DEPARTMENT OF THE AIR FORCE
WASHINGTON DC

Office of the Assistant Secretary

SAF/MRBD (PDBR)
3351 Celmers Lane
JBA NAF Washington, MD 20762-6435

MEMORANDUM FOR THE DIRECTOR, ARMY REVIEW BOARDS AGENCY

SUBJECT: Physical Disability Board of Review Recommendation on Case Number PD-2017-05425

In accordance with Title 10 § 1554a and in compliance with DoDI 6040.44, the Physical Disability Board of Review (PDBR) adjudicated the disability rating accompanying the medical separation of the covered individual from the United States Army. After carefully reviewing the application and medical separation case file, the PDBR recommended no re-characterization of the separation or modification of the disability rating previously assigned. I recommend you accept this proposed decision.

The covered individual (CI) was a National Guard E4, Multichannel Transmission Operator/Maintainer, medically separated for “chronic daily headaches” with a disability rating of 10%. The PEB analogously coded the condition 5399-5323 (Group XXIII: muscles of the head, neck, and shoulders), citing headaches are not migraines and rated as moderate. The VA rated the headaches as 30%, coded 8100 (migraines), based on the Compensation and Pension examination, citing “headache causing impairment of function about three times a week.”
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 per month, or more frequently, over the last several months prior to separation to support a rating higher than 10%. Although the CI reported hedaches of increased severity that impaired his function three times per week at the pre-separation VA examination, there was no evidence in the service treatment record of lost work time or other evidence of “prostrating” headaches.  The PEB utilized an analogous muscle code (5399-5323, muscles of the head, neck, and shoulders) for rating of the headache condition, rather than 8100. The panel agreed there was no evidence to support rating the headache condition analogous to a moderately severe muscle injury for higher rating under this code. 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 headache condition.

2	PD-2017-05425

AR20200004556,

Dear	:

DEPARTMENT OF THE ARMY
ARMY REVIEW BOARDS AGENCY 251 18TH STREET SOUTH, SUITE 385
ARLINGTON, VA 22202-3531

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.

Sincerely,

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