RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXX	CASE:  PD-2014-01146
BRANCH OF SERVICE:  AIR FORCE	BOARD DATE:  20150226
SEPARATION DATE:  20080317

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-3 (Security Forces Journeyman) medically separated for headache conditions.  These conditions could not be adequately rehabilitated to meet the physical requirements of his Air Force Specialty (AFS) or satisfy physical fitness standards.  He was issued a profile and referred for an Medical Evaluation Board (MEB).  Migraines were forwarded to the Physical Evaluation Board (PEB) IAW AFI 48-123.  No other condition was submitted by the MEB.  The Informal PEB adjudicated common migraine headaches as unfitting, rated 0%, referencing Defense Instruction (DoDI) 1332.39 and the Veterans Affairs Schedule for Rating Disabilities (VASRD).  The CI made no appeals and was medically separated.

CI CONTENTION:  “The migraine headaches I get occur 2-3 times a month and last up to 4 days at a time.  During this time, work is extremely difficult and I usually have to take time off.”

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:

Service IPEB – Dated 20080204	VA* - (~3 Mos. Post-Separation)	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Common Migraine Headaches	8100	0%	Migraine Headaches	8100	30%	20080623	
Other MEB/PEB Conditions x 0 (Not In Scope)	Other x 1 (Not in Scope)	
RATING:  0%	RATING:  30%	
*Derived from VA Rating Decision (VARD) dated 20080819 (most proximate to date of separation [DOS])

ANALYSIS SUMMARY:

Migraine Headaches Condition.  The CI was first seen for headaches on 5 December 2006 when the he reported headaches since November 2005.  Over the next year, he was tried on both prophylactic and abortive medications without adequate benefit.  He endorsed a positive family history with a father and sister who both had migraine headaches.  The CI was removed from Personnel Reliability Program status (special weapons access) and weapon carrying on 31 October 2007.  A detailed note on 10 December 2007 by his neurologist noted that the CI could function during his headaches.  The CI had elected to have no further treatment or appointments for his headaches.  In an undated memorandum, the commander noted that the CI had missed no work but had a modified duty schedule due to his medical issues (headaches).  There was not a separate MEB narrative summary in the record.  It appears that the PEB relied on the information in the commander’s letter and the 10 December 2007 neurology note as language from both is in the remarks section of the PEB Form 356.  It noted, “Your condition has had significant impact on your ability to complete assigned tasks/ duties although you have not missed any work days, you have been unable to post to the missile field to perform duties in your assigned AFS.  The examiner noted that you elected to have no further treatments or appointments, and stated that you could function with the headaches although they are quite bothersome.  It appears that you have prostrating attacks less often that one every two months.”  The CI concurred with this assessment as noted on the AF Form 1180 signed 4 February 2008.

At the VA Compensation and Pension examination performed 3 months after separation, the CI reported that he had headaches 3 times a month which lasted 6 hours.  During a headache, he was unable to do anything and he had to stay in bed.  During the worst pain he was unable to perform simple tasks.  The neurological examination was normal.

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the headache condition at 0% using the code 8100, migraine headaches.  The VA used the same code, but rated the headache condition at 30% noting that the headaches lasted for 6 hours and were three times a month even though the headaches were not prostrating.  The Board noted that the headaches began within weeks of accession although the CI did not present for treatment for a year.  The CI was noted to be able to continue to do his duties during a headache despite the fact that they were bothersome.  The PEB specifically noted this in its adjudication with which the CI concurred.  Absent prostrating attacks, the Board found no route to a rating higher than the 0% adjudicated by the PEB.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (Reasonable doubt), the Board concluded that there was insufficient cause to recommend a change in the PEB adjudication for the migraine headache condition.

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.  As discussed above, PEB reliance on DoDI 1332.39 for rating the migraine headaches was operant in this case and the condition was adjudicated independently of that instruction by this Board.  In the matter of the migraine headache 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 recharacterization of the CI’s disability and separation determination.

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20140221, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAF/MRB
1500 West Perimeter Road, Suite 3700
Joint Base Andrews, MD  20762

XXXXXXXXXXXX
XXXXXXXXXXXX
XXXXXXXXXXXX

Dear XXXXXXXXXXXX:

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2014-01146.

After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was appropriate.  Accordingly, the Board recommended no re-characterization or modification of your separation.

I have carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding and their conclusion that re-characterization of your separation is not warranted.  Accordingly, I accept their recommendation that your application be denied.

Sincerely,

XXXXXXXXXXXX
Director
Air Force Review Boards Agency

Attachment:
Record of Proceedings