RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 
NAME:    
BRANCH OF SERVICE:  MARINE CORPS 
CASE NUMBER:  PD1200174                                                                 SEPARATION DATE:  20030315 
BOARD DATE:  20121031     
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered  individual  (CI)  was  a  mobilized  Reserve,  LCPL/E-3  (0341,  Mortar  man),  medically 
separated for migraine headaches.  The CI developed severe headaches with two episodes of 
loss of consciousness (LOC) in February 2002.  A diagnosis of migraine headaches was made. 
This  condition  could  not  be  adequately  rehabilitated  with  treatment  to  meet  the  physical 
requirements of his Military Occupational Specialty (MOS) or satisfy physical fitness standards.  
He  was  placed  on  limited  duty  [LIMDU]  and  referred  for  a  Medical  Evaluation  Board  (MEB).  
History of syncope and presyncope and history of somnambulism, identified in the rating chart 
below, were also identified and forwarded by the MEB.  The Physical Evaluation Board (PEB) 
adjudicated the migraine headaches as unfitting, rated 10%, with application of the Veteran’s 
Affairs Schedule for Rating Disabilities (VASRD).  The remaining conditions were determined to 
be not unfitting and determined to be Category III and IV.  The CI made no appeals, and was 
medically separated with a 10% disability rating.   
 
 

CI CONTENTION:  “I believe the rating issued to me regarding my separation should be changed 

based  on  the  loss  of  quality  of  life  I  have  been  reduced  too.    The  migraines  and  the  many 
triggers  that  bring  them  on  prevent  me  from  having  a  normal  life.    The  intensity  of  the 
migraines  has  had  documented  side  effects  while  I  was  on  duty  to  include  syncope  (loss  of 
consciousness) that continues today.  I have also started having bilateral hand weakness that 
the  VA  has  recognized  as  relating  to  my  migraines  as  of  August  of  2008.    Most  recently 
(November 2011) the VA has diagnosed me with the anxiety disorder of Post Traumatic Stress 
Disorder relating back to my hospitalization in February of 2002 while on active duty.”   
 
 
SCOPE OF REVIEW:  The Board wishes to clarify that the scope of its review as defined in the 
Department of Defense Instruction (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.    The  conditions  migraines  and  syncope  as  requested  for  consideration  meet  the 
criteria prescribed in DoDI 6040.44 for Board purview; and, are addressed below.  The other 
requested  conditions 
(anxiety  disorder/PTSD)  are  not  within  the  Board’s  purview.  
Somnambulism is not a physical disability IAW DOD 1332.38 and will be discussed no further.  
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 Board for Correction of 
Naval Records.   
 
 
 
 
 
 
 
 

Service IPEB – Dated 20030122 

VA (5 Mos. Pre-Separation) – All Effective Date 20030316 

Code 
8100 

Rating 
Condition 
10%  Migraine Headaches 

Not Unfitting (CAT III) 

Not a disability (CAT IV) 

Pre-syncope and syncope 
episodes 
Somnambulism 
DDD L spine 

8999-8914 
5010-5292 
0% X 1 / Not Service-Connected x 1 

Combined:  40% 

Code 
8100 

8199-9108 

Rating 
30% 
0% 

Exam 

20021016 
20021016 

NSC 
10% 

20021016 
20021016 
20021016 

 
RATING COMPARISON:   
 

Condition 

Migraine Headaches 
History of Syncope and 
Presyncope 
History of 
Somnambulism 

↓No Additional MEB/PEB Entries↓ 

Combined:  10% 

  
  
 
ANALYSIS SUMMARY:  The Disability Evaluation System (DES) is responsible for maintaining a fit 
and  vital  fighting  force.    While  the  DES  considers  all  of  the  member's  medical  conditions, 
compensation  can  only  be  offered  for  those  medical  conditions  that  cut  short  a  member’s 
career, and then only to the degree of severity present at the time of final disposition.  The DES 
has neither the role nor the authority to compensate 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 Veterans’ Affairs, 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  the  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 developed a febrile illness in February 2002 associated 
with loss of consciousness (LOC), cough, stiff neck, photophobia and severe headaches while 
preparing for involuntary mobilization.  A diagnosis of viral syndrome was made after medical 
evaluation  of  the  febrile  illness.    After  initial  treatment  the  headaches  continued  and  were 
diagnosed as migraine headaches (HA).  On a neurology evaluation performed on 8 July 2002, 
8 months prior to separation, the CI noted HA two to three times a week of which one third 
were  rated  as  10/10  and  remainder  less  intense  (7-8/10).    The  CI  was  begun  on  migraine 
specific medication at the time.  By 30 July 2002, the CI reported feeling better with symptoms 
improved and HA frequency reduced to one per week or less.  However, on neurology exam for 
the MEB/NARSUM performed on 19 August 2002, 7 months before separation, the CI reported 
HA to occur daily but to be relieved by current daily medication.  The dose of this medication 
was  adjusted  and  new  medications  added  to  the  CI’s  treatment  regimen.    The  examining 
physician recorded that the CI could perform standard duties for periods up to 8 hours in total 
duration.    On  the  VA  Compensation  and  Pension  (C&P)  examination  performed  16  October 
2002, 5 months prior to separation, the CI noted the frequency of the HA to be ‘dramatically’ 
reduced on the new treatment regimen to twice a week or once a month and to be controlled, 
when occurring, with nonnarcotic oral medication.  The CI was reported to ‘be shown to have 
the  ability  to  function  during  headache  episodes.’    At  the  time  of  the  NARSUM  addendum, 
5 December 2002, 3 months before separation, HA symptoms were reported to be improving 
on new medications and the CI noted at least a 50% improvement in frequency and severity.  
On  an  urgent  care  clinic  visit  for  a  sore  throat,  performed  on  15  April  2003,  a  month  after 
separation, the CI reported taking no daily migraine medications and having only an occasional 
HA responding to rescue medication.   
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
PEB  and  VA  both  adjudicated  the  migraine  headache  condition  under  VASRD  Code  8100, 

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migraine, but at different rating levels.  When rating headaches under the diagnostic code 8100 
migraine  headaches,  VA  guidance  does  not  specifically  define  prostrating  and  therefore  the 
clear  English  definition  of  prostrating  is  applicable.    The  standard  dictionary  definition  of 
"prostration" is "utter physical exhaustion or helplessness".  Under code 8100 a rating of 10% 
requires  characteristic  prostrating  attacks  averaging  once  in  2  months  over  a  several  month 
period.  The next higher rating, 30%, requires characteristic prostrating attacks averaging once 
a month over a several month period.  The highest rating, 50%, requires completely prostrating 
attacks productive of severe economic inadaptability.  The VA rated at 30% citing the reported 
frequency of twice a week to once a month on the C&P exam.  The PEB rated at 10% citing the 
marked  improvement  in  the  migraine  condition  after  medication  adjustment  noted  in  the 
NARSUM addendum, performed on 5 December 2002, 3 months before separation.  Both the 
VA  and  PEB  agreed  that  a  rating  of  50%  was  not  supported by  the  record  in  evidence.    The 
Board debated whether the CI's headaches at the time of separation merited a 10% or a 30% 
disability rating.  The Board opined that the migraine condition was frequent and severe at its 
inception,  but  responded  with  continued  improvement  with  adjustment  of  medication.    The 
Board  unanimously  agreed  the  condition  had  evolved  to  a  level  of  stability  in  response  to 
appropriate medical treatment and that at the time of separation the migraine attacks were 
occasional,  not  prostrating,  and  responded  to  standard  treatment.    After  due  deliberation, 
considering  all  of  the  evidence  and  mindful  of  VASRD  §4.3  (reasonable  doubt),  the  Board 
concluded  that  the  chronic  headache  condition  more  nearly  approximated  the  10%  rating 
under the VASRD code 8100 at separation.  All evidence considered, there was not reasonable 
doubt  in the  CI’s  favor supporting  a  change  from  the  PEB’s  rating  decision for the  headache 
condition.   
 
Contended PEB Conditions.  The contended condition adjudicated as not unfitting by the PEB 
was  the  history  of  syncope  and  pre-syncope.    The  Board  noted  two  episodes  of  syncope  in 
February  2002  during  the  initial  hospitalization.    The  record  in  evidence  contains  no  further 
episodes of syncope.  The Board concluded this syncope was an isolated occurrence and related 
to  the  initial  headache  condition  prior  to  treatment.    The  Board  noted  several  episodes  of 
dizziness  in  the  record  but  these  were  related  to  migraine  headaches  early  in  its  medical 
course.  This condition was reviewed by the action officer and considered by the Board.  There 
was no evidence for concluding that it interfered with duty performance to a degree that could 
be  argued  as unfitting.   After  due deliberation  in  consideration of the preponderance of the 
evidence, the Board concluded that there was insufficient cause to recommend a change in the 
PEB fitness determination for the syncope 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 and IAW VASRD §4.124, the 
Board  unanimously  recommends  no  change  in  the  PEB  adjudication.    In  the  matter  of  the 
contended syncope and pre-syncope condition, the Board unanimously recommends no change 
from  the  PEB  determination  as  not  unfitting.    There  were  no  other  conditions  within  the 
Board’s scope of review for consideration.   
 
 
 

 

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RECOMMENDATION:  The Board, therefore, recommends that there be no recharacterization of 
the CI’s disability and separation determination, as follows:    
 

UNFITTING CONDITION 

VASRD CODE  RATING 

8100 

COMBINED 

10% 
10% 

Migraine Headaches 

 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120213, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 
 

 

             
           President 
           Physical Disability Board of Review 

   4                                                           PD12-00174 

 

MEMORANDUM FOR DIRECTOR, SECRETARY OF THE NAVY COUNCIL 
                                  OF REVIEW BOARDS  
 
Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS 
 
Ref:   (a) DoDI 6040.44 
             (b) CORB ltr dtd 26 Nov 12 
 
      In accordance with reference (a), I have reviewed the cases forwarded by reference (b), and, 
for the reasons provided in their forwarding memorandum, approve the recommendations of 
the PDBR that the following individual’s records not be corrected to reflect a change in either 
characterization of separation or in the disability rating previously assigned by the Department 
of the Navy’s Physical Evaluation Board: 
 
                  -  former USN  
-  former USMC 
 
-  former USMC 
 
 
-  former USMC 
 
-  former USMC 
  
     
 
 
 
 
 
 
 
 
 
 

  
Assistant General Counsel 
(Manpower & Reserve Affairs) 

 
      
 

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