Navigating the Medical Evaluation Board

A few months into pilot training, my husband was diagnosed with a pretty serious medical condition. I started dating my husband during his time at the Air Force Academy, so it seemed like a given that he would spend the next several years of our lives as an active-duty member of the Air Force. I didn’t know anything about medical separation or retirement until he was notified that he was going to be going through it. Over the course of the process, we were told a lot of things that weren’t true. In the beginning, we were told that there was no way the military would get rid of my husband since he was a recent Academy grad, and that maybe they wouldn’t even waste their time going through the Medical Evaluation Board (MEB) process. He was even told that there was a chance that he could still be a pilot. As time went on, it became pretty frustrating to feel like we had to fact-check everything we were told. My husband was fully committed to being retained in order to reclassify into a different AFSC, but he was eventually placed on the Temporary Disability Retirement List. 

This article won’t cover every single piece of information related to Med boards and medical discharges, but I hope it will help someone else have a bit of a fuller picture. To anyone going through the same thing, I am truly so sorry you’re experiencing this. It’s such a lonely thing to experience in my opinion. It’s hard enough to deal with a sudden diagnosis of a significant medical condition, but to also have to deal with the loss of a military career is an entirely different level. Remember to give your spouse and yourself grace in dealing with such a difficult situation.

What is MEB and what does it mean?

When a service member is diagnosed with a medical condition that prevents them from doing their job or that causes them to no longer meet the medical standards of the military, they will be referred to a Medical Evaluation Board (MEB). It is triggered automatically once a diagnosis is given that doesn’t fit the medical standards. This site was one of the few clear resources I was able to find when I started searching for information.

There are four possible outcomes:

1. Seperation

If the disability rating is not more than 30% and the service member does not have 20 years of service, they will be separated. This means they will be given a single lump sum severance payment that is calculated based on years of service. I believe it is two months of pay for each year of service.

2. Retirement

If the disability rating is higher than 30% OR the service member has more than 20 years of service they will be retired. This is basically the same as retirement after 20 years of service: healthcare for the service member and dependents, base access, etc.

3. TDRL (Temporary Disability Retirement List)

If the condition could improve or has not stabilized, the service member can be placed on the Temporary Disability Retirement List. While on this list, it is as though the service member is retired. You will be re-evaluated between one year and 18 months after you were placed on the TDRL. You can be returned to duty, separated or retired.

4. Return to Duty

the most self-explanatory, you are returned to duty in the military. This can be with or without limitations. You also potentially will have to be re-assigned to a new career field if you can no longer perform the duties of your original job. This is what my husband was hoping for, as he could no longer be a pilot. 

Any level of service-connected disability allows you to retain your commissary and exchange access, the disqualifying condition will be covered by VA healthcare, and you will be given an honorable discharge.

What does the process look like?

• MEB: The first decision is made in the Medical Evaluation Board. The two outcomes at this stage are: return to duty or referral to the Physical Evaluation Board.

• PEB: The next stage of the process. This is the stage where the determination is made about whether or not to retire, separate or return to duty. My husband received TDRL at 80% disability. He appealed the decision as he wanted to be returned to duty and it moved to a Formal Physical Evaluation Board.

• FPEB: The Formal Physical Evaluation Board is the last step in the process. This decision was again TDRL at 80%. Had my husband had the support of his Major Command, the case would have moved to the Secretary of the Air Force.

• After the initial decision of the MEB, my husband began the appeal process to try and be returned to duty. His degree would have made him a good fit in a critically manned AFSC, so he wanted to be re-assigned as he could no longer be a pilot. His commander was very supportive and helpful during this process. Part of this was writing a letter asking for the support of his Major Command. The letter passed all the way up the chain of command with multiple people voicing their support before the top general denied it. If he had approved it and the final decision of the medical board had been unfit for duty, the case would have passed to the Secretary of the Air Force. 

• For us, the process took 6 months from the onset of his condition to the final decision of the MEB. If he hadn’t continued appealing, it would have been about 3 or 4 months. After the onset, it was about 2 weeks waiting for a diagnosis and then another month before he was officially referred to a medical board. We spent most of the next few months waiting for next steps. It was still during the height of COVID, so we had a mix of in-person and virtual meetings. The furthest we had to travel was about 2 hours. 

What does that mean for the future of your careers?

The specifics of my husband’s medical condition have made it difficult for me, as a spouse to find a job. I had also been unemployed for an extended period of time before this because of our frequent moves which didn’t help. We had been planning on the Air Force controlling the next 10 years of our lives and now we only had a few months to sort out where to live and what to do. Thankfully, my husband was able to find a job relatively quickly, but it was not in a location that was ideal for our situation. Now that we’ve regained our footing a bit we are beginning the process of relocating (again) somewhere more suitable. TDRL makes this a bit more difficult since his benefits could change once the re-evaluation decision is made. Although it is for different reasons, finding a job has been about as difficult as it was when my husband was active duty.

Helpful tips and tricks:

Since my husband had only been in the Air Force for about a year before he was med boarded, the hardest part for him was dealing with the loss of the career he spent 4 years preparing for. He hadn’t really gotten a chance to enjoy his hard work. In order to best support him, I had to learn when to let him vent and be angry and upset, and when to stop him from spiraling too much. We had several people, including medical staff, tell us that he was lucky to be getting out of the military so early. Personally, this was not what we wanted to hear. My husband was committed to doing everything he could to be returned to duty, so I tried my best to do anything I could to help. 

We also came up with the rule that after a certain time each day, we stopped doing anything related to the medical board. For us it was 6 pm. Initially, we would spend all day researching and stressing out about how everything was going to play out. Sometimes it felt like we were wasting time and that our entire future was on the line, but it really helped make space for things that brought us joy. In order to ensure that we had enough time to wind down each night, we made sure to stop any waiver research, zillow house hunting or job searches by the 6 o’clock deadline. Once we had gotten used to this, it made the time we spent doing things related to his case feel more productive and the time we spent after 6 more relaxing. 

While my husband had been in pilot training, I did most of the house work since I was unemployed and he was gone for 12 hours a day.  After his diagnosis, I felt like I had to continue to do absolutely everything myself since the doctors told my husband that stress made his condition worse. I focused all my energy on figuring out our next steps in the process while also trying to sort out where we would move if he was not retained. This was not sustainable, especially once the initial shock of the situation wore off. My biggest tip would be to take a little bit of time for yourself each day. Having even just a few minutes to myself really helped me process everything without having to worry about my husband. You can’t pour from an empty cup! There was no way that I could have been any help to my husband in the long run if I let myself stay in constant crisis mode. Obviously, there were things I needed to do that he couldn’t, but I also made sure to tell him when I needed a bit more help.

As much as my husband wanted to stay in the Air Force, now that the process is over, there are things we get to enjoy about civilian life that we thought we’d have to wait 10 years for. We can go on vacation whenever and wherever we want, no approvals needed! We also know that we don’t have to move again if we don’t want to. During the process, it was difficult to look forward to civilian life as it was not the outcome we wanted, but now that we are on the other side we are trying to be grateful for the good things instead of focusing on the disappointments. That being said, I am a big proponent of really letting yourself feel that disappointment in order to work through it.