RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2014-00298
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20060531

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-6 (Water Treatment Specialist) medically separated for migraine headaches.  The condition could not be adequately rehabilitated to meet the physical requirements of her Military Occupational Specialty (MOS).  She was issued a permanent P3U3 profile and referred for a Medical Evaluation Board (MEB).  The “migraine headaches”, “chronic left neck pain” and “chronic upper back pain” conditions were forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501.  No other condition was submitted by the MEB.  The Informal PEB adjudicated “migraine headaches with characteristic prostrating attacks…” as unfitting, rated 10% with application of the Veterans Affairs Schedule for Rating Disabilities (VASRD).  The remaining conditions were determined to be not unfitting.  The CI made an initial rebuttal but was then medically separated.  

CI CONTENTION:  The CI contends that her current condition still exists and that it hinders her ability to work due to sick time.  The complete submission is at Exhibit A. 

SCOPE OF REVIEW:  The Board’s scope of review is defined in DoDI 6040.44, Enclosure 3, paragraph 5.e. (2).  It is limited to those conditions determined by the PEB to be unfitting for continued military service and when specifically requested by the CI, those conditions identified by the PEB, but determined to be not unfitting.  Any conditions outside the Board’s defined scope of review and any contention not requested in this application may remain eligible for future consideration by the Board for Correction of Military/Naval Records.  Furthermore, the Board’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate.  The Board’s assessment of the PEB rating determinations is confined to review of medical records and all available evidence for application of the VASRD standards to the unfitting medical condition at the time of separation.  The Board has neither the role nor the authority to compensate for post-separation progression or complications of service-connected conditions.  That role and authority is granted by Congress to the Department of Veterans Affairs, operating under a different set of laws.  The Board gives consideration to VA evidence, particularly within 12 months of separation, but only to the extent that it reasonably reflects the severity of the disability at the time of separation. 

RATING COMPARISON:  

IPEB - Dated 20060313	VA* - (~3 Mos. Post-Separation)  	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Migraine Headaches with Characteristic Prostrating Attacks	8100	10%	Chronic Migraine Headaches	8100	10%	20060831	
Other MEB/PEB Conditions x 2(Not in Scope)	Other x 4	
RATING:  10%	RATING:  30%	
*Derived from VA Rating Decision (VARD) dated 20070403 (most proximate to date of separation (DOS)).  

ANALYSIS SUMMARY:  

Migraine Headaches with Characteristic Prostrating Attacks Condition.  
A neurology evaluation dated 28 December 2004 documented a 4-5 year history of migraine headaches.  At the evaluation the CI reported headaches 3 times per week with nausea, vomiting, and light sensitivity.  The CI underwent several trials of prophylactic (prevent the migraines) and abortive (stop the headaches after they have occurred) medications.  The CI was evaluated for headaches at the emergency department/sick call and for 12 months prior to separation was issued quarters approximately 5 times.  At the narrative summary (NARSUM) examination performed 3 months prior to separation, the CI reported two headaches a week which were relieved within 30-40 minutes of taking Relpax (medication used to relieve migraine pain and symptoms).  The neurologic examination was normal.  At the VA Compensation and Pension examination performed 30 months after separation, the CI reported weekly headaches which were well controlled with Relpax.  She reported that most of the headaches were prostrating for several hours.  The neurologic examination was normal.  

The Board directed its attention to its rating recommendation based on the above evidence.  The PEB and VA rated the condition at 10%, coded 8100 (migraine). Although the CI reported weekly headaches, the Board noted that in 12 months prior to separation the CI was issued quarters for “characteristic prostrating attacks” approximately once every two months.  The evidence did not support “characteristic prostrating attacks” on average once a month for a higher rating.  Considering the totality of the evidence and mindful of VASRD §4.3 (reasonable doubt), members agreed that a disability rating of 10% for the migraine condition was appropriately recommended in this case. 

BOARD FINDINGS:  IAW DoDI 6040.44, provisions of DoD or Military Department regulations or guidelines relied upon by the PEB will not be considered by the Board to the extent they were inconsistent with the VASRD in effect at the time of the adjudication.  The Board did not surmise from the record or PEB ruling in this case that any prerogatives outside the VASRD were exercised.  In the matter of the migraine condition and IAW VASRD §4.124a, the Board unanimously recommends no change in the PEB adjudication.  There were no other conditions within the Board’s scope of review for consideration.  

RECOMMENDATION:  The Board, therefore, recommends that there be no re-characterization of the CI’s disability and separation determination.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20140108, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAMR-RB						

MEMORANDUM FOR Commander, US Army Physical Disability Agency 
(AHRC-DO), 2900 Crystal Drive, Suite 300, Arlington, VA  22202-3557

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for XXXXXXXXXXXXXXXXXXXXXX, AR20160002135 (PD201400298)

I have reviewed the enclosed Department of Defense Physical Disability Board of Review (DoD PDBR) recommendation and record of proceedings pertaining to the subject individual.  Under the authority of Title 10, United States Code, section 1554a,   I accept the Board’s recommendation and hereby deny the individual’s application.  
This decision is final.  The individual concerned, counsel (if any), and any Members of Congress who have shown interest in this application have been notified of this decision by mail.

 BY ORDER OF THE SECRETARY OF THE ARMY:

Enclosure

CF: 
(  ) DoD PDBR
(  ) DVA