RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXX CASE: PD1201554 

BRANCH OF SERVICE: ARMY BOARD DATE: 20130423 

SEPARATION DATE: 20040402 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was a National Guard SGT/E-5 (31R/Radio Operator) medically separated 
for a headache condition. He had a long standing history of intermittent migraines, 
exacerbated during a 2003 deployment to the Gulf region leading to an early return to his home 
station. The condition could not be adequately controlled after deployment to meet the 
requirements of his Military Occupational Specialty. He was issued a permanent P3 profile and 
referred for a Medical Evaluation Board (MEB). The MEB forwarded migraines and a 
sinusitis/rhinitis condition for Physical Evaluation Board (PEB) adjudication as medically 
unacceptable IAW AR 40-501. The PEB adjudicated migraine headaches as unfitting, rated 0%, 
with likely application of the Veteran’s Affairs Schedule for Rating Disabilities (VASRD). The 
sinusitis/rhinitis condition was determined to be not unfitting. The CI made no appeals and was 
medically separated with a 0% disability rating. 

 

 

CI CONTENTION: The application states simply, “Disability rated for migraines at 0%.” 

 

 

SCOPE OF REVIEW: The Board’s scope of review is defined in DoDI 6040.44, Enclosure 3, 
paragraph 5.e. (2). It is limited to those conditions determined by the PEB to be unfitting for 
continued military service and those conditions identified but not determined to be unfitting by 
the PEB when specifically requested by the CI. Ratings for unfitting conditions will be reviewed 
in all cases. The Service rating for the unfitting migraine condition is addressed below; no other 
conditions are within the DoDI 6040.44 defined purview of the Board. Any conditions or 
contention not requested in this application, or otherwise outside the Board’s defined scope of 
review, remain eligible for future consideration by the respective Service Board for Correction 
of Military Records. 

 

 

RATING COMPARISON: 

 

Service IPEB – Dated 20031124 

VA - (14 Mos. Pre-Separation) 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Migraine Headache 

8100 

0% 

Migraine Headaches 

8100 

0%* 

20021212 

Chronic Sinusitis/Allergic Rhinitis 

Not Unfitting 

Not Service Connected 

No Additional MEB/PEB Entries 

Other x 6 

20021212 

Combined: 0% 

Combined: 10% 



Derived from VA Rating Decision (VARD) dated 20030122 (most proximate to date of separation [DOS) 

* Rating increased to 30% on VARD dated 20060327, effective to 20051006. 

 

 

ANALYSIS SUMMARY: The Military Disability Evaluation System (MDES) is responsible for 
maintaining a fit and vital fighting force. While the MDES considers all of the service member's 
medical conditions, compensation can only be offered for those medical conditions that cut 
short a service member’s career, and then only to the degree of severity present at the time of 
final disposition. The MDES has neither the role nor the authority to compensate service 
members for anticipated future severity or potential complications of conditions resulting in 


medical separation nor for conditions determined to be service connected by the VA but not 
determined to be unfitting by the PEB. However, the Department of Veteran Affairs (DVA), 
operating under a different set of laws (Title 38, United States Code), is empowered to 
compensate all service connected conditions and to periodically re-evaluate said conditions for 
the purpose of adjusting the veteran’s disability rating should his degree of impairment vary 
over time. The Board’s role is confined to the review of medical records and all evidence at 
hand to assess the fairness of PEB rating determinations, compared to VASRD standards, based 
on severity at the time of separation. 

 

Migraine Headache Condition. The CI reported a history of migraine headaches from 1991 to 
1996 during a break in service, but had not experienced headaches for several years, including 
previous deployments. The CI also had a long history of allergic rhinitis, sinusitis, and sinus 
headaches for which he had been treated with immunotherapy and sinus surgery in the past. 
The CI had recurrent headaches refractory to management while deployed in March 2003. The 
CI was seen by neurology and thought to have possible aggravation of his underlying sinus 
condition. He was then evacuated back to the US to remove him from the local environment. 
Upon his return, the CI was evaluated by neurology, allergy and immunology, and seen in the 
primary care clinic. The CI’s workup included a CT scan performed on 17 June 2003 which 
normal. A CT of his sinuses on 10 September 2003, revealed mucosal thickening in the 
maxillary antra bilaterally and a mild deviation of the nasal septum. The CI was tried on several 
medications for migraine headaches, both prophylactic and abortive. He was noted to be 
improved on Verapamil with his headaches decreased from daily, but still 1-2 per week. He was 
started in the MEB process. Allergy testing showed a significant response to multiple allergens, 
but immunotherapy was deferred until he was back at his permanent home. The narrative 
summary (NARSUM) was dictated on 16 October 2003, a little over three months prior to 
separation. The CI reported that his migraine headache condition started in his early thirties 
and then “disappeared for about 6 years.” These recurred while deployed and the CI described 
his headaches as unilateral throbbing pain, often accompanied by nausea, photophobia, and 
photophonia. The CI would have to stop what he was doing and lie down. He denied an aura 
but reported that he would have a feeling like “a storm brewing” in his head. The headache 
reported having headaches about 3-4 times a week, prior to being placed on Verapamil 
(antihypertensive medication used for migraine headache prophylaxis) and Imitrex tablets. The 
CI reported that the Imitrex would work if taken at the onset of symptoms. The CI was still 
having two to four headaches a week with his treatment regimen. The examiner’s assessment 
was that the CI’s “attacks are currently frequent and incapacitating.” The examiner felt that the 
resurgence of the headache condition may have been related to environmental factors having 
to do with deployment. The CI was felt to have no limitations between his headaches and there 
was some possibility that he may have some resolution with treatment and return to a pattern 
of less frequent headaches. He was thought to not be deployable. An addendum to the 
NARSUM, dictated on 21 October 2003, was performed by an allergy and immunology 
specialist. The examiner reported that the CI developed an acute sinusitis during his 
deployment, followed by recurrent migraine headaches. (The Board noted that the CI had sinus 
surgery in both 1992 and 1995.) The examination revealed “nasal mucus membrane edema 
and pallor” (felt to be compatible with allergic rhinitis) and a “deflection of the nasal septum 
and turbinates toward the right with relatively narrower right nasal passage on the left.” The 
examiner again recommended immunotherapy (allergy shots) for the CI when he returned to 
his home state. It was the opinion of the examiner that the allergies/sinuses were a trigger for 
the CI’s migraine headaches. The commander noted that the CI had “done an excellent job 
while working with the MEDDAC staff in the Medical Hold office and with the First Sergeant.” 
She went on to state that he was incapable of performing the duties in his MOS. No comment 
was made on how often he needed to leave work due to his headaches. There were no records 
in evidence that the CI had been placed on quarters for his migraines or given a sick slip for 
these. The CI did not show for his VA compensation and pension (C&P) examination. 


The Board directed its attention to the rating recommendation based on the above evidence. 
The VASRD §4.124a rating schedule for 8100 (Migraine) rests heavily on the frequency of 
‘prostrating’ attacks. Both the PEB and the VA rated the migraine headache condition using 
VASRD code 8100 at 0%. The VA rater noted that the CI failed to show up for his C&P 
examination and, therefore, there was no information regarding the CI’s migraine condition 
“over the last several months.” The VA later awarded an increase of the migraine headache 
condition to 30%, only dating back to 06 October 2005, at which time there was documented 
evidence in the VA records of worsened migraine type headaches. The Board reviewed the 
service treatment records proximate to the time of separation and agreed that, although, the CI 
had improvement of migraine headache condition, he continued to have headaches one to 2 
times per week, at least some of which required him to stop what he was doing. The Board 
agreed that this constituted sufficient severity to meet the threshold as prostrating. After due 
deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the 
Board recommends a disability rating of 30% for the migraine headache condition. 

 

 

BOARD FINDINGS: IAW DoDI 6040.44, provisions of DoD or Military Department regulations or 
guidelines relied upon by the PEB will not be considered by the Board to the extent they were 
inconsistent with the VASRD in effect at the time of the adjudication. The Board did not 
surmise from the record or the PEB ruling in this case that any prerogatives outside the VASRD 
were exercised. In the matter of the migraine headache condition, the Board unanimously 
recommends a disability rating of 30%, coded 8100 IAW VASRD §4.124a. There were no other 
conditions within the Board’s scope of review for consideration. 

 

 

RECOMMENDATION: The Board recommends that the CI’s prior determination be modified as 
follows; and, that the discharge with severance pay be recharacterized to reflect permanent 
disability retirement, effective as of the date of his prior medical separation: 

 

UNFITTING CONDITION 

VASRD CODE 

RATING 

Migraine Headache 

8100 

30% 

COMBINED 

30% 



 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120808, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 xxxxxxxxxxxxxxxxxxxxxxx, DAF 

 Director of Operations 

 Physical Disability Board of Review 

 


 

SFMR-RB 


 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency 

(TAPD-ZB / xxxxxxxxxxxxxxxx), 2900 Crystal Drive, Suite 300, Arlington, VA 22202-3557 

 

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation for 
xxxxxxxxxxxxxxxxxxxxxxxxxx, AR20130010186 (PD201201554) 

 

 

1. I have reviewed the enclosed Department of Defense Physical Disability Board of Review 
(DoD PDBR) recommendation and record of proceedings pertaining to the subject individual. 
Under the authority of Title 10, United States Code, section 1554a, 

I reject the Board’s recommendation and hereby deny the individual’s application. There is 
insufficient justification to support the Board’s recommendation in accordance with Army and 
Department of Defense regulations. 

 

2. Although the Medical Evaluation Board (MEB) examining physician reported the individual’s 
headaches as frequent and incapacitating, the objective evidence is lacking. There is no 
documentation of missed duty time, confinement to quarters, or emergency room visits that 
would better delineate the criteria required by the Veterans Administration (VA) Schedule for 
Rating Disabilities to increase the rating. It is noted that the individual had a 0% rating by the 
VA prior to mobilization and after medical management of the current exacerbation of the 
applicant’s headaches, he was assessed by the Physical Evaluation Board (PEB) to meet the 
criteria for a 0% rating. The applicant was familiar with a 0% rating, concurred with the PEB’s 
assessment and did not seek a higher rating from the VA for another 2 years. 

 

3. This decision is final. The individual concerned, counsel (if any), and any Members of 
Congress who have shown interest in this application have been notified of this decision by 
mail. 

 

BY ORDER OF THE SECRETARY OF THE ARMY: 

 

 

 

Encl xxxxxxxxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)