RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY 

CASE NUMBER: PD1201595 DATE OF PLACEMENT ON TDRL: 20021107 

BOARD DATE: 20130402 DATE OF PERMANENT SEPARATION: 20041123 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty SFC/E-7 (31P/Strategic Microwave Chief), medically 
separated for chronic back pain and migraine headaches. Over the CI’s military career, he had 
several motor vehicle accidents and then a crane accident which resulted in him seeking care 
for head, face and neck pain, and low back pain (LBP) with radiation to the lower extremity. 
The CI did not improve adequately with conservative treatment to meet the physical 
requirements of his Military Occupational Specialty (MOS) or satisfy physical fitness standards. 
He was issued a permanent P3/U3/L3 profile and referred for a Medical Evaluation Board 
(MEB). Nine other conditions, as identified in the rating chart below, were forwarded on the 
MEB submission as medically unacceptable conditions. The MEB also forwarded lyme disease, 
currently asymptomatic as medically acceptable. The Informal Physical Evaluation Board (IPEB) 
adjudicated the migraine headache condition which was prostrating and debilitating with 
atypical face pain/facial nerve entrapment at 30%; and adjudicated the LBP at 10%, with 
application of the Veterans Affairs Schedule for Rating Disabilities (VASRD); and adjudicated the 
remaining MEB conditions not unfitting, as identified on the rating chart below. The CI 
concurred with the IPEB proceedings and was placed on Temporary Disability Retired List 
(TDRL). Two years later the IPEB adjudicated the migraine headaches at 0% and the chronic 
back pain at 10%, using the new VASRD spine rules from 2003, and changing the code as 
identified in the chart below. The CI appealed to the US Army Physical Disability Agency 
(USAPDA). The USAPDA adjudicated the migraine headaches at 10% and the chronic back pain 
at 10%. The CI was thus removed from TDRL and separated with a 20% combined disability 
rating. 

 

 

CI CONTENTION: The CI states: “Review for accuracy & fairness.” [sic] 

 

 

SCOPE OF REVIEW: The Board wishes to clarify that the scope of its review as defined in DoDI 
6040.44 Enclosure 3, paragraph 5.e.(2) is limited to those conditions which were determined by 
the PEB to be specifically unfitting for continued military service; or, when requested by the CI, 
those condition(s) “identified but not determined to be unfitting by the PEB.” The ratings for 
unfitting conditions will be reviewed in all cases. Any not unfitting 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 Army Board for Correction of Military Records. 

 

 

 


TDRL RATING COMPARISON: 

 

Service FPEB – Dated 20040923 

VA* – All Effective Date 20021107 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

On TDRL – 20021107 

 

TDRL 

Sep. 

Migraine Headaches 
w/Atypical Face 
Pain/Facial Nerve 
Entrapment 

8100 

30% 

10% 

Migraine Headaches 

8100 

30% 

20030212 

Nerve Damage in Neck and 
Face 

8399-8311 

NSC 

20030212 

Chronic Back Pain 

5299-
5295* 

10% 

10% 

Chronic Strain, L-Spine 
w/Mild Posterior Spur 
Formation 

5292 

10% 

20030212 

Rebound Headaches 

Not Unfitting 

No VA Entry 

 

 

 

R Hip DJD 

Not Unfitting 

Chronic Strain, R Hip 

5299-5251 

10% 

20030212 

Cervical Spine DJD 

Not Unfitting 

Cervical Spine Condition 

5290 

NSC 

20030212 

Thoracic Spine DJD 

Not Unfitting 

Thoracic Spine Condition 

5299-5291 

NSC 

20030212 

Tinnitus, L Ear 

Not Unfitting 

Tinnitus, L Ear 

6260 

10% 

20030212 

L Shoulder Impingement 
Syndrome 

Not Unfitting 

L Shoulder Impingement 
Syndrome 

5299-5201 

0% 

20030212 

L Ankle Posttraumatic DJD 

Not Unfitting 

Status Post Surgery, L Ankle 
w/Residual Pain 

5271 

10% 

20030212 

 

L Elbow, Mild to Moderate DJD 

 

Not Unfitting 

Scar, L Elbow 

7804 

10% 

20030212 

L Elbow, DJD 

5299-5211 

0% 

20030212 

Acne Keloidalis Nuchae 

Not Unfitting 

Acne, Occipital Region 

7828 

0% 

20030212 

Lyme Disease, currently 
asymptomatic 

Not Unfitting 

Lyme Disease 

6319 

NSC 

20030212 

.No Additional MEB/PEB Entries. 

Moderate Restrictive 
Ventilatory Defect 
w/History of Asbestos 
Exposure 

6833 

30% 

20030212 

Chronic Strain, L Hip 

5299-5251 

10% 

20030212 

Temporomandibular Joint 

8199-8305 

10%** 

20030212 

 

0% x 0/Not Service Connected x 2 

20030212 

Combined: 20% 

Combined: 80% 



*Code changed to 5237 using new VA spine rules. 

 

ANALYSIS SUMMARY: The Board acknowledges the CI’s contention to “review for fairness and 
accuracy.” 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. The Board must emphasize that its recommendations are 
confined to those conditions determined to be unfitting at the time of the CI’s placement on 
TDRL. Unlike the VA which provides compensation for all service connected conditions, the 
Disability Evaluation System (DES) (and by extension the Board) provides compensation only for 
those conditions determined to render the member incapable of further military duty. It must 
also judge the fairness of PEB fitness adjudications based on the fitness consequences of 
conditions, as they existed at the time of separation. The Board’s threshold for countering DES 
fitness determinations is higher than the VASRD §4.3 reasonable doubt standard used for its 
rating recommendations; but, remains adherent to the DoDI 6040.44 “fair and equitable” 
standard. In this case the CI concurred with the original IPEB determinations of the unfitting 
migraine headaches w/atypical face pain/facial nerve entrapment and chronic LBP and 
associated ratings as well as with the determinations of the not unfitting conditions prior to 
placement on TDRL. Therefore the Board will review the unfitting conditions that placed the CI 
on TDRL. The Board takes the position that subjective improvement or worsening during the 
period of TDRL should not influence its coding and rating recommendation at the time of 
permanent separation. The Board’s relevant recommendations are assigned in assessment of 
the service’s permanent separation and rating determination, and the TDRL rating assignment 


is not considered a benchmark. It is recognized, in fact, that PEB’s across the services 
sometimes apply an overly generous initial rating in order to meet the DoD requirement of 30% 
disability for placement on TDRL. This is in the member’s best interest at the time and does not 
mean that a final lower rating is unfair, even if perceived as incongruent with subjective 
severity from one rating to the next. Thus the sole basis for the Board’s permanent disability 
recommendation is the optimal VASRD rating for disability at the time the CI is permanently 
separated at exit from TDRL. 

 

Migraine Headaches. In June 1995 the CI was involved in freak accident while working at an air 
show. A steel beam fell from a cane and knocked him off an 18 wheel tractor trailer, causing 
him to fall eight feet. He acutely had a loss of consciousness for a few minutes, fractured his 
pelvis and ribs and had direct trauma to his head, neck and left side of his face. The evidence 
was lacking service treatment records (STR) for acute treatment of these injuries. The CI 
started seeking care in May 1997 for persistent, episodic facial pain both in the area of the 
trigeminal and facial nerves with decreased sensation as well as numbness of the perioral 
region of the face. The facial pain had been occurring every other day but gradually increased 
in frequency, severity and duration. The facial pain was described as sharp, shooting, stabbing 
radiating to around the ear, occurred 5-15 times per day and could last minutes at a time. The 
pain worsened with chewing or when with the wind was on that side of his face. He underwent 
multiple evaluations by neurology, neurosurgery, otolaryngology (ENT), pain clinic, and 
maxillofacial surgery (OMFS). Several diagnoses were entertained herein listed as from the 
most frequent diagnosis to the least; trigeminal neuralgia, migraines, atypical facial pain related 
to migraine, sinusitis, Eagle’s syndrome (elongated styloid process), cervical disc disease with 
radiculopathy and temporal mandibular joint disorder (TMJD). A computer tomography (CT) of 
the head was negative for sinus problems, a brain magnetic resonance imaging (MRI) was 
normal, cervical spine exams, and X-rays did not reveal a radiculopathy, Eagle’s syndrome was 
ruled out and the TMJD evaluation was inconclusive and ongoing at the time of the MEB. 
Therefore therapy was directed at a probable trigeminal neuralgia and a migraine headache 
diagnoses. He was tried on multiple pain modifying and anti-seizure medications which had 
been ineffective. He also underwent a nerve blocking procedure by pain clinic, injections in the 
head and neck region which provided temporary yet minimal long-lasting relief. He elected not 
to undergo surgical exploration of the facial nerve. The CI was permanently profiled in May 
2002. The profile specified a P3 characterization likely for the identified facial pain and 
migraine headache conditions but did not label specific limitations to these conditions. The 
profile did allow wearing of a Kevlar helmet and the carrying and firing of a weapon. The 
commander’s statement documented the profile disqualified him from his MOS. 

 

At the MEB exam, the CI additionally reported was currently being followed by neurology, ENT 
and by OMFS for his headaches and atypical facial pain. The MEB exam demonstrated multiple 
facial and scalp scars, tenderness of the left temple to the ear and proximal mandible, positive 
TMJD clicking, deviated nasal septum, and was silent to specific neuromuscular findings. The 
MEB examiner diagnosed atypical face pain/facial nerve entrapment that was 
moderate/frequent in intensity and occurrence, and migraine headaches secondary to closed 
head injury that was moderate/occasional in intensity and occurrence. The MEB examiner also 
documented the CI had difficulty wearing a Kevlar helmet or load bearing equipment in the 
field because of his frequent headaches and tinnitus. The neurology addendum for the MEB 
additionally documented the CI reported two to three headaches per week with typical 
migraine features which had been ongoing for years and also had a daily, dull ache of the entire 
head. He reported treating his migraine headaches by lying down but did not specify the time 
or if he left work. The neurology exam demonstrated normal cranial nerve testing, normal 
carotid artery findings, and normal motor, sensory, and reflex findings. The examiner 
diagnosed atypical facial pain, migraine without aura and analgesic rebound headache. The 
examiner documented the CI reported successful treatment with the recommended anti-
seizure medication, Depakote for his atypical facial pain in that he would go several days 


without pain. The examiner also documented the CI was having side effects with the use of 
Imitrex and Motrin for the migraines and that the examiner would be changing medications to 
Amerge (triptan medication) and Vioxx (nonsteroidal anti-inflammatory medication) to 
optimize his migraine care management. 

 

At the VA Compensation and Pension (C&P) exam 3 months after TDRL placement, the CI 
reported taking Imitrex (triptan medication) and Elavil (antidepressant/pain modifying 
medication) for his migraine and atypical face pain, respectively. He reported migraine 
headaches twice a week that lasted two or three hours each time which usually responded to 
Imitrex and a dark, quiet room. He still reported facial pain that started in the left neck 
shooting to the back of his left ear which happened twice daily. The exam was normal for 
neurosensory findings and a normal cervical spine without evidence of radiculopathy or other 
nerve injury, facial or cervical. The examiner diagnosed migraine headache. 

 

At the TDRL exit exam the CI reported to the neurologist he had no interval improvement. He 
reported twice a month getting a severe migraine headache that dissipated with Imitrex, a dark 
room, and immobility over several hours. The shooting left facial pain currently occurred less 
frequently (1-7 x days) but was now lasting 30 minutes. He was taking Neurontin (pain 
modifying medication), for his atypical facial pain and Imitrex, and Vioxx for his migraine 
headaches. The neuromuscular, cranial nerve and sensory findings were normal. The 
neurologist diagnosed atypical facial pain and migraine without aura, prostrating, occurring 
twice a month. 

 

The Board directs attention to its rating recommendation based on the above evidence. The 
VASRD §4.124a rating schedule for 8100 (Migraine) is excerpted below: 

 

 With very frequent completely prostrating and prolonged attacks 

 productive of severe economic inadaptability-------------------------------50 

 With characteristic prostrating attacks occurring on an average once 

 a month over last several months---------------------------------------------30 

 With characteristic prostrating attacks averaging one in 2 months over 

 last several months-------------------------------------------------------------10 

 With less frequent attacks------------------------------------------------------------0 

 

The PEB combined migraine headaches with atypical facial pain. The Board notes likely these 
two conditions were combined to achieve the 30% rating to meet the DoD requirement for 
placement on TDRL, as the evidence did not elucidate the monthly prostrating headaches 
required for the 30% criteria stipulated by the VASRD 8100 code (migraine headache). The VA 
assigned the 30% rating coded 8100 (migraine headache), subsuming head pain, as their 
evidence did support this criteria. The VA chose not to service-connect the left neck, facial 
pain, as there was no evidence of cervical radiculopathy or facial nerve entrapment. The Board 
notes the IPEB adjudicated solely the migraine headache condition on exit of TDRL and is silent 
to any adjudication of the atypical facial pain. The Board is thus challenged with the 
consideration of decoupling the migraine headache condition from the atypical facial pain 
condition which was adjudicated by the IPEB at the time of placement onto TDRL placement. 
The Board first considered if atypical facial pain, having been de-coupled from the combined 
PEB adjudication, remained independently unfitting. This condition is profiled, does not meet 
retention standards, and is a separate distinct condition treated by the neurologist. The 
medical member discussed likely this is a permanent residual of the direct trauma to his face 
from the crane accident. Therefore all members agreed that the atypical facial pain, as an 
isolated condition, would have rendered the CI incapable of continued service within his MOS, 
and accordingly merits a separate rating. It is clear that the rating under 8100 hinges on the 
frequency of ‘prostrating’ attacks; and, it is incumbent on the Board to apply DoDI 6040.44-
compliant and uniform criteria which would define a recurrent migraine episode as ‘prostrating’ 


and ratable. Under DoDI 6040.44, the Board is directed to: “use the VASRD in arriving at its 
recommendations, along with all applicable statutes, and any directives in effect at the time of 
the contested separation (to the extent they do not conflict with the VASRD in effect at the 
time of the contested separation).” Since the VASRD does not provide a definition of 
‘prostrating’, it can be argued that the Board is directed to apply the DoDI 1332.39 definition 
which requires evidence that medical treatment is sought for each rated episode. The Board, 
by precedence, has not required rigid proof of medical attention for each and every episode to 
characterize it as prostrating; but, does require reasonably convincing evidence that rated 
attacks force the abandonment of work or current activity to treat the migraine; although, self-
management (medication and/or sleep) has been accommodated within this threshold. Board 
members agreed at the time of placement onto TDRL the migraine headache evidence supports 
the 0% rating as the evidence, while it supports headaches two to three times per weeks, lacks 
elucidation if these attacks are prostrating. As for a TDRL rating recommendation for the 
atypical facial pain the Board considered VASRD code 8405 (neuralgia, fifth (trigeminal) cranial 
nerve) as the most clinically appropriate and agreed the evidence supports the 10% incomplete, 
moderate criteria and does not approach the 30%, incomplete severe criteria. While the 
combined ratings for both these conditions does not approach the 30% rating which was 
assigned on entry onto TDRL the Board notes it recommendation may not produce a lower 
rating than of the PEB. 

 

As for the permanent rating recommendation the TDRL exam is the only exam closest to 
separation for consideration. For the migraine headaches the evidence supports neurology 
documented twice a month prostrating headaches which meets the 8100 30% criteria which 
the VA had rated 3 months post TDRL placement. However, the USAPDA upon their review of 
the documents noted that the CI directed the physician to document his headache condition 
more specifically. The Board does not have evidence to refute or accept that the physician 
notes were clarified and therefore agreed there is inconsistency in the record of the number of 
prostrating headaches. The Board first agreed the evidence reflects ongoing neurologic medical 
management of both the migraine headaches and the atypical facial pain with changes in 
medications to reflect active disease and therefore agreed this meets the 10% 8100 criteria. 
The Board next turned its attention to the medication profile evidence from both military and 
civilian providers. The members agreed the Imitrex prescribed documents continued treatment 
yet the refills do not support a once a month treatment of headaches to meet the 30% criteria. 
As for the atypical facial pain permanent rating recommendation, the Board notes the atypical 
facial pain had decreased to 1-7 daily attacks from 5-15 yet they are longer in duration 
30 minutes rather than minutes. Therefore members agreed the evidence continues to support 
the 10% rating with the 8405 code. After due deliberation, considering all of the evidence and 
mindful of VASRD §4.3 (reasonable doubt), the Board recommends no change in the rating for 
placement onto TDRL, however for the permanent rating recommends separate disability 
ratings of 10% for the migraine headache condition and 10% for the atypical facial pain 
condition. 

 

Low Back Pain. The CI was involved in several accidents that injured his low back. The most 
proximate accident was in 1999 when he was rear-ended by another driver which aggravated 
his low back condition. He was evaluated and treated by orthopedics and physical therapy for 
LBP with radiculopathy with confirmed disk pathology at L5-S1 on a CT scan. He received some 
relief with epidural steriod injections (ESIs) and had some control with the nonsteroidal 
medication, Vioxx. The MEB physical exam demonstrated tenderness to palpation over the L4-
5 region and over the left sacroiliac joint and palpation of the left sciatic notch elicited pain to 
the left lower extremity. There was limited forward flexion to 30 degrees measured with a dual 
inclinometer and pain limited motion with lateral flexion particularly on the left side. There 
was decreased motor strength of the extensor hallicus longus, 4 of 5, which correlated to the S1 
nerve root and decreased sensation over the L4 and S1 distribution; otherwise the remainder of 
the neuromuscular findings of the lower extremity was normal. He had difficulty with a heel 


walk. There were no Waddell’s signs. X-rays revealed decreased joint space at the L4-5 and 
MRI revealed a broad based disk at L5-S1 with protrusion and displacement of the left S1 nerve 
root and associated disk desiccation at L4-5. The examiner diagnosed LBP secondary to 
herniated nucleus pulposus (HNP) L5-S1 with left S1 radiculopathy. The examiner documented 
he was placed on an updated profile to prevent symptoms. The examiner further documented 
he was on a profile that did not allow jumping, road marching or carrying a rucksack, limited his 
ability to carry heavy loads, not qualified to operate military tactical vehicles and not allowed to 
perform an alternate physical training test. At the C&P exam while on the TDRL, the CI 
additionally reported constant LBP that did not extend to either leg which was aggravated with 
bending, walking a quarter of a mile, or lifting more than 10-15 pounds. He reported morning 
stiffness and had daily flare-ups with sudden twisting or bending activity that lasted up to two 
hours. The C&P exam additionally demonstrated a normal gait, the ability to walk with 
tiptoe/heel without difficulty, normal posture, no pain, or spasm in manipulation of the lumbar 
spine, normal neuromuscular findings, and LBP with straight leg testing (SLR) at 60 degrees 
bilaterally, an equivocal finding for disc disease. X-rays revealed mild posterior spur formation 
at the level of L5-S1. The examiner diagnosed chronic strain, lumbosacral spine with mild 
posterior spur formation. 

 

At the final TDRL exam, 7 months prior to separation, the CI reported a mild to moderate 
increase in severity of his chronic LBP and that he regularly took the non-steroidal medication 
Naprosyn and rarely took the narcotic based pain medication, Percocet. The TDRL exam 
demonstrated tenderness to palpation at the L4-5, otherwise a normal gait, heel-toe and 
tandem walk, negative straight leg raise bilaterally, no Waddell’s signs and normal 
neuromuscular findings of the lower extremities. The examiner diagnosed LBP secondary 
thought to be secondary to degenerative lumbar disease in addition to a HNP and additionally 
documented there was no current evidence of previously diagnosed S1 radiculopathy. 

 

There were two goniometric range-of-motion (ROM) evaluations in evidence, with 
documentation of additional ratable criteria, which the Board weighed in arriving at its rating 
recommendation; as summarized in the chart below. 

 

Thoracolumbar ROM 

degrees 

MEB ~10 Mo. Pre-TDRL 

dual inclinometer 

VA C&P ~3 Mo. Post-TDRL 

goniometric 

TDRL ~7 Mo. Pre-Sep 

goniometric 

Flexion (90 Normal) 

30 

70 

90 

Ext (0-30) 

0 

30 

-10 

R Lat Flex (0-30) 

30 

30 

30 

L Lat Flex 0-30) 

30 

30 

30 

R Rotation (0-30) 

 

30 

30 

L Rotation (0-30) 

 

30 

30 

Combined (240°) 

 

220 

200 

Comment 

+ Tenderness; painful 
motion, motor deficits 
S1 

painful motion 

Silent to painful motion 

§4.71a Rating 

10% vs. 20% 

10% 

10% 



 

The Board directs attention to its rating recommendation based on the above evidence. The 
PEB and VA chose different coding options for the condition, yet both based their rating 
recommendations IAW 2002 VASRD coding and rating standards for the spine, which were in 
effect at the time of TDRL entry, which were modified on 23 September 2002 to add 
incapacitating episodes (5293, intervertebral disc syndrome), and then changed to the current 
§4.71a rating standards on 26 September 2003. The 2002 standards for rating based on ROM 
impairment were subject to the rater’s opinion regarding degree of severity, whereas the 
current standards specify rating thresholds in degrees of ROM impairment. The three 
potentially applicable codes from the 2002 VASRD are excerpted below: 

 


5292 Spine, limitation of motion of, lumbar: 

Severe ………………………………………………………..……….…………... 40 

Moderate …………………………………….……………….…….…………...… 20 

Slight ………………………………………………………..…………………..….10 

 

5293 Intervertebral disc syndrome: 

Pronounced; with persistent symptoms compatible with: sciatic 

 neuropathy with characteristic pain and demonstrable muscle 

 spasm, absent ankle jerk, or other neurological findings appropriate 

 to site of diseased disc, little intermittent relief ………………..….……….….. 60 

Severe; recurring attacks, with intermittent relief ……………..…….………..….…40 

Moderate; recurring attacks ……………………………………………............…...20 

Mild ……………………………………………………………..…………….….…10 

Postoperative, cured ……………………………………………..……………....…..0 

 

5295 Lumbosacral strain: 

Severe; with listing of whole' spine to opposite side, positive 

Goldthwaite's sign, marked limitation of forward bending in 

 standing position, loss of lateral motion with osteo-arthritic 

 changes, or narrowing or irregularity of joint space, or some 

 of the above with abnormal mobility on forced motion …………………..…... 40 

With muscle spasm on extreme forward bending, loss of lateral spine 

 motion, unilateral, in standing' position ……………...…………..…...….….. 20 

With characteristic pain on motion ………………………………..……...…….…. 10 

With slight subjective symptoms only ……………………...………………...……. 0 

 

The VA exam was most proximate to TDRL entry therefore the Board assigned it the most 
probative exam for its TDRL rating recommendation. The PEB and the VA chose different 
coding options yet both used the 2002 VASRD old spine rules applicable at the time of TDRL 
placement and assigned a 10% rating. The Board agreed the evidence does not support a 20% 
higher rating for any of the three above applicable codes. As to the Boards permanent rating 
recommendation, the TDRL 7 months prior to separation is the most proximate exam to base 
its rating recommendation. It is clear from the evidence, while the CI subjectively reported a 
mild to moderate increase in symptoms of his LBP, while on TDRL the physical exams 
progressively improved, likely due to treatment and with an updated profile. The VASRD 
§4.71a rating standards were in effect at the time of separation which were more objectively 
defined with goniometric detail or other ratable data. The PEB assigned a 10% rating consistent 
with a decrease in the combined ROM for the thoracolumbar spine. The Board agreed there is 
no other ratable data to consider the low back for a higher rating. There is no evidence of 
persistent radiculopathy and therefore no evidence of ratable peripheral nerve impairment 
which would provide for additional or higher rating. There is no evidence of documentation of 
incapacitating episodes which would provide for additional or higher rating. After due 
deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the 
Board concluded that there was insufficient cause to recommend a change in the PEB 
adjudication for the low back pain 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 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 no change in the PEB entry TDRL rating adjudication. The Board unanimously 


recommends to decouple the migraine headache condition from the atypical facial pain 
condition and further unanimously recommends separate disability ratings of 10% coded 8100 
and 10% coded 8405, respectively for each condition, IAW VASRD §4.124a at the time of 
permanent separation. In the matter of the LBP condition and IAW VASRD §4.71a, the Board 
unanimously recommends no change in the PEB adjudication at the time of TDRL entry or at 
permanent separation. 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/her prior medical separation: 

 

UNFITTING CONDITION 

VASRD CODE 

RATING 

TDRL 

PERMANENT 

Migraine Headaches 

8100 

30% 

10% 

Atypical Face Pain/Facial Nerve Entrapment 

8405 

- 

10% 

Low Back Pain 

5237 

10% 

10% 

COMBINED 

40% 

30% 



 

 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120827, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 xxxxxxxxxxxxxxxxxxxxxxxx, DAF 

 Director of Operations 

 Physical Disability Board of Review 

 


SFMR-RB 


 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency 

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

 

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation 

for xxxxxxxxxxxxxxxxxxxxxxx, AR20130009602 (PD201201595) 

 

 

1. Under the authority of Title 10, United States Code, section 1554(a), I approve the enclosed 
recommendation of the Department of Defense Physical Disability Board of Review (DoD PDBR) 
pertaining to the individual named in the subject line above to recharacterize the individual’s 
separation as a permanent disability retirement with the combined disability rating of 30% 
effective the date of the individual’s original medical separation for disability with severance 
pay. 

 

2. I direct that all the Department of the Army records of the individual concerned be corrected 
accordingly no later than 120 days from the date of this memorandum: 

 

 a. Providing a correction to the individual’s separation document showing that the 
individual was separated by reason of permanent disability retirement effective the date of the 
original medical separation for disability with severance pay. 

 

 b. Providing orders showing that the individual was retired with permanent disability 
effective the date of the original medical separation for disability with severance pay. 

 

 c. Adjusting pay and allowances accordingly. Pay and allowance adjustment will 
account for recoupment of severance pay, and payment of permanent retired pay at 30% 
effective the date of the original medical separation for disability with severance pay. 

 

 d. Affording the individual the opportunity to elect Survivor Benefit Plan (SBP) and 
medical TRICARE retiree options. 

 

 

 

 

 

 

3. I request that a copy of the corrections and any related correspondence be provided to the 
individual concerned, counsel (if any), any Members of Congress who have shown interest, and 
to the Army Review Boards Agency with a copy of this memorandum without enclosures. 

 

BY ORDER OF THE SECRETARY OF THE ARMY: 

 

 

 

 

Encl xxxxxxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)