RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXX		CASE: PD-2017-00220 BRANCH OF SERVICE:  NAVY	SEPARATION DATE: 20060921

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Personnel Specialist, medically separated for “migraines” with a disability rating of 10%.

CI CONTENTION: Review requested of “severe issues” with migraines and additional conditions not identified by the Medical Evaluation Board (MEB) and Physical Evaluation Board (PEB). 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 PEB to be unfitting for continued military service, and when specifically requested by the CI, those conditions identified by the MEB, but determined by the PEB 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. The panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections when appropriate. The panel’s assessment of the PEB rating determination is based on review of medical records and all available evidence relevant to application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards for 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, which operates 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 disability at the time of separation.

RATING COMPARISON:

SERVICE PEB - 20060731	VARD - 20070925	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Migraines	8100	10%	Migraine Headaches	8100	0%	STR	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 0%	

ANALYSIS SUMMARY:

Migraines. According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s migraines began in December 2003, after delivery of her third child. The headaches resolved after multiple treatment regimes, and she was returned to full duty in June 2004; however, symptoms resurfaced in December 2005.

The 7 March 2006 MEB NARSUM examination, 6 months prior to separation, noted complaints of headaches associated with nausea, photophobia (light sensitivity) and dizziness. The CI stated

that vision loss and headaches made it difficult to work and take care of her children. Physical examination was unremarkable except for bilateral visual field constrictions which were found to be of a non-organic origin.

The 20 June 2006 MEB psychiatric addendum examination, 3 month prior to separation, documented improved headaches with the use of Migranal (vascular headache suppressant), and that the CI did not require inpatient treatment (previously successful in achieving headache relief). The provider noted that a Botox injection on 5 June 2006 decreased headache intensity, but that the CI still had 3-4 headaches a week while using the Migranal. There was no VA examination proximate to separation in evidence.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the migraine condition 10%, coded 8100 (migraine headache). Utilizing the same VASRD code, the VA rated the same condition 0%, based on the STR, citing no evidence of prostrating attacks averaging 1 in 2 months over the previous several months. The VA also noted that the CI did not attend scheduled examinations which could have assisted in properly assessing the migraine condition. Members carefully considered the frequency and nature of the headaches including objective and corroborating subjective evidence, but agreed that the record did not show prostrating headaches occurring on average once per month, or more frequently, over the last several months prior to separation to support a rating higher than the 10% adjudicated by the PEB. After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded there was insufficient cause to recommend a change in the PEB adjudication for the migraine condition.

BOARD FINDINGS: In the matter of the migraine condition and IAW VASRD §4.124a, the panel recommends no change in the PEB adjudication. There are no other conditions within the panel’s scope of review for consideration. Therefore, the panel recommends 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 20160619, w/atchs Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

2	PD-2017-00220

DEPARTMENT OF THE NAVY
SECRETARY OF THE NAVY COUNCIL OF REVIEW BOARDS 720 KENNON STREET SE STE 309
WASHINGTON NAVY YARD, DC 20374-5023

IN   REPLY  REFER  TO,
1850
CORB: 003 20May20

From: Director, Secretary of the Navy Council of Review Boards

Subj:  PHYSICAL DISABILITY  BOARD OF REVIEW (PDBR)

Ref:	(a) DoDI 6040.44
(b) PDBR ltr <ltd 24 Oct 18

1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation (reference (b)) to the Department of the Navy on 5 Mar 2020 for appropriate action.

2.	On 20 March 2020, the Assistant Secretary of the Navy (Manpower & Reserve Affairs) accepted the recommendation of the PDBR ofno change to your characterization of separation or disability rating assigned by the Department of the Navy's Physical Evaluation  Board.

3.	The Secretary's decision on your PDBR application is final and is not subject to appeal or additional review by the Board for Correction of Naval Records.