with the lack of Army time lines on here compaired to other branches I will make sure I start a thread on my time line for the rest of the Army guys out here! Thanks again everyone!
 
No need to apologize, I've been called much worse :)

Feel free to ask any other questions you have.
 
All,

Here is an update after I had a meeting with DET SGT today. He said he is going to go talk to our 1SG and CO (who have nothing to do with our detachment except for admin). He is going to sugest that our CO starts the MEB process. My first question is can a CO start this process or does the Doc have to start this process. Second question... wich looks better for me having the Doc or CO start the process? The last question I have as of now is if the CO starts does the process work the same as having a MEB doc do a physical, will all conditions be concidered by the board? Thanks for any help!
 
Nick,

Your Commander can start the MEB process via an order for a fit for duty exam. It does not make a difference how the process is started (it is perceived neither as good nor bad by the powers that be), but you are probably better off having your CO initiate the MEB since he/she will now be in the "know" by virtue of referring you to the MEB. Your CO will have to write a recommendation as to whether or not you can perform your duties later in the process. Having him/her involved this early in the game is, in my opinion, a huge advantage. You will find that your unit being aware of your needs regarding your MEB/PEB status is very important as their cooperation can make this process a whole lot easier.

The procedures of the MEB will remain the same regardless of the initiating source. Remember, the MEB evaluates all conditions you have and determines if they fail retention standards (outlined in AR 40-501 Chapter 3). Of your conditions that fail retention standards, the PEB determines if they are unfitting for duty and assigns disability percentages as necessary.
 
Dennis,

Thanks againg for answering me so fast! I looked in the downloads and saw several examples of CO letters for the AF but none for Army. Does anyone have an example of an Army CO letter. With us being detached from the unit I am sure our CO will ask my DET SGT to write the letter with his signature block and my DET SGT will tell me to write. I know this isnt the way it should happen but this is the reality of where I am but I think this way it will help because our CO doesnt have access to our building. He also just redeployed with the rest of our unit and I am sure he has no clue who I am. So at this time I feel like I have a lot going for me. I will keep you all updated and I am sure I will be asking some questions. Depending on how things go monday I will start my time line thread so Army guys can have a feel for how long this take from Germany.
 
So here is the update. I was refered the MEB section today. I did have one question about the VA. If I get rated rated at 20% from the DOD with severance pay and the VA rates me at lets say 40%. I have to pay back my severance pay to the VA to get the other 20% right? And if the VA rates me at over 30% would I still get the blue id card and all the other benifits? Thanks again for all the help!
 
The VA and DoD rating are separate. DoD rating of 30% or more is what gets you the retiree ID card and the benefits. The VA rating (in and of itself) has no bearing on your retirement status with the military - a 30% rating from the VA does not change your status with the military.

If you are separated with severance from the military and then receive a VA disability award, VA disability compensation is withheld until the entirety of the severance is paid back (there is an exception here). In any case, it is all the more reason to start your VA claim as early as possible (my first stop after receiving my IPEB findings was the local VA office). There are various methods to file your claim early, you should contact the nearest VA rep (calling the national number, they will just tell you to wait until discharge).
 
Might I suggest getting a second opinion for another Doc. Possibly locally on the economy. One Doc who said he can't fix you is enough to make me run away form him....

Just my 2.5 cents worth, but anytime a doc tells me there is nothing he can do after reviewing one MRI makes me question his ability or specialty. Go get another Doc to look at you.
 
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