A little while ago I wrote about the importance of lists.  Rather naively I thought that I was pretty much done with them as I approached the completion of my checkout sheet.  As usual, I was wrong.

The mighty checkout sheet, about which I wrote several posts, is the administrative key to the other side of transition.  To my dismay, however, I found that the checkout sheet alone wasn’t mighty enough to set me free.  That required that I complete my final physical examination, and just like everything else involved with transition there was so much more to it than meets the eye.

My last post about the final physical left us at the Regimental Surgeon’s office, where I learned about the complexities of the mother of all physical exams: the vaunted Final Physical.  It is the mother of all examinations because it is no simple or cursory survey, but instead an inexorably thorough inquisition of one’s bodily health and mental condition that left nothing uninspected.

It is for good reason, as I learned from the good surgeon.  My final physical serves as the last chance for me, the soon to be departed from the Marine Corps, to avail myself of military medicine and fix those things that had heretofore been unfixed or ignored in typical macho tough-guy fashion.  While the thought of military medicine may make the reader shudder, it really isn’t bad- in fact it is very good, because military health care providers are well resourced and have had a lot of real world practice over the last decade of war.  The perceived problem with it stems from poor management and care several decades ago- problems that have long been corrected.  The point to the physical was to get me into the best shape possible  before showing me the door, whereupon the Veteran’s Administration would take up the responsibility for my health and wellbeing.  I will write more about the VA later, but suffice it to say that the surgeon’s description of the process made me a believer in the process.

“It’s up to you, sir,” he said, “but you’d be foolish not to take advantage of everything you can.  It’s free, and you have the time to take care of anything that may crop up.”

A wise man, that surgeon.

“You would be smart to contact every [health care] provider that you have seen in the last few years.  They will re-evaluate your condition and record it in your health records.  That will help you in the long run, especially with your disability claim,” he continued.

Disability claim?

Visions of walking canes, wheelchairs, and blue parking spaces rocketed through my head.

He saw my look of horror and chuckled.

“You’ve been in for a long time,” he said as he flipped through my medical record, “your knees are bad, your ankle is bad, your feet are a mess….”  He trailed off as he continued to review my case.  “You are going to be rated with some disabilities, and it is important that the ratings are done correctly.  Don’t worry about it.  It’s a rough life being a Marine, and you are going to be evaluated to make sure that you are taken care of.  Here’s my number.  If you have any problems, have them give me a call.”

As Indiana Jones said to Marion in “Raiders of the Lost Ark”:  It’s not the years, honey, it’s the mileage.

With a firm handshake, I left his office with my records in one hand and a newly printed checklist in the other.

The checklist was very thorough.  It ranged from lab work (shots anyone?  A vial or two or seven of blood for testing?) to audiograms for my artillery-assaulted ears (What? What did you say?) to an EKG to make sure my ticker still ticked and a chest x-ray to look at my ribs or something else that is equally important.  How was I going to get any of this stuff taken care of?

In true Navy fashion, I had not walked ten feet before a motivated and professional Petty Officer took pity on me and beckoned me to the counter.  “Hi, sir!  Lemme see that,” he said as he pointed to my checklist, “we’ll get you squared away.”

And he did.  With the dexterity of the queen of the typing pool and the suavity of a Tiffany Jewelry salesman he typed, called, cajoled, and printed appointment after appointment for me.  Within ten minutes he had teed up meetings with specialists and medical providers across the base.  Not only did he hit the basic requirements, but also those specialty clinics and providers that I had seen over the last few years- orthopedics for my feet, physical therapy for my knees, optical for my eyes, audiology for my ears….and so on.  With a smile and a cheery “here you go, sir!” he handed me a sheaf of appointment reminders and turned back to his duties.

That’s why Navy medicine is great- they really bent over backwards to make sure I was taken care of.  I have never seen anything like that at a civilian HMO, that’s for sure!  I looked over the appointment reminders and was surprised at just how long it was going to take to knock this final physical out- all told it was going to take over three months to hit all of my appointments.  Three months!  Yikes.  Navy medicine may be helpful, but it isn’t particularly speedy I guess- especially for those of us getting our outprocessing physicals.  Oh well.  Fortunately I had the time.

So, with a feeling of great relief (and a little trepidation, to be sure!) I walked out of the Regimental Aid Station and set out on the journey that would be my final physical.

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Lessons Learned:

1.  Start EARLY.  I began my outprocessing physical about four months before I went on terminal leave with the naive expectation that it would be a quick and easy thing to do.  Not so much!

2.  Plan ahead.  Take the time to write a list of all the things that are bothering you or that you have been treated for over the past few years.  Most Marines just “suck it up” and refuse to show weakness by getting medical care, which is good when the Taliban are chucking hand grenades at you but not so good when you are about to get out.  If you do not have your problems recorded in your record then they do not exist.  Simple as that.  And if they do not exist, they cannot be evaluated for disability purposes or for future care in case they get worse.  And they always get worse….

3.  Go into your initial final physical appointment with your notes and with your complete medical record.  You will get out of it what you put into it.  If you blow it off then you will get a rubber stamp with nothing behind it, and possibly lose out on medical benefits or monetary compensation in the future.  The time to be the big tough Marine ends at the hatch to the aid station!

4.  Take notes as you go.  This is important, because you will ultimately have a second set of physicals with the Veteran’s Administration to determine your disability rating.  If you forget what the doctors tell you during their examination you can’t pass that information to the VA, which will weaken your claim for benefits.