RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01105
BRANCH OF SERVICE:  mARINE CORPS 	SEPARATION DATE:  20080815

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was a Reserve E3, Rifleman, medically separated for “migraine headaches, exercise-induced” with a disability rating of 0%.  

CI CONTENTION:  The CI did not contend any conditions, but rather had questions about his DD Form 214.  The complete submission is at Exhibit A.  

SCOPE OF REVIEW:  The panel’s scope of review is defined in DoDI 6040.44.  It is limited to review of disability ratings assigned to those conditions determined by the Physical Evaluation Board (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 or non-compensable.  Any conditions outside the panel’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 Records.  Furthermore, the panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate.  The panel’s assessment of the PEB rating determination is based on review of medical records and all available evidence for application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards to the unfitting medical condition(s) at the time of separation.  The panel 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 panel 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 PEB - 20080624	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Migraine Headaches, Exercise-Induced	8100	0%	No VA Exam in Evidence	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Migraine Headaches, Exercise-Induced.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI developed exertional migraine headaches during training in March 2007.  At a 26 September 2007 neurology visit, he reported his headaches became more severe in May 2007 and were accompanied by photophobia and nausea, which progressed to vomiting that occurred about twice a week.  Physical and neurological examinations were normal, but it was noted that the CI had a very strong family history of incapacitating migraine headaches.  The STR was silent for any headache care between November 2007 and the time of separation.  

The 26 April 2008 MEB examination (recorded on DD Forms 2807-1 and 2808), 4 months prior to separation, noted a history of migraine headaches but no symptoms at the time of the examination.  Additionally, the CI felt better with use of a prophylactic medication.  

At the 22 May 2008 MEB NARSUM examination, 3 months before separation, the CI reported only three or four episodes of severe headaches since November 2007, with each responding well to Imitrex (serotonin receptor agonist) injections; there was no indication that the  headaches were prostrating.  The CI worked as an assistant to a recruiter and could do light exercises without precipitating a headaches.  The neurological examination was normal.  

The commanding officer’s non-medical assessment on 13 May 2008 noted the CI missed about 10 hours per week due to his condition specifying that “the hotter the weather gets the worse his headaches become.”  There was no VA examination in evidence proximate to separation.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the migraine condition 0%, coded 8100 (migraine headaches).  Rating guidance for diagnostic code 8100 is based on the frequency of “prostrating attacks” over the “last several months.”  The VASRD does not further define prostrating attacks, however commonly accepted definitions include “utter physical exhaustion or helplessness” (Webster's New World Dictionary of American English), “complete physical or mental exhaustion” or “extreme exhaustion or powerlessness” (Dorland's Illustrated Medical Dictionary).  The panel carefully considered the STR documentation and NARSUM examination to determine the frequency and nature of the CI’s headaches and accurately assess the overall disability picture (§4.2) at the time of separation.  Members agreed that the evidence did not show prostrating headaches occurring on average once every 2 months, or more frequently, over the last several months prior to separation to support 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 panel concluded that there was insufficient cause to recommend a change in the PEB adjudication for the migraine headache condition.  

BOARD FINDINGS:  In the matter of the migraine headache condition and IAW VASRD §4.124a, the panel unanimously recommends no change in the PEB adjudication.  There are no other conditions within the panel’s scope of review for consideration.  The panel, therefore, recommends there be no modification or re-characterization of the CI’s disability and separation determination. 

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150611, w/atchs
Exhibit B.  Service Treatment Record

MEMORANDUM FOR DIRECTOR, SECRETARY OF THE NAVY COUNCIL OF REVIEW
               BOARDS 

Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS
 
Ref:   (a) DoDI 6040.44

      In accordance with reference (a), I have reviewed the cases listed below and approve the recommendations of the PDBR that the following individual’s records not be corrected to reflect a change in either characterization of separation or in the disability rating previously assigned by the Department of the Navy’s Physical Evaluation Board:

		- XXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXX, former USN

		
							XXXXXXXXXXXXXXXXXXX
	     				Principal Deputy, Assistant 
						Secretary of the Navy
						(Manpower and Reserve Affairs)
						Performing the Duties of the 
						Assistant Secretary of the Navy
						(Manpower and Reserve Affairs)