# Officially Brocken



## CuongNhuka (Oct 18, 2009)

I rant of a medical nature to follow:

So, starting a year ago (remember this factoid) my knee has been killing me off and on. It started because I kept falling on the 'hikes' at Boot Camp and MCT. A hike, by the way, is when you go and down steep 'hills' for a few miles. With body armor, a rifle, and a total of 90 lbs. of gear. Anyways.
So, my knee was ok (more or less) until recently. I was going running 2-3 times a week for 4-6 miles at a time. One day (3 weeks ago) I get done with my run and decide I'm going to finish off with a little weight lifting, cool down, yah know? It took a moment for me to realise that the reason my knee looked bigger then normal, was because it was swollen. So swelling, and pain. FML.
So, I stop running until yesterday. My plan is to see Doc and find out whats up. First, a CFT. OK, no big deal. Done it before, and the swelling of my knee will show what I'm talking about. Of course, my left knee giving out four times during the firemans carry made it so I failed. But, I should be ok if I get Doc to sign off whatever to say 'he was hurt, let him redue it later'.
Is Doc there? Nope. Luckily for me, the Navy's Corpsman is here. Her advice? Take pain killers for two weeks, and if it still hurts go to a Doctor. OK, take 5 weeks off from running, hope for the best, and then go see a doctor. FML.
So, today, we're getting thrashed because our whole company basicly sucks at PT and had a sorta high number of fails. During a part where we're sprinting back and forth mindlessly, I slipt on the mud, my knee went 'Nope, screw you', and next thing I know, I'm sliding on the mud. I manage to get up, finish the lap, realise how much my knee hurts, and sit down. Luckily, the Sgt in charge of us figured I probably hurt myself, and let me be.
A minute or two later, my Platoon Sgt walks out, asks me if I'm ok (knowing my knee is messed up). I tell him what happened, and he says 'ok, when you feel you can walk, come inside and find Doc'
A few minutes later, he's having me talk to the Navy's Doc again. She tells me to go see her Active Duty counterpart in a different part of the base. They refuse to see me because they swear that our Doc is in. Turns out they were right.
-later that day-
Doc has me sitting on a table with my cammi pant legs rolled up around my knees. She's standing back looking at my knees. She steps forward and starts messing with my knees. She decides I'm alright, and basicly, didn' stretch before PT. Yep, that explains the chronic problem I told you about. I didn't stretch before PT today.
She gives me an Ice Pack (that barely helps) and some pain killers, and pretty much tells me to go away. I end up in the Supply Office the rest of the Drill (because our Supply Sgt likes me, and knew I was hurt). 
I bumped into the Navy Corpsman who was dumb founded that our Doc didn't do anything, and dumb founded that I wasn't going to push the matter.

My plan? I'm going to wrap my knee, ice it for an hour a day, and take pain killers for a week (half the time I was told to take it). Then, go running for 3 miles. When my knee swells up like a balloon with a huge amount of pain, I'm going to drive to a civilian doctor, tell him to bill the Marine Corps, and call our Doc and tell her where to shouve it, how hard, and at what angle.


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## MBuzzy (Oct 18, 2009)

You know that isn't how TriCare works, right?  I can tell you what you do need to do, but DO NOT just go to a random doctor and "tell them to bill the Marines" because they will bill you.  Trust me.  I have had a lot of troops who have gotten themselves in trouble...Big trouble.  Money trouble involving large bills from civilian doctors.


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## CuongNhuka (Oct 18, 2009)

Yes I know that. I also wasn't being literal. Well, I sorta was. Since it was a training accident resulting in injury, the Marines are obligated to make sure I'm fixed. So, they will have to reinburse me. I just have to make like 3 or 4 calls.


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## MBuzzy (Oct 18, 2009)

ummm, not so much dude.  They aren't obligated to do anything.

You MUST MUST MUST have a referral from a MILITARY DOCTOR or officially authorized representative, i.e. someone at a military base or TriCare office, if you EVER go downtown to ANY doctor.

They ARE NOT obligated to fix you, training related or not.  It is up to a military doctor to make that determination and to what degree the military's responsibility is.  Sometime it is as easy as 3 or 4 calls, but most of the time, it is not.


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## MBuzzy (Oct 18, 2009)

You need to get in to see a military doctor.  If they won't give you a referral or start the process to get off base.  Basically, the way it works, is that the military doctor puts in a request to TriCare for a referral, then the doctors at the local office determine if a referral is authorized.  Then you get a letter, you take that letter to the doctor and office that you were authorized to go to.  To that doctor ONLY.  you can't go anywhere else, or they will charge you. 

There is no reimbursement, they flat out pay it.  You should never see a bill of any kind.  If they say that you are ok and won't do further treatment, you need to keep making appointments, request different doctors and put in a rebuttal to the Tricare office.  If they CAN'T fix it, then they will MEB you.  I just had a troop get kicked out on an MEB for his knee actually, so it is touchy.  If you can, best case scenario is that they refer you to one of the regional hospitals....


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## jks9199 (Oct 18, 2009)

And it's very possible that they will turn around and point to the injuries BEFORE the drill and say it's your problem and you only made it worse on drill, because you failed to have it properly addressed in the first place.

Were the problems during marches documented?  Documentation is the key to a lot of these things...  

I strongly suggest you listen to Mbuzzy's guidance here... and maybe even consider asking him via PM if he'd be willing to give you more specific guidance.


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## MBuzzy (Oct 18, 2009)

bottom line is - don't THINK that you understand the process, KNOW that you understand the process and when you see any doctor who is not ON a military base, BEFORE you talk to anyone, be sure that your insurance information is in the system, correct and authorized.  

I thought that I fully understood the system and ended up paying $800 a few months ago....it can happen, BE CAREFUL.  Seriously, trust me on this one.  I have dealt with it many times with myself and troops that have worked for me - and the trip to the tricare office is worth the time, when it means that you don't have to pay out of pocket.


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## MBuzzy (Oct 18, 2009)

jks9199 said:


> And it's very possible that they will turn around and point to the injuries BEFORE the drill and say it's your problem and you only made it worse on drill, because you failed to have it properly addressed in the first place.
> 
> Were the problems during marches documented?  Documentation is the key to a lot of these things...
> 
> I strongly suggest you listen to Mbuzzy's guidance here... and maybe even consider asking him via PM if he'd be willing to give you more specific guidance.



Exactly!  A lot of "recurring problems" can start a line of duty investigation.  Basically that is where they dig into your history to figure out if the injury at hand is the Military's fault or your fault.  If you have had recurring pain and never saw a doctor or got it documented, that can be a big problem.  If you had it before you came in, another big problem.  

Here's a good one.....I knew a guy that got hurt while skiing....never told a military doctor, went to a civilian doctor and paid out of pocket.  Kept having pain, eventually went to see the military doctor, they figured out that he had a pre-existing problem, dug up his civilian doctor's records....BOOM, kicked out and paid for his military treatment.  I know that isn't your situation........but the medical system is hard to navigate.  I've been in the military for 7 years and I still did something stupid and ended up having to pay.  Thank god it was only $800......it could have been worse.  Even if it was $20,000 - if I didn't have the right authorization, they won't pay.


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## jks9199 (Oct 18, 2009)

MBuzzy said:


> Exactly!  A lot of "recurring problems" can start a line of duty investigation.  Basically that is where they dig into your history to figure out if the injury at hand is the Military's fault or your fault.  If you have had recurring pain and never saw a doctor or got it documented, that can be a big problem.  If you had it before you came in, another big problem.
> 
> Here's a good one.....I knew a guy that got hurt while skiing....never told a military doctor, went to a civilian doctor and paid out of pocket.  Kept having pain, eventually went to see the military doctor, they figured out that he had a pre-existing problem, dug up his civilian doctor's records....BOOM, kicked out and paid for his military treatment.  I know that isn't your situation........but the medical system is hard to navigate.  I've been in the military for 7 years and I still did something stupid and ended up having to pay.  Thank god it was only $800......it could have been worse.  Even if it was $20,000 - if I didn't have the right authorization, they won't pay.


FYI -- the civilian systems aren't lots easier!  

I've paid out of pocket for a few things because I didn't get the right pre-authorizations.  Or not been covered to the extent I expected because of the quirks of the system...

And I know of cases where people got fired for trying to make an off-duty injury look like it occurred on the clock...


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