RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-00584
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20051026

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Indirect Fire Infantryman, medically separated from the Temporary Disability Retired List (TDRL) for “migraine headaches” with a disability rating of 0%.  

CI CONTENTION:  Review requested of migraine headaches and additional conditions not identified by the Medical Evaluation Board (MEB) and Physical Evaluation Board (PEB) at TDRL removal.  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 - 20051013	VARD - 20050421	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Migraine Headaches 	8100	0%	Migraine Headaches	8100	0%	20050314	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Migraine Headaches.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s migraine headaches began in August 2002.  He was separated and placed on TDRL on 26 October 2005.  

At the 14 March 2005 VA Compensation and Pension (C&P) examination, 7 months before TDRL removal, the CI reported sharp headaches 2-4 times a month that usually lasted 2-4 hours, whether at rest or during activities.  Physical examination revealed the headaches were not dysfunctional and that he continued to perform in his usual occupation.  There was no photophobia, phonophobia or loss of function, and a CT scan was normal.  
The 30 August 2005 MEB NARSUM examination, 2 months prior to TDRL removal, noted complaints of headaches 2-3 times per month, each lasting up to 4 hours.  The CI claimed he no longer took a headache preventive because it was ineffective at managing his headaches.  The headaches seemed to respond well to 3-4 hours of sleep in a dark room and were described as right retro-orbital and frontal, throbbing in nature, and accompanied by nausea, photophobia and phonophobia.  Physical examination showed an unremarkable cranial nerve evaluation to include pupils, fundi and full visual fields.  Motor testing revealed normal tone, bulk and strength with no pronator drift was observed.  Sensory evaluation was grossly normal to all primary modalities and Romberg testing (for balance) was negative.  

The panel directed attention to its rating recommendation based on the above evidence.  The CI was removed from the TDRL with a permanent disability disposition of separation with severance pay at 0%.  The PEB rated the headache condition 0%, coded 8100 (migraine), citing no medication, response to 3-4 hours of sleep in a dark room, and no prostrating attacks IAW DODI 1332.39.  The VA also rated the headache condition 0%, coded 8100, based on the C&P examination, citing no dysfunction or prostrating attacks from the headaches, and no photophobia /phonophobia or medication use for the headaches.  Members agreed that the record did not show prostrating headaches occurring on average once every 2 months, or more frequently, over the several months prior to TDRL removal 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 there was insufficient cause to recommend a change in the PEB adjudication for the migraine headaches at TDRL removal.  

BOARD FINDINGS:  In the matter of the migraine headaches and IAW VASRD §4.124a, the panel recommends no change in the PEB adjudication at the time of TDRL removal.  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 20170216, w/atchs  
Exhibit B.  Service Treatment Record  
Exhibit C.  Department of Veterans Affairs Record  

AR20180012968, XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found your separation disability rating and your separation from the Army for disability with severance pay to be accurate.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed), and I accept its recommendation.  I regret to inform you that your application to the DoD PDBR is denied.  

	This decision is final.  Recourse within the Department of Defense or the Department of the Army is exhausted; however, you have the option to seek relief by filing suit in a court of appropriate jurisdiction.