Expert: Cynthia Bedell - 9/10/2008

Question
QUESTION: Hello,

  I am a U.S. Navy Diver. I recently suffered at perilymph fistula while on a
deployment to South East Asia. I did it during a navy dive while on active duty.  
So here is my question. It has been 2 months since this accident, I still suffer
from tinnitus, moderate hearing loss, dizziness, vertigo, migraine head aches (
I spent 3 days in the hospital 8 months before this deployment for chronic migraine head aches), trouble sleeping, the tinnitus wakes me up during the
night, i can't lift anything heavy I can't exert myself, I can't work out, I really
can't do anything. As of now I am disqualified from diving duty, so no diving
until BUMEDs clears me. The over all question is what option do I have. I don't
want to continue diving because the chances of this happening again while
diving are very likely, and if this happens again i will more than likely suffer permanent hearing loss, and possibly more. Is it my option to go for a medical
review board and get medically discharged/retired. I came into the navy as a
navy diver so sending me to the regular navy more than likely will not happen,
due to my symptoms being on a ship or anything else just doesn't seem
logical. No one else really has an answer for me because they want me to heal
before they start doing paper work. my master-diver on the other hand is
preparing me for a medical discharge, because in the milpers manual perilymph fistula is right there in black and white as disqualifying from diving
duty. thank you for you time.

ANSWER: Dear Scotty --

The Navy is authorized to offer you a position that you are physically capable of handling, either temporarily while you recover, or as a permanent change of occupational specialty.  I always recommend that military members take this offer, and a limited duty profile in order to heal.

If you do not heal well enough to continue service in the Navy, the effort you made in rehabilitation makes you more eligible for medical retirement rather than medical separation.  If you do heal well enough, you can apply for other Navy jobs that you might enjoy since diving is too risky for you.

Your master diver should not be the one preparing medical discharge paperwork on you.  Only a commanding officer, and a medical board can make that determination.  The master diver may recommend to the commander that you be transferred because you are no longer fit for diving duty, or he can recommend to the commander that you be assigned to a local job that does not require diving, but requires full understanding of dive equipment, and planning.  

However, you should be certain that you have a temporary limited duty profile on record.  You do not want anyone trying to make you do any jobs that will worsen your condition.  You should also be afforded time to visit the doctors and conduct whatever rehabilitative training is applicable.

Please write back, and let me know, if you are on your first enlistment or if you have re-enlisted at least once.  Also let me know how much time in  service you have.  That will help me advise you on medical separation versus medical retirement.

I hope you are able to heal.  Thank you for your service.

---------- FOLLOW-UP ----------

QUESTION: As of right now, I am on a limited duty, but I am still working at my dive command.
I have almost 3 yrs of service. I know the stipulation about 8 yrs of service or in the
line of duty to get full retirement, or something along those lines. I did this during
a diving operation in a combat zone. the thing with a perilymph fistula is that it
will never heal all the way, and I will always have that hole from my inner to middle
ear. so with that said, my question is do I have a choice to take a waiver and
continue diving (which I can do and this is what my diving medical officer wants to
do also) or can i deny the wavier myself and seek a medical review board?  

Answer
Dear Scotty --

You do not have to apply for or accept a medical condition waiver when continued service is likely to result in further injury.  The commander is still the one that determines a medical review board is required.  You are responsible to continue to do your job within the limitations of your profile.  If you cannot do what is expected of you, you must have the doctor write a more prohibitive profile.

You will need a record of the fact that your injury was in line of duty.  I know that in line of duty is clear right now, but as time passes it will be harder to prove.  

A medical retirement at your rank and years of service will be a very small monthly payment.  You will probably not get a very high disability rating.  The major benefit a retirement will make to you is that you will maintain your Veteran's benefits, and your health care will be covered by VA.  You will also be eligible for VA job training, and any rehabilitative services they have.   

Please write back, if you have any issues during this process.  It can take a long time, as commanders are expected to allow their charges to heal before making a determination to start the medical board process.  If there is no way to repair your ear, your medical officer should be issuing you a permanent limited duty profile.  A permanent profile usually kick-starts the medical board process.

Good luck to you.