RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME: XXXXXXXXXXXXXXXXX	CASE: PD-2017-01837
BRANCH OF SERVICE: NAVY	SEPARATION DATE: 20060713

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E7, Transmission System Technician, medically separated for “chronic migraine headaches” with a disability rating of 0%.

CI  CONTENTION:	“My  rating  is  60%.     Tried  to  get  changed  due  to  high  blood  pressure. Disapproved.”  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 Medical Evaluation Board (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 - 20060310	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Migraine Headaches	8100	0%	No VA Examination in Evidence	
COMBINED RATING: 0%	COMBINED RATING OF ALL VA CONDITIONS: NA	

ANALYSIS SUMMARY:

Chronic Migraine Headaches. According to the service treatment record and MEB narrative summary (NARSUM), the CI had a history of migraine headaches dating back to age 14. He has been on multiple abortive and prophylactic headache medications since September 2003 when he was first evaluated by neurology, with no other treatment offered except a 6 month LIMDU. During the 31 May 2005 MEB examination (recorded on DD Forms 2807-1 and 2808), 14 months prior to separation, the CI reported severe headaches controlled by medication.

At the time of the neurology clinic appointment on 10 January 2006, 6 months prior to separation, the CI reported 7/10 headache pain and mixed results since his last evaluation (6 weeks ago). While on board the ship, he typically had a constant headache that he attributed to smells on the ship. While on leave the previous month, he had only one headache, which was mild in intensity. With his last shore duty he had few headaches. The examiner opined that he had an apparent environmental ship-related trigger for his headaches and was concerned if the CI returned to full duty at sea, his headaches may recur. During the neurology clinic appointment on 15 February 2006, 5 months prior to separation, the CI had been working at Chesapeake courthouse with the shore patrol while on LIMDU. His headaches had decreased to one per week and symptoms were relieved with Imitrex. The examiner noted that the CI was in for a repeat BOTOX injection, 2 weeks short of the 3 month period. Prior delay in re-injection resulted in a worsening of his headaches, which occurred while on shore duty. Impression was the CI’s headaches now were under fairly good control with BOTOX and B2. At the time of the neurology clinic appointment on 26 April 2006, 3 months prior to separation, the CI reported increased headaches of one or two per week, relieved with Imitrex. Otherwise he felt well. He had still been working with the shore patrol while on LIMDU. He was optimistic about his job prospects in information technology. On examination the impression was chronic headaches with only fair control with BOTOX and B2. The examiner opined the increase in headache frequency was stress- related. During the neurology clinic appointment on 24 May 2006, 2 months prior to separation, the CI reported increased headaches to two per week, relieved with Imitrex. He continued to work at shore patrol, while he awaited discharge and worked only 2 days per week. The examiner opined the CI was due for another BOTOX injection, as his headaches seemed to be increasing in frequency. Impression was chronic headaches with fair control with BOTOX, Imitrex and B2. There was no VA examination in evidence.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the migraine headache condition 0%, coded 8100 (migraine headaches). Rating guidance under 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 frequency and nature of the CI’s headaches including objective evidence and corroborating subjective evidence. Review of the record 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 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 headache condition.

BOARD FINDINGS: In the matter of the migraine headache 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.

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 dtd 14 May 19

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 of no 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.