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 ASSISTANT SECRETARY OF THE NAVY, MANPOWER AND RESERVE AFFAIRS

SUBJECT: Physical Disability Board of Review Recommendation on Case Number PD-2018-00579

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 Navy. 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 an active duty E4, Information systems Technician,
medically separated for “unremitting migraines” with a disability rating of 10%. The PEB coded the headaches 8100 (migraine) and listed motion sickness as a related Category II diagnosis contributing to the disability in this case. The CI reported headaches associated with dizziness and was diagnosed with vertiginous migraines. The panel concluded the Category II diagnosis was not a separate condition which could be reasonably justified as separately unfitting, nor would separate ratings be achievable without violation of VASRD §4.14 (avoidance of pyramiding). The VA rated the migraine condition 50%, also coded 8100, citing “very frequent, completely prostrating, and prolonged attacks productive of severe economic inadaptability.” 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 considered the results of the examinations along with the evidence of the service treatment records (STR) to accurately assess the overall disability picture (§4.2) at the time of separation. 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 the 10% adjudicated by the PEB. Although at the pre-separation VA examination, the CI estimated he missed work two to three times per month due to headaches, there was no evidence in the STR of frequent absences from work. The non-medical assessment (NMA) noted the CI missed on average 3 hours per week due to his medical condition, including all medical appointments for treatment and evaluation. The NMA also noted that the migraine condition prevented sea duty but did not indicate the CI was otherwise unable to perform his duties. There

was no objective evidence of prostrating headaches as described above. 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.

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

IN REPL Y REFE R TO :
1850
CORB: 003 IO Sep20

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

Subj: PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) Ref:	(a) DoDI 6040.44
1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation to the Department of the Navy on 13 Aug 2020 for appropriate action.

2.	On 27 August 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.