Time For a Rethink

I recently started ramping down my anti-depression and anxiety medication that I take for my PTS linked issues. I didn’t make this mental health decision lightly. You see, based on my doctor’s recommendation, I tried to ramp down before. I wasn’t successful. My mood swings were too erratic and unpredictable. After the failed attempt, I decided to stay on the medication until I ended my Active Duty military career. I figured the natural stress relief created by retirement would greatly assist efforts to balance my moods more naturally.

However, a few recent experiences persuaded me to reconsider that decision. The first is a continuing deterioration of my physical health. The cascading effects that issue has created, and my attempts to manage the pain, built a desire to end all but the most benign medications. My psychotropic medication is anything but benign. While it definitely evens my temperament and smooths my erratic behavior, the side effects are numerous. This includes interruptions of my sleep cycle, weight gain, and a heightened tendency to sweat and dehydrate.

Number Two and Three

A recent conversation with a medically retired Iraq veteran was the second event that persuaded me to ramp down my medication. He’d been wounded in a roadside bombing in the heyday of the U.S. occupation and the Sunni-Shiia rebellion. This included shrapnel through his shoulder, traumatic brain injury (TBI), and PTSD. He was fairly adamant that his quality of life improved significantly after he ended his medications, despite the need to continuously stay on top of his PTSD through more natural methods like better nutrition, exercise, and meditation.

The straw that broke the camel’s back though is a recent vacation that I took with Mrs. Grumpus. We had a great time without the kids; hiking and exploring the country we visited. The number of outdoor activities we engaged in made me realize how much my retirement will suck if I’m not in the mental and physical condition to enjoy it. All the places we’re considering living in retirement feature an outdoor lifestyle. Furthermore, we have young kids with all their potential youth sports ahead of them. I want to be able to play, teach, and coach them as much as possible.

Sometimes Good Is Good Enough

So yeah, I convinced myself to come off the meds, got with the doctor, and started the process. In reality, there’s no better time to start. I currently benefit from the best health care that I’m probably ever going to get access to (unless I move to a country with top-notch socialized healthcare). That isn’t to argue that the military health care system provides the best care ever, but it is to say that my current healthcare is good enough to ensure that I get the help I need. Why?

Well, certain parts of the U.S. military have done a great job over the last decade of ensuring that its members receive all the health care they need to remain employable and deployable. That means the military member is ready to answer the call when needed. I currently find myself serving in that part of the military. Thus, I have every available type of health care professional available to me to ensure the best chance of success. Mental health professionals? Check. Pharmacologists? Check. Pain management? Check. And on it goes.

Fair Vs. Good

Is it fair that some parts of the U.S. military get better healthcare service than others? Probably not. It’s probably just as unfair as the fact that U.S. military members (and their families) benefit from a taxpayer-funded universal health care system, whereas the rest of the U.S. does not. That isn’t to say that military personnel receives the world’s best healthcare, but it is to say that in consideration of the alternatives in the U.S., that it’s pretty damn good.

Have I ever complained about the bureaucratic and byzantine nature of the military healthcare system? Absolutely. I think you’d be hard pressed to find someone with my longevity who hasn’t. However, I can honestly say that I love this system. Not only that, but I think that everyone deserves access to such a relatively high standard of healthcare. Thanks to the military, I’ve lived in countries with national healthcare systems and worked for an organization with taxpayer-funded universal healthcare. My assessment is that it’s a much more fair system than the employment linked / employer subsidized system that the U.S. currently operates.

What’s Good For Me, Not The System

All of that said, I’m not writing this post in an attempt to solve the U.S. healthcare problem. Many smarter people than me have tried and failed at that Quixotic task. I’m here simply to explain (mostly to myself) why I’m ramping down my medication again while on active duty. The main answer is the big safety blanket that is military life. By that, I mean that if I start to slip, there are numerous guardrails to prevent me from complete self-destruction. Some, but certainly not all, of those guard rails go away after retirement. Thus, it’s in my best interest to give this another shot now.

There are other reasons too. Top on that list is I’m starting to chaff (again) under the strain that is military life. You read that correctly. Despite all the writing, and the planning … and the writing about the planning; I’m starting to question whether my original plan to stay in until 21-years (in order to secure my GI Bill’s transferability) is worth it. In other words, my “worth vs. worth it” calculus is starting to change.

Some of that “chaffing” is probably related to the fact that I recently passed 19-years of service. Thus, the option of retirement feels more tangible than ever. In addition, some of the chaffing is due to a general discontent that’s been building inside me for a while. The specifics aren’t germane to this blog, but the effect is — I’m ready to move on. While that chaffing feeling isn’t great for my well-being, I’m at least happy that I’ve enough self-awareness to recognize the symptoms this time around. I just want to ensure that I go into any decision to “stay or go” at 20, vice 21-years, with an understanding of my motivations and with all my options explored.

Which Brings Me Back to Mental Health

Step one in that “all options explored” process is determining the true extent of my mental and physical health problems. The doctor who originally diagnosed me with PTS said it was episodic based on a specific set of events which I’ve blogged about in the past. He said once I resolved my emotions around those events the PTS should fade. The medication was meant to be temporary, and it went hand-in-hand with therapy. That said, my therapy ended about a year ago, but here I am still on the medication. So the way I see it, this attempt at ramping down the medication is necessary to determine if the original diagnosis was correct … or not.

If the ramp down works, and the original diagnosis was correct, then great! It’s one less issue to deal with as I make my retirement decision. I can then move on to my physical health issues and the math problem that retiring at 20 presents (described below). On the other hand, if the ramp down doesn’t work, or if it turns out the original diagnosis was wrong, then I need to know that as well. Continuing mental health problems coupled with my ongoing physical issues may open up a medical retirement option, or at the very least, a level of VA disability that I hadn’t previously planned for or considered.

The Math Problem

Unfortunately, if I retire at 20-years without transferring my GI bill, I’m going to have a math problem. For those who read my article where I crunched my retirement budget scenarios through a high powered retirement calculator, you’ll remember all my retirement calculations were based on a southern California cost of living with either 21 or 23 years of military pension. You’ll also remember that the only retire at 21-year scenario that worked included saving enough cash to buy a house without a mortgage. In that scenario, I assumed college expenses for the kids would be taken care of through a combination of their 529s, the GI Bill and California’s in-state tuition waiver for the children of a disabled rated veteran. Thus, I didn’t even budget for their university expenses.

Now, here’s where the math problem comes in. The cascading effect of retiring earlier than I originally planned will probably mean we won’t have saved enough to buy a house in cash in southern California. The options at that point would be to buy a house with a small mortgage or chose to live in a different state where housing and the cost of living is cheaper. If we chose the small mortgage, either Mrs. Grumpus or I would have to work a job that brings in real money for a few years. That runs contrary to the intent of my original retirement plan, which was to achieve Financial Independence, and dispense with the need to work for either of us.

Moving out of state presents its own set of problems, mostly centered around university for the kids. Residing someplace other than California takes away the opportunity to use the super awesome free tuition deal I mentioned above since it’s only available for veteran residents and their children. Thus, if I retire at 20 without transferring my GI Bill, and we choose to live in another state, that puts Mrs. Grumpus and me on the hook to fund college with only the 529s.

VA Disability and Geoarbitrage to the Rescue?

Anyone who’s read Friend of Grumpus’s guest post in the Pension Series about VA Disability knows it can be an extremely powerful retirement tool. Why is a high VA disability rating important? The bottom line is that it means more money and benefits in retirement. That’s not only good for the overall retirement budget, but also important when it comes time to pay for my kids’ college.

As my friend discussed in his article, there are powerful federal income tax benefits from a high disability rating. What he didn’t discuss is that a high VA disability rating can also help you at the state level. He didn’t do that because each state has different laws, and his article would’ve been huge. Due to time, I’m not going to address individual state benefits either. In general, though, I will say it’s important for any veteran to understand that different U.S. states offer different levels of tax relief, often times based on your VA disability rating. In many states, various levels of VA disability ratings also unlock different levels of state assistance for your children’s in-state college expenses.

Most (but not all) states have a fairly high VA disability threshold to unlock their benefits, especially for in-state college tuition waivers. California’s threshold (a 0% rating) for the college tuition waiver is the lowest that I know of, but in return, they have no waiver for state income tax. Other states partially or fully waive income tax on pensions, and many waive property tax. It’s also worth noting that some states in general simply don’t tax pensions, which I wrote about previously in the Pension Series.

The bottom line is that a veteran with a high disability rating should probably factor state-level benefits into their choice of retirement location. It certainly shouldn’t be the only consideration, but it should be considered somewhere, especially if the retirement budget is going to be tight. In my specific situation, the cumulative total of those benefits could be enough to offset the decision to retire without transferring my GI Bill.

How Do I Find Out My Disability Rating in Advance?

Which brings me to something of a conundrum. Is there a method to figure out my disability rating in advance? If I’m looking for an exact rating percentage, that answer is “No”. A person’s final rating can only be determined by going through the official VA process when you resign or retire from the military.

However, as Friend of Grumpus pointed out in his post, there are numerous benevolent organizations like Disabled Veterans of America (DVA), the American Legion, and Veterans of Foreign Wars (VFA) who groom and prepare medical records for military personnel looking to get out. Since I’m within a year of potential retirement, I’m eligible for this service. Not only that, but the part of the military I serve in has a charitable foundation that also provides classes and services similar to those I just described. I need to look into those.

So, while I may not be able to obtain an exact VA disability rating number in advance, I can probably get a rough estimate. Hopefully, that estimate will be good enough for planning purposes. That way I can answer some of those retirement budget and geoarbitrage issues I just reviewed above.

Is there anything else I could do? There is, but it gets into tricky territory. In conjunction with my medical department, I could attempt to obtain a referral to a medical board. For those unfamiliar with the process, a medical review board is where the military medical community reviews a service person’s case and determines whether or not they should be medically discharged or retired. It’s something of a nuclear option because the process is long, bureaucratic, and painful for the command that owns the service person while the review takes place. However, if my mental health issues persist, and the ramp down from my medication doesn’t go well; it’s probably an option I should seriously consider given the physical health issues I’m experiencing as well.

I Bet You Never Saw That Coming!

For some of my longtime readers, this article may come as a slight surprise. Up to this point I’ve written about “gutting it out” from anywhere between 21 to 23-years of military service based on the peace of mind that the pursuit if FI has given me. I’ve even talked about it during both of my podcast interviews. However, life and circumstances change. Challenges and opportunities present themselves that make a person reconsider previous decisions, or at least make them consider the alternatives. That’s where I currently find myself.

With that said, my first priority is to concentrate on my mental health issues and to continue to perform my duties as assigned at work and home. Once I get a feel for how the medication ramp down is going, and how my physical health issues are progressing, then I can start to plan as necessary. No doubt that when I do, I’ll use many of the methods I’ve espoused on this website. This includes making an informed “Worth vs. Worth It” decision and conducting more retirement budget crunching using a high-powered retirement calculator. I’ll make sure to keep everyone updated as to how all of that goes, and share as many of the numbers and techniques I use along the way. Until then ….

— GM