Type 1 in the Military and the MEB process

By cowman12 Latest Reply 2015-06-01 22:24:35 -0500
Started 2014-10-09 10:45:55 -0500

Quick Background: I am a 24 y/o Air Force pilot diagnosed with type 1 in June after a stay in the hospital for DKA. As you may know, the military does not allow for type 1 diabetics especially in flying positions.

I, of course, have been very intensively looking at every available path to stay a flyer or at the very least in the military. In my newly found free time (I'm essentially a random tasker at this point) I have been intensively exercising, eating well, researching and gernerally going nuts trying to set myself up as best I can for the medical board to evaluate. I took myself off insulin in mid August after I determined I was stable enough to do so. My numbers have been relatively low ever since, averaging 70-90 during most of the day and up to 160 after meals.

I met with the flight doc the other day to discuss possible courses of action and what I should expect. He said when he sends up my package to the MEB, he must include a his official reccomendation. Now he personally knows of a case in which a pilot in the exact same situation as me with type 1 was put back in the cockpit due to the fact that he did not require insulin. Now I know everyone says all type 1 diabetics will eventually need insulin… However, this particular pilot made it safely 3 years without insulin. So essentially there is a precedent that if there is no insulin dependency, then there is no reason to keep a pilot out of the cockpit.

Now I know 3 years does not make a career, but my overall goal, since I am a brand new pilot is to use this time and milk it as much as possible for experience and flying hours since there is a chance that the FAA may soon allow type 1 diabetics to fly as airline pilots.

I will update this discussion as I go through the process because when I was diagnosed, I could find almost no information on the subject of MEBs or diabetics already in the military at the time of diagnosis. If anyone out there has experience with this, as always, any help is appreciated.


21 replies

Type1D 2015-06-01 22:24:35 -0500 Report

Thanks for your help. I guess having my gate months complete helps, and I could have taken a 15 year retirement last year. I just don't want to get stuck losing my retirement. My commander is working with the flight doc to not start the meb until I have a few months to get my a1c down, so hopefully that helps.

Type1D 2015-06-01 20:14:24 -0500 Report

Navigator here. Diagnosed 1.5 months ago with an 11.5 A1C. MEB should be starting shortly. I have 16 years in. Any advice?

cowman12 2015-06-01 22:19:08 -0500 Report

I can't imagine that your experience is going to be much different from mine. I am assuming that T1 disqualifies you as a nav so I would expect them to retire you. I know you are pretty close to 20, but the disability retirement is pretty much the same if not better than a 20 year retirement depending on your rating. In the beginning, I planned to fight the MEB all the way through but there was nothing I could do. If you want to stall like I did, let your PEBLO know you want to fight it. If you have a good PEBLO they will help you out. In my case I had to find her because I went months without hearing anything. My circumstance may be different than yours since I was right out of UPT and maybe they would rather get rid of a new Lt than lose an experienced nav. If you have any more questions let me know. Good luck!

Piratefan4 2015-05-18 09:34:00 -0500 Report

Hi, just read you story and had to comment. I am in the air force and was a year into CSO/ NAV school when I was diagnosed type 1 and have now been sitting on MED hold for a year. My case is up at the MEB and should be going to the PEB soon. What was the time line like for you in all of this? I saw you said you got rated 60%! That's amazing from everything that I have been reading, hope the same works out for me.

I am completely insulin dependent and take 4 injections a day, any help in the process would be awesome! Thanks for posting!

cowman12 2015-05-18 12:01:11 -0500 Report

And their justification for the 60% was I think because my doctor noted possible future complications from my initial onset since I was pretty bad when I went to the hospital. BTW are you academy?" I have to ask haha

cowman12 2015-05-18 11:57:34 -0500 Report

Sorry man I know that sucks, especially if you were so close to finishing. If you were diagnosed a year ago, you theoretically should be ahead of me. I was diagnosed in June of last year. I was pulled from C130 training immediately and they started the MEB. The PEB began in November. If you still haven't gotten your results from the VA and the PEB, I got mine about 3 months after my VA screenings. I went through all the VA stuff in late November and got my results in mid February with the 60% disability from the VA and the Air Force with a recommendation of permanent disability retirement. At that point you will have 10 days the either accept their findings or challenge it. I chose to challenge, but was later told it wouldn't help and I may actually lose some benefits. After I dropped the appeal, they gave me a retirement date only 2 weeks later. I am being medically retired on 28 June. Hope this helps. Let me know how it goes.

Piratefan4 2015-05-18 12:13:23 -0500 Report

I was diagnosed after losing 40 pounds and came into the ER with A1C of 15.7, currently have it down to 5.7. They waited 6 months for me to stabilize and then started the process, as of last week my package was at the MEB and waiting to go to the PEB. I am on 4 shots insulin and currently "stable" so hopefully will be out in the next few weeks but I am not holding my breath. Of course waiting at the beach has its benefits, but my wife is ready to move on.

I am not an academy grad haha but know several, visited while in Pueblo but that was enough.

cowman12 2015-05-18 12:44:58 -0500 Report

I know that feel. I have to warn you though, job searching is a major pain in the b hole once you get there. Most government jobs will require you to send them a DD214 which you wont get until you retire. There is a way around that but even then you at least need retirement orders. And its really hard to write a resume when all you have done since pilot training is be a glorified errand boy. That has been the hardest part for me since I retire in a month and haven't been hired yet. My wife and I are both antsy since we have no idea where we will be going or what we will be doing 2 months from now. If you can, go to a TAPS class at AFRC. Assume you will be medically retired and go from there. It's a weeklong class explaining everything from VA and retirement benefits to resume writing and more. It would have been much more helpful for me if I knew what was going to happen to me but when I went I had no idea if I was going to be retained, separated, retired, or go to grad school, or find a job, or anything. So if you haven't yet.. do that

cowman12 2015-05-11 09:25:48 -0500 Report

Final update (maybe): I have been given a retirement date at the end of June. I chose to drop the appeal after being told it may be detrimental to my retirement status. I am married and currently looking for a follow on job so I can't risk losing what I have. I hope anyone finding themselves in this process will contact me for any questions. This process was far from clear and I found myself surprised by new information entirely too many times. Good luck all, see you on the civilian side.

rae13 2015-05-04 05:49:10 -0500 Report

I just met with a major in the medical unit and he said that I will begin the process of early retirement and will have no benefits because type 1 is only technical.

cowman12 2015-05-11 09:18:27 -0500 Report

False. Type 1 is treated no differently that anything else. If you get a 30% rating or higher, you will receive all benefits

cowman12 2015-05-11 09:21:38 -0500 Report

Also, get used to getting tons of misleading information until you get your final result. Just FYI because I was told so many different versions of how this would play out.

cowman12 2015-02-23 20:57:51 -0600 Report

Ok, it has been a while since I have updated anything. In November, I went through all the VA medical screenings while my PEB was processing. I have continued to maintain excellent physical condition and have continued to take insulin. Its seems like sometimes my insulin requirements change so I guess my pancreas still sputters on and off every now and then. I did not hear anything back until last week. I was given a 60% disability rating from the VA and 60% from the PEB with the recommendation that I be medically retired. Neither the PEBLO nor I have ever heard of such a high rating for type 1 so our best guess was that it was due to my hospitalization for DKA and brushes with hypoglycemia. Either way it was far more than I thought it would be especially since it was purely for the type 1 and nothing else. This week I am going to sign the papers and opt to challenge the case. I'm not going to appeal the VA rating, but I am going to go to San Antonio to stand before a board and plead my case. I know the outlook is not in my favor but I have to say what I need to say and at least try to stay a flyer. What are they going to do? Kick me out? Anyway, this is all I have so far. The whole point of documenting this is so that if this happens to anyone else, hopefully they will find this and have an idea of what to expect. I will keep you posted of the results.

cowman12 2014-11-18 13:42:28 -0600 Report

Update: I saw the rep who is handling my paperwork for the MEB a couple of weeks ago. Her job is to fill me in on the process and explain my possible courses of action. I was not happy with the fact that I had to track this person down myself and was offered no help from her department. When I finally found her, she quickly scheduled a meeting in which she explained to me that I have no chance of staying in the military. I cannot even change jobs to something non-pilot like weather officer which I am clearly qualified for. She explained that had I already been anything besides a pilot in the AF I would most likely be able to stay in the military. Once the MEB process starts there is no changing jobs. You either stay in your career field or the you get a medical discharge. Essentially what I learned was that there is no common sense solution to this. Had I washed out of (failed) Pilot Training before the diabetes type 1 onset, I would have been reclassed as a weather officer and would not be having a problem now. However, I completed the training and now will be discharged because the beaurocratic process does not allow for this common sense solution. During the process, you cannot use your own leave whenever you want.. It must be approved by this rep. Already bought a plane ticket? Too bad, you just got scheduled for a VA appointment the day after Thanksgiving. This happened and I made her reschedule it (they ordinarily do not allow this but I was beyond pissed at that point) since she did not feel the need to tell me this before I bought the $500 ticket. Essentially I have had to rapidly switch gears and apply to grad schools and look for meteorology jobs since I do not know when I will be discharged. Also, I was off insulin between August and until 2 weeks ago. During that time even as a type 1 I was able to manage the surar with strict diet and a ton of exercise. However, my sugar staarted creeping higher and higher for no reason so now I am back to taking small amounts every day to offset this.

TL;DR: If you are going through an MEB do not expect anyone to help you. Track down the PEBLO (the MEB rep on base) and make them explain everything to you before they start the MEB since they will wait until it is too late to give you any useful information.

cowman12 2014-10-16 10:10:01 -0500 Report

Update: Just got back my A1c results.. Not what I was hoping for. I ended up with a 6.1 which I know is not bad but still not in the 5-ish range I was hoping for. Should help that I have been off insulin for almost 2 months though. My med board package is going to be sent in on 4 November and will contain everything I have that will help my case including the doctor's recommendation that I stay on flying status, my excellent PT scores (I took the PT test in late August and did the best I have ever done) and my relatively low A1c. I've done that best I can for now so I know there's nothing else I could have done. I'll keep updating as things happen.

GabbyPA 2014-10-10 06:17:01 -0500 Report

Thank you for your service and your desire to remain there and work so hard to keep your self healthy enough to continue to serve. People like you are what make our military exceptional.

I am confused though. I don't know how a type 1 cannot use insulin. As a type 1 your body doesn't produce insulin for any number of reasons. Are you sure you are not type 2? Or even type 1.5? For the sake of your career, you may want to have a C-peptide test done or seek a second opinion. That will make it definitive if you have type 1 or type 2. It is not unusual to be misdiagnosed, though I will be honest, many with type 1 are first diagnosed with type 2.

Type 2 diabetes may lead to insulin dependance, but usually doesn't start there and exercise and diet can maintain a type 2 often for many years without meds.

cowman12 2014-10-10 10:01:00 -0500 Report

Its for sure type 1 according to the endo. It was rapid onset DKA back in June. The GAD test showed really high levels of antibodies, but interestingly enough, the C peptide test showed that my pancreatic function ad actually increased over the last few months. She says its an extended honeymoon period, but I know of two pilots who went through this. One went off insulin for a year while the board was ongoing but was not retained. The other kept flying for another 3 years after the board. When I say I've been dieting and exercising like crazy I mean it. I was in good shape before my hospital stay and I'm now by far in the best shape of my life. I'm kind of hard-headed when it comes to my flying career haha. I's not something that any pilot, especially military will easily let go of without a fight.

cowman12 2014-10-10 10:02:38 -0500 Report

Seems to me the length of the honeymoon period depends on a lot of things but one variable may be just how bad you want it

Just Joyce
Just Joyce 2014-10-09 13:12:41 -0500 Report

No experience with that. However, diabetes can be different for each person. What happened with one pilot may not happen for you. Thanks for your service to the country.

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