Pending disqualification R259.10. Need advice PLEASE

[foxtrot17]

So this is my actual situation... I just got my remedial codes but I am getting DQ for two of my three issues and I am not being asked for remedials for those two issues I am getting DQ (or pending a DQ) for.

This is all the information on my DODMERB page:


Date Event Code(s)
10-AUG-17 Application Added
10-AUG-17 Date applicant entered into DoDMERB system
04-DEC-17 Actual date of exam
18-DEC-17 Date exam reviewed
18-DEC-17 Date exam received at DoDMERB
18-DEC-17 Medical data entry
02-JAN-18 Date exam reviewed
03-JAN-18 Date letter uploaded - Remedial R259.10, R139.99, R261.01

Agency: US Air Force CSB
Cycle Year:2017
Code Description.

R139.99 Please have your physician provide a brief narrative summary of your hypothyroidism, provide current medication dose, state whether it is stable on your current medication dose, and provide copies of your last 2 TSH test results.

R259.10 Applicant pending Disqualification for:

D223.40 - Current or history of recurrent plantar fasciitis and

D223.80 - History of uncorrected anterior or posterior cruciate ligament injury , must complete AMI(s) before waiver processing may be considered.

R261.01 Please obtain thyroid stimulating hormone (TSH)


I am aware that I can submit medical paperwork at any time but my dilema is if I SHOULD WAIT to be asked for it by the waivering authority (in my case USAF) once they get all the paperwork of my initial AMI's for the thyroid issue and the initial questionaire filled by me and the physician or should I go ahead and contact my medical tech about this now and send her extra documentation??? I am afraid they will not ask about it later in the waivering process and that I will just get DQ and have a much harder time fighting a rebuttal.

Anyone has experienced this before?

As a side note while I filled my medical questionaire the system made me fill up additional information in my own words (Orthopedic questionnaire) about these two issues and I described my diagnosis and prognosis. I described it pretty well...and I know the doctor did too BUT still I believe the extra docs that I have at the ready would help me. Those were not transcribed 100%.

When I was examined by the doctor they assigned to me (physician) he told me that DODMERB would probably ask for more documentation and that I should wait until they asked to send it in. I had brought all documents with me that day but he refused to send them in and told me to wait instead. He also mentioned that I had great hopes of being qualified because my physical was excellent and he would continue to explain everything in great detail to my benefit.

Should I just sent what I am being asked for right now and wait or should I sent extra docs right now?

I need opinions and direction please anything is appreciated. Thank you!!!

 

[Falcon A]

foxtrot -- I am not a doctor

I think you have nothing to lose. Send to DoDMERB what you have.

Best wishes and thank you for your willingness to serve.

 

[foxtrot17]

Any more advice? What would you do? @Pima @AROTC-dad

anyone?

Thanks!

 

[2021mom]

Foxtrot: Have you gotten an AMI letter in addition to the updates you listed above? If not, it sounds like it should be coming soon.
The statement: "must complete AMI(s) before waiver processing may be considered" seems to indicate an AMI request for your two pending DQ conditions.
You should get a letter stating what additional info they want/where to send it.

 

[foxtrot17]

Foxtrot: Have you gotten an AMI letter in addition to the updates you listed above? If not, it sounds like it should be coming soon.
The statement: "must complete AMI(s) before waiver processing may be considered" seems to indicate an AMI request for your two pending DQ conditions.
You should get a letter stating what additional info they want/where to send it.

The Ami's they were requesting here were for my Thyroid and I had to submit them along with the questionnaire for waiver consideration for the three issues. The thyroid should not be a problem if I get another normal TSH.

I had this concern and since it was not answered here or anywhere I went ahead and contacted Larry MULLEN at DODMERB and I explained the situation. He told me I could send any medical documents that could help whenever BUT told me he would ask for specifics and sent me a detailed email of what he needed to build the package for the waiver authority.

He even got my Detachment Commander involved to give a Commander's assessment (PT wise) and submit my PT scores. I have to submit all my Knee and feet records too so that will help too because I do not have the conditions anymore (at the present) I just have a history of (still getting DQ because of the History but more chance for a waiver because of the evidence).

I was also asked by Mr. Mullen to fill a recreation and sports questionnaire and write personal statements for all my three disclosed conditions. I am working on all of this and waiting on appointments to visit doctors to get my records and to obtain statements from them too.

Mr. Mullen also found out there was a big error on my diagnosis. A DODMERB doctor gave a contradictory statement for one of my conditions saying I have it at the present when the DODMETS physician wrote that I am completely normal so that is getting corrected too!

Mr. Mullen has been very helpful and even called me on a weekend late at night to help. I am glad I reached out because I felt I had more to show to help my situation and getting a waiver for my issues.

 

[THParent]

Just so you know, I'm no doctor either!

The plantar fasciitis is easily correctable simply with rest, a change of shoes, stretching, orthotics, iontophoresis, or corticosteroid injections (or a mixture of all of these).

It's the history of an ACL or PCL injury that's probably the big deal here, since it wasn't corrected surgically.
If you have an ongoing "instability" of any joint (an ACL or PCL tear would typically cause "instability of the knee"), then it's an automatic DQ.

There is wording in various DoDMERB remedials for instability of joints in which they are waiverable if you have a "positive consult with a doctor" which reveals that you have full strength and range of movement with no instability.
Have you ever consulted with an Orthopedic Surgeon about your knee? Was the injury more of a strain or sprain (stretching but not tearing) than a tear, and surgery wasn't indicated?
If this is the case, you'll need to have that part in writing from the doctor.

One thing that you will do a lot of in the military is running.

 

[foxtrot17]

Just so you know, I'm no doctor either!

The plantar fasciitis is easily correctable simply with rest, a change of shoes, stretching, orthotics, iontophoresis, or corticosteroid injections (or a mixture of all of these).

It's the history of an ACL or PCL injury that's probably the big deal here, since it wasn't corrected surgically.
If you have an ongoing "instability" of any joint (an ACL or PCL tear would typically cause "instability of the knee"), then it's an automatic DQ.

There is wording in various DoDMERB remedials for instability of joints in which they are waiverable if you have a "positive consult with a doctor" which reveals that you have full strength and range of movement with no instability.
Have you ever consulted with an Orthopedic Surgeon about your knee? Was the injury more of a strain or sprain (stretching but not tearing) than a tear, and surgery wasn't indicated?
If this is the case, you'll need to have that part in writing from the doctor.

One thing that you will do a lot of in the military is running.

Yes long story is this:
I had a ACL and meniscus tear in the summer of 2012. I fell on both knees on a hardwood floor my left knee took more of that fall. I was walking incessantly for 2 weeks after that and at the ending of my vacation (in New York no less) I came back from vacation with a swollen left knee. I did an MRI of that knee and it showed a meniscus tear and also an ACL tear. I saw an orthopedic surgeon who recommended anthroscopic surgery but also recommended therapy as an alternative if I was not going to do any sports... I Decided on not having arthroscopic surgery since I would not fathom a surgery and was worried for getting worse and since I was not an athlete decided to just do therapy and see what happened. For all those years I would go to therapy and get tens/hot/cold therapy and massages if I got any pain. I would do that in my home too. I changed diet and started a more healthier living in 2016. My knee kept improving with time and in January 2017 I got a MRI for both knees and it was normal. No tears, nothing.

I have read that the location and the size of the tear (also the care you take with the knee) has a lot to do with recovery. Though I also asked a Sports Medicine doctor if this was possible (healing completely) and she told me yes but "once in a blue moon".

I will be gathering statements from about three doctors on this and in the Plantar Fasciistis.

 

[foxtrot17]

Sorry for the orthographic errors. I am trying to correct and I am receiving a message saying that I can't because I am "posting spam"

 

[foxtrot17]

New update:

So I got all my records from knee and feet and I just found out I have one weird diagnosis I never knew of and of course did not address on the paperwork/initial questionaire because I did not knew of it. I just found out my Dr wrote in 2016 and 2017 that I used to have chondromalacia patellar as the answer to my bilateral knee pain at that moment.

Dr has already cleared me on a new 2018 letter he just wrote yesterday and has given me a full discharge from all treatments... He mentions in that certification letter that I am free of any issues on feet and knees and that I have full range of motion, no pain and I am able to continue physical activities without restriction.

I am afraid sending this papers in particular will cause me to get yet another DQ. Any advice?

 

[Korab]

New update:

So I got all my records from knee and feet and I just found out I have one weird diagnosis I never knew of and of course did not address on the paperwork/initial questionaire because I did not knew of it. I just found out my Dr wrote in 2016 and 2017 that I used to have chondromalacia patellar as the answer to my bilateral knee pain at that moment.

Dr has already cleared me on a new 2018 letter he just wrote yesterday and has given me a full discharge from all treatments... He mentions in that certification letter that I am free of any issues on feet and knees and that I have full range of motion, no pain and I am able to continue physical activities without restriction.

I am afraid sending this papers in particular will cause me to get yet another DQ. Any advice?

I don't know whether you will get a DQ, but more remedials are certainly likely.

"D224.81 Current or history of chondromalacia"

 

[foxtrot17]

Yeah probably another remedial because it is a history of and now all I am sending actually shows that it is a history of but since it is a diagnosis I did not address since I did not knew about it, it will throw my perfect remedial package out of whack. I don't know what else they could ask for. I have all my history there plus the doctors note releasing me and giving me the ok to continue military training.

Maybe ask the doctor to do a new letter addressing that and mentioning that it is also resolved (even though he already said all my knee issues are resolved??)

 

[Korab]

Yeah probably another remedial because it is a history of and now all I am sending actually shows that it is a history of but since it is a diagnosis I did not address since I did not knew about it, it will throw my perfect remedial package out of whack. I don't know what else they could ask for. I have all my history there plus the doctors note releasing me and giving me the ok to continue military training.

Maybe ask the doctor to do a new letter addressing that and mentioning that it is also resolved (even though he already said all my knee issues are resolved??)

Yes, that would be a good idea. Perhaps ask for xrays, too. Negative xrays would at least rule out arthritic chondromalacia, and if your symptoms have otherwise resolved, hopefully they wont DQ you for it.

 

[foxtrot17]

Yeah probably another remedial because it is a history of and now all I am sending actually shows that it is a history of but since it is a diagnosis I did not address since I did not knew about it, it will throw my perfect remedial package out of whack. I don't know what else they could ask for. I have all my history there plus the doctors note releasing me and giving me the ok to continue military training.

Maybe ask the doctor to do a new letter addressing that and mentioning that it is also resolved (even though he already said all my knee issues are resolved??)

Yes, that would be a good idea. Perhaps ask for xrays, too. Negative xrays would at least rule out arthritic chondromalacia, and if your symptoms have otherwise resolved, hopefully they wont DQ you for it.

I already submitted a new MRI that was done on 2017 and it turned out normal. No evidence of chondromalacia patellar or of my original diagnostic (uncorrected ACL/meniscus tear). Everything was resolved.

 

[Korab]

Yeah probably another remedial because it is a history of and now all I am sending actually shows that it is a history of but since it is a diagnosis I did not address since I did not knew about it, it will throw my perfect remedial package out of whack. I don't know what else they could ask for. I have all my history there plus the doctors note releasing me and giving me the ok to continue military training.

Maybe ask the doctor to do a new letter addressing that and mentioning that it is also resolved (even though he already said all my knee issues are resolved??)

Yes, that would be a good idea. Perhaps ask for xrays, too. Negative xrays would at least rule out arthritic chondromalacia, and if your symptoms have otherwise resolved, hopefully they wont DQ you for it.

I already submitted a new MRI that was done on 2017 and it turned out normal. No evidence of chondromalacia patellar or of my original diagnostic (uncorrected ACL/meniscus tear). Everything was resolved.

Then your doctor should have an easy time showing it is no longer a concern.