Medical board

My first (and only) patient of the day was already in when I arrived at clinic from morning report, getting his skin tests. He was a bit unusual in that he wasn't a new patient; he had been seen by COL Yang about a year and a half ago, before he was deployed to Iraq. At that point, he was being evaluated for his deployability, due to his history of allergies diagnosed and treated by a civilian allergist since he was a teenager. Needless to say, COL Yang determined him deployable (ie, his allergies wouldn't be enough of a problem to prevent him from doing his job in Iraq).

Well, unfortunately for the patient, he got in a motorcycle accident while he was on R&R nine months into his deployment, landing him in the hospital and rehab back in Hawaii. He messed up his shoulder during the accident, and there wasn't much a motor transport operator (88M for those of you familiar with Army MOS) could do, so he's been spending most of the last year on a medical profile. When it became obvious that he wouldn't be able to do his job again, he was referred to the medical board for a medical discharge. One thing that happens on medical board is they go through your medical record (obviously) and go over everything they've seen a specialist for. So, he had to go back to COL Yang to be evaluated for his allergies again. Guess what? We discovered he still has allergies (surprise, surprise). So we refilled his prescriptions, recommended he get hypoallergenic mattress covers and pillows, and determined that while he does have allergies, it wouldn't prevent him from retention (staying in the Army), which gave him a 10% disability with the VA (from what I figure, that means they have a condition that requires specialty care, but doesn't really cause disability). Conditions are summative; if someone has five conditions that each cause 10% disability, he is considered to be 50% disabled. In the case of this patient, his shoulder/back injury from the motorcycle gives him more than enough to get his medical discharge and to get full medical care from military facilities for life.

So, my one case today was yet another example of government red tape--a man who quite obviously can't do his job requiring him to lift 200+ pounds of equipment being evaluated for the dust mite allergy that causes him to sneeze.