Welcome back, dear BogiDope readers, for the final installment in our series about VA Disability. Here’s a quick review of what we’ve covered so far:
- In Part 1, we noted that VA Disability is a standard part of the military service contract each of us signs. We didn’t write that contract or decide on the terms…the US Government did. The Government planned on paying you VA Disability because you are an expendable resource to it. There’s no moral superiority in passing up on a VA Disability Rating.
- In Part 2, we focused on the process for obtaining the Class 1 FAA medical certificate needed to work as an airline pilot. In the vast majority of cases, having a VA Disability Rating shouldn’t affect your ability to get an FAA medical at all. (Just don’t lie to the FAA about anything related to your health!) There are a few disqualifying conditions, but some of those fall under the standard of “There’s a waiver for everything.” If you’re not sure whether a given condition will cause you trouble later in life, there are doctors who can help you.
- In Part 3, we covered the process of applying for a VA Disability Rating.
Now that we have all of these basic pieces in place, it’s time to formulate a strategy for you to use throughout your military career. If you do this right, it will be quick and easy to get the VA Disability Rating guaranteed by your contract after you leave full-time military service. If not, you’ll essentially be taking food from your kids’ mouths. That would make you a bad parent, but we don’t want to be bad parents, so we’re going to choose to do better. Here’s how:
Table of Contents
- Documentation – Early and Often!
- Keep the FAA In Mind
- Are You a Doctor?
- Back to Perspective
- Peer and Command Pressure
Documentation – Early and Often!
As we covered in Part 3, the VA looks for chronic conditions or conditions that continue to affect you over a long period of time. Those conditions can be things that started during your military service. However, they can also be conditions you had before you joined the military, that got worse while you were serving.
The easiest and most important part of proving the existence of these conditions to the VA is making sure they appear in your military medical records. This means that you need to tell your flight doc about any condition you notice. Do not wait until your annual flight physical. Make an appointment or skip a morning of email checking to go to sick call and get documented!
In my experience, most flight docs are happy to listen to our concerns. However, their primary focus is treating us and keeping us flying. (As it should be, right?) He or she may not be predisposed to write a lot of notes about seemingly small issues if 800 mg of Motrin and some water can get you back on the flight line ASAP.
That said, if you explain what you’re trying to accomplish they seem to be pretty good about documenting things like you want them to. This isn’t you complaining or whining. You can be upfront and professional about it.
“Hey doc, I’ve noticed that sitting in my aircraft seat on these 7-hour missions leaves my legs and back sore. Over time, I feel like I’m losing some range of motion. Will you please make specific notes about that in my record?”
There are a few docs who will be resistant to this, but most will be more than glad to help.
Most doctors choose that profession because they’re interested in making lives better by treating sickness and injury. Few docs will be happy to stop at documentation; they’ll want to prescribe treatment or refer you to a specialist who can. This is good!
Imagine you’re the VA doc trying to determine whether I qualify for a VA Disability Rating. If you see back issues mentioned here and there throughout my medical record, it might be enough. However, if you see that I got referred to an orthopedic specialist and he or she concurred that I have back issues, it’s an even easier decision.
Don’t pass up the opportunity to get a condition treated. You’re not doing yourself any favors in the long-term living with an actual sickness or injury in hopes of earning a few bucks and getting free license plates later in life.
In fact, you’ll have to ask for that treatment in many cases. There are plenty of those Motrin and water docs who are constantly behind schedule and don’t feel obligated to give you more unless you ask for it. However, if you ask, they’ll definitely get you what you need. Getting a referral or a more involved treatment could improve your Quality of Life in the short term, and it’ll help with documenting long-term conditions for the VA. It’s a win/win for you.
While you should absolutely document and chase down any conditions that you have, you also need to make sure that you continue to document the progress of each given condition over time.
Every time you identify a health complaint, you need to make a mental (or physical) note to evaluate health in respect to that complaint every time you visit the doctor. At the very least, give your flight doc an update on each condition at your annual flight physical. However, if you experience any sickness, pain, or impact to your ability to work or live life normally, you should make an appointment to mention it to the doc ASAP.
Let’s again put ourselves in the VA doc’s shoes. If you’re looking through my medical record and you see that I’ve complained about my allergies being worse at several (or all) of my military assignments, it’s pretty easy to conclude that the Air Force assignment process increased the impact of this condition.
When looking through the VA’s individual disability schedules, I’ve noticed that the difference between a rating of “mild” versus “moderate” for some conditions is frequently wording along the lines of “affecting the member one time per year” versus “affecting the member two – three times per year.” To me, this says that if I have an ongoing condition, like a bad knee from all the running that the Air Force seems to love lately, I need to make sure that I mention my knee pain and weakness to my doc at least once per year. However, if I experience issues with it more often, getting to the doc to get that reported a few times a year is even better.
Put yourself into the shoes of our future VA doc. If I were looking through a medical record, I’d want to see consistent documentation for any given condition. It’d make my determination even easier if the record showed treatment, possibly from a specialist, as part of that recurring documentation. Take the time to get this done. Maybe it’s even an excuse to get out of your next staff meeting.
Keep the FAA In Mind
We spent an entire part of this series considering the FAA’s position on all of this. When you compare the criteria the FAA has set for a Class 1 medical certificate against the criteria for VA Disability ratings, I see a lot that doesn’t even remotely overlap. As long as you’re physically capable of flying an airplane, I feel like few of the items for which you’re likely to get a VA Disability Rating will impact your ability to get an FAA medical.
Sure, there are a few disqualifying conditions on the FAA’s list, and some are things that military pilots could encounter. Like I said in Part 2, your first step is taking care of yourself and treating things while they’re small. Don’t let slightly high cholesterol or blood pressure turn into one of the cardiovascular issues on the FAA’s no-go list.
If, at any point during your military career, you find yourself facing a condition that you think might jeopardize your future FAA medical, talk to someone about it! Many Aviation Medical Examiners are happy to consult with you on an informal basis. The FAA even has a website for finding AMEs near you. (I recommend you talk to an AME over a military flight doc. They’re more familiar with the FAA side of things and can give you better advice.)
If you can’t find an AME willing to just talk, there are companies that specialize in doing this for a fee. In Part 2 I recommended Aviation Medicine Advisory Service (AMAS), mostly because I know the owner personally and think he’s a fantastic pilot, doctor, and overall human being. You don’t have to limit yourself though. A quick search will find you other options if you want.
Don’t be scared off when these services ask you to pay a fee. I quantified the value of a major airline career in my book, and it’s at least $8,000,000 in most cases. You’re far better off paying a few hundred bucks now to make sure you can protect that career in the long term.
Are You a Doctor?
In the past, aviation has been dominated by a hyper-machoism that did more harm than good. In that culture, a pilot may have been ridiculed for stopping by the clinic to get a little shoulder pain documented. This has caused us to think that it’s complaining if we go to the doctor for “little” things. Unless you’re “coughing up a lung” you shouldn’t go to the doc at all.
I’m far from perfect here. My 7th deployment happened to be my 1st and only deployment to Africa. As much as it sucks to be away from family, I’ve always loved deployed living. The flying is plentiful and engaging, the squadron camaraderie is fantastic, and you get more free time than you’ll ever have at home. Even though Djibouti is truly one of the armpits of the Earth, I was happy to be there.
And then, after just a couple days, I swung down from my top bunk and landed on the wheel of my roommate’s suitcase that happened to be sticking out from under the bed. I’m pretty sure I broke the middle toe on my left foot. I say “pretty sure” because I didn’t go to the flight doc about it. It was, however, swollen, painful to touch, and is crooked to this day. The flight doc would have undoubtedly grounded me, costing me hundreds of combat hours. Worse, if I hadn’t been able to fly they might have just sent me home. I would have felt ashamed to go home for something as stupid as a little broken toe.
I taped my toe to the one next to it, and found that I could walk just fine. I even went for a short run to prove to myself that I could effectively evade bad guys if I happened to crash in [Undisclosed Location].
Please learn from my mistakes and know that my decision was stupid!
I later learned that flying with broken bones is extremely dangerous because you’re at increased risk of getting a blood clot. Although I told myself that I was fine to hike long distances with my injury, it could have easily caused a problem if we’d been in a no-kidding evasion situation.
In the context of today’s discussion, by failing to report my injury to the flight doc I failed to get it documented for my VA Disability claim later in life. This was absolutely a service-related injury that could be earning my family at least $1,000 per year. However, since there is zero documentation of the injury anywhere in my medical records, I don’t think I’ll ever get a dime for it. Don’t be like me!
I think this machoism culture is slowly dying out, but please do your part to help me kill it off for good!
Sure, there are a lot of complaints that might seem small to you right now, but do you know how those issues will affect you in the long term? Here’s another way of phrasing this:
Are you a doctor?
I assert that the average pilot lacks the systems knowledge to determine the long-term impact of any given sickness or injury on the human body. What might seem like a little back pain now could end up a fused vertebrae in the future. That’ll involve pain, surgery, and limited mobility for the rest of your life.
Remember, the US Government determined its VA Disability Ratings using a treasure trove of long-term data. They have a very good idea of how that little back pain is going to affect you in the future. They’ve already budgeted the funds to pay for your treatment. You’re not whining or complaining by stopping by to get it documented. You’re just making sure you accomplish the document required by the contract you signed with the government years ago.
Don’t assume that just because something seems small now it won’t become a bigger issue later in life. You’re not a doctor, so you have no basis for making that assumption. Also, don’t let an assumed perception from your friends impact your decisions. Go see the doc, for anything that could have any impact later in life, and then continue to get it documented over time!
Back to Perspective
Before we wrap this up, I want us to again consider the perspective from which we’re approaching VA Disability.
It’ll require effort, time, and attention on your part to make sure you keep up with the documentation I’m suggesting here. With everything else going on in your life, it’ll be easy to forget or just say, “Well, this issue really isn’t that bad. I’ll address it later.” Please don’t fall into that trap.
It’ll also be easy to feel like you’re whining about stuff that doesn’t matter in the long run. Military flight docs are busy and we don’t want to waste their time…if we can even get an appointment in the first place. We use all sorts of mindless catch phrases to convince ourselves that “pain is weakness leaving the body.” We don’t want to be seen as weak complainers.
I’ll remind you once again, that although this is a foreign concept for most pilots:
It’s not all about you.
Your family sacrifices a lot to enable your military service. (We haven’t covered it here, but there are some dependent benefits associated with VA Disability. Look them up here.) In the long term, your spouse and/or children may have to deal with the long-term health impacts of your military service. How many times have you seen a veteran with hearing aids, glasses, an oxygen bottle, a wheelchair, etc.?
We don’t like to think about these things happening to us, but they can. Unfortunately, in many cases they will. How is your family going to pay for all that after you stop working?
VA Disability payments aren’t hush money or an entitlement program. They’re the best way the US Government can think of to provide for your long-term service-connected medical issues. If you fail to obtain the VA Disability Rating that your health issues warrant, you’re just increasing the long-term financial burden that your spouse and/or kids will have to bear. Don’t do that to them.
I regret not taking my VA Disability process more seriously the first time around. I was busy getting started in a new job, and splitting my time between Europe and the US, and I told myself that I was just too busy.
My laziness has cost my wife and children benefits that the US Government planned and budgeted to give anyway. It’s reduced the amount of money they’ll have to cover my health issues in the future. That makes me a bad husband and a bad father. (Yes, writing this has prompted me to go back through this process and get it right this time.)
Don’t be like me. Take this process seriously. If you’re still serving full-time, take advantage of the opportunity to document everything you can. Continue to document those conditions over time so that the VA doc will have a clear-cut way to grant you the VA Disability Rating you deserve.
You’re not whining, and you’re not being selfish. You’re taking care of your family.
Peer and Command Pressure
I think a lot of pilots find themselves in my position at the end of their Active Duty service. Throughout our careers, VA Disability was discussed in general terms, but rarely in the specifics I’ve covered in this series. Without understanding those specifics, we don’t know what to address with our doctors, or realize that this documentation has to be consistent.
Although I think the military overall as an organization is pretty terrible about taking care of its people, I felt that most of my squadron commanders cared about me on an individual level. I had a few go out of their way to help me and my family and I’m grateful for that. However, these commanders are extremely busy. They’re so caught up with close-range threats that it’s tough for them to see the long-range ones. There are probably a few commanders who aren’t as in the dark about the VA Disability process and the rest of us, but they’re too busy to emphasize it with their people.
If you are or will be a military commander, please take the time to explain VA Disability to your people!
Help them understand what and how they need to document with their doctors, make sure they have the time to get to those doctor’s appointments, and then follow up to make sure they get it done. (Please don’t think of me selfish for suggesting that this article series should be mandatory reading for every pilot in the US military.)
We can also all make a difference on a peer-to-peer level. Now that you understand this process, at least better than before, spread the word to your brothers and sisters. Have them read this series. Tell them how you’ve stated ensuring good, meaningful documentation of even your most minor maladies. (Remember, you’re not a doctor. You don’t know what could end up being a big deal later in life!)
Remind your compadres that none of you are doing this to mooch off some entitlement program. VA Disability is part of the contract that you signed with the US Government when you decided to enter military service. They fully intended, from day one, to chew you up and spit you out. They budgeted and set up a gigantic system to compensate you for the damage they’re intentionally doing to your body. Chances are, even if you receive VA Disability Ratings for every bit of that damage, it still won’t be a fair exchange for the long-term effects you’re going to endure later in life.
The US Government set up the VA Disability system for a reason. The government views you as an expendable resource, and has quantified the wear and tear they’re likely to put on you. When you signed your military service contract, you agreed to a compensation package that included these VA Disability benefits.
Taking advantage of these benefits should not have any influence on your airline career, in most cases. For the few cases where it might, there are individual doctors and services that will consult with you and help find a way forward. Don’t pass up on VA Disability benefits because you’re worried about getting an FAA medical. The only people who get in big trouble here are the ones who lie about things on their medical certificate application.
Obtaining a VA Disability Rating is an arduous process, but it’s worth pursuing. You can make this process much easier and more effective for yourself with good documentation during your military career. Don’t hesitate to have your doctor document any sickness or injury you encounter. Something that may seem small now could become far worse over time. Don’t hesitate to get treatment now, including referrals to specialists. This actually improves your documentation for the VA. Be sure to revisit the status of your past conditions every time you go to the doctor. Recurring documentation is very important for the VA Disability process.
Remember that this whole topic isn’t actually about you. It’s about honoring the terms of a contract that the US Government wrote without any input from you. It’s about you providing a way for your family to pay for health issues you’re likely to encounter later in life. If you’re a military commander, make sure your people understand these points.
Obtaining a VA Disability Rating is an important way for you to take care of your family. I wish you all healthy and safe flying, but if something does happen to you, don’t be afraid to get it documented so you can report it to the VA later in life.
The veterans in our feature image are from: https://www.dvidshub.net/image/4452895/veterans.
Our approachable flight surgeon is from: https://www.dvidshub.net/image/3360629/fighting-multiple-fights-life-flight-surgeon.
The flight doc with the tongue depressor is from: https://www.dvidshub.net/image/3088909/flight-surgeon-conducts-exam.
The post-deployment Air Force family pictures is from: https://www.dvidshub.net/image/6132591/family-photo.
We borrowed the “I’m here to help” photo from Sporty’s: https://studentpilotnews.com/wp-content/blogs.dir/10/files/2015/02/FAA-Ramp-Check.jpg.
Commander’s Call: https://www.dvidshub.net/image/4185328/february-2018-commanders-call.