RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

 

BRANCH OF SERVICE:  MARINE CORPS  
SEPARATION DATE:  20020315 

 
NAME:   
CASE NUMBER:  PD1200513 
BOARD DATE:  20130115 
 
  
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered  individual  (CI)  was  an  active  duty  LCpl/E-3  (0621/Field  Radio  Operator),  medically 
separated for facial neuralgia with migraine headaches.  The CI sustained a blow to a previously 
injured, but, healed area of the right face.  A chronic facial pain condition developed.  This could 
not be adequately rehabilitated to meet the physical requirements of his Military Occupational 
Specialty or satisfy physical fitness standards.  He was consequently issued a limitation of duty 
and referred for a Medical Evaluation Board (MEB).  A facial neuralgia with migraine headaches 
condition  was  forwarded  to  the  Physical  Evaluation  Board  (PEB).    In  addition,  essential 
hypertension  condition  was  identified  by  the  MEB  and  forwarded.    The  PEB  adjudicated  the 
facial neuralgia with migraine headaches condition as unfitting, rated 10%, with application of 
the  Veterans  Administration  Schedule  for  Rating  Disabilities  (VASRD). 
  The  essential 
hypertension  condition  was  determined  to  be  not  unfitting  (Category  III  condition).    The  CI 
made no appeals, and was medically separated with a 10% disability rating.   
 
 
CI CONTENTION: “Migraines have continued and in some cases worsen.  Knees that were not 
rated continue to cause discomfort.”(sic) 
 
 
SCOPE  OF  REVIEW:    The  Board  wishes  to  clarify  that  the  scope  of  its  review  as  defined  in 
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 unfitting facial neuralgia with migraine headaches 
condition is addressed below.  The not unfitting hypertension condition was not contended by 
the CI and will not be discussed.  The knee condition alluded to in the CI’s contention was not 
included in the PEB process and is, therefore, outside the 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 Board for Correction of Naval Records.   
 
 
RATING COMPARISON:  
 

Service IPEB – Dated 20020205 
Condition 
Facial  Neuralgia  with 
Migraine Headaches 
Essential Hypertension 
↓No Additional MEB/PEB Entries↓ 
Combined:  10% 

Code 
8100 
Not Unfitting 

Rating 
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, 

VA (2 Mo. Post-Separation) – Effective 20020316 
Condition 
Headaches with Facial Neuralgia 
No VA entry 
Back Pain S/P Lipoma Removal 
Not Service Connected x 3 
Combined:  40% 

Code 
8100 

7804 

Rating 
30% 

Exam 
20020525 

10% 

20020525 
20020525 

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  Department  of  Veterans  Affairs  (DVA)  but  not 
determined to be unfitting by the PEB.  However, the 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 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. 
 
Facial Neuralgia with Migraine Headaches.  The CI sustained a fracture to the bones of the right 
lower face requiring placement of surgical plate for repair in 1998.  After successful healing the 
area was asymptomatic and the CI joined the service in 1999.  The CI sustained a direct blow to 
this area in February 2000 with development of persistent right facial pain.  X-rays of the face 
demonstrated  no new  fractures or  disruption  of  the prior  surgical  site.    On  neurology  exam, 
4 May  2000,  the  diagnosis  of  migraine  type  headaches  possibly  of  facial  nerve  etiology 
(trigeminal neuralgia etiology), related to new facial trauma at an old fracture site was made.  
Neurologic exam was normal without evidence of facial nerve neuropathy.  The CI was treated 
with  neuropathy  medications  with  unsustained  improvement.    He  was  examined  by  both 
neurosurgeons and maxillofacial surgeons, who agreed that surgical intervention, short of plate 
removal, a procedure with associated post operative sequelae, was not indicated.  At the MEB 
narrative summary  evaluation performed on 2 August 2001, 7 months prior to separation, the 
CI reported having two to four headaches a week but being able to perform his duties (office 
clerk) adequately, except when suffering a severe headache which required him to go home.  
He noted this to occur once or twice a month.  On physical evaluation, the neurologic exam was 
normal.  At the VA Compensation and Pension examination, 2 months after separation, the CI 
reported totally debilitating headaches 4 to 5 times a week each lasting 2 to 36 hours.  Physical 
examination  revealed  slight  tenderness  over  the  right  lower  face  without  evidence  of  gross 
deformity or bony instability.   
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
PEB and VA both adjudicated the facial pain condition under VASRD Code 8100, migraine, but at 
different rating levels, the PEB at 10% and the VA at 30%.  Under code 8100 a rating of 10% 
requires  characteristic  prostrating  attacks  averaging  one  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.    When  rating  headaches  under  the 
diagnostic  code  8100  migraine  headaches,  VA  guidance  uses  the  clear  English  definition  of 
prostrating.    The  standard  lexicon  definition  of  "prostration"  is  "utter  physical  exhaustion  or 
helplessness."  The Board noted the statements in the non-medical assessment describing the 
CI  as  a  hard  working  and  respectful  Soldier  away  from  work  2 to 3  days  a  week  for  medical 
evaluation, treatment or recuperation.  The Board further noted the JDET report of the CI away 
from work for severe ‘prostrating’ headaches 1 to 2 times a month over a 1-year period and 
opined that this constituted prostrating attacks.  After due deliberation, considering all of the 
evidence and mindful of VASRD §4.3 (Resolution of reasonable doubt), the Board unanimously 
concluded that the facial pain/headache condition met the criteria for 30% rating at the time of 
separation.  A higher rating of 50% was not supported by the record in evidence.  The Board 
was  unable  to  find  any  pathway  to  a  higher  rating  for  this  condition  under  any  applicable 
VASRD code including §4.123 or §4.124. 
 
 

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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 facial pain/headache condition, the Board unanimously 
recommends a disability rating of 30%, coded 8100, IAW VASRD §4.124.  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 
Facial Neuralgia with Migraine Headaches 

VASRD CODE  RATING 
8100 
COMBINED 

30% 
30% 

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120604, w/atchs. 
Exhibit B.  Service Treatment Record. 
Exhibit C.  Department of Veterans Affairs Treatment Record. 
 
 
 
 
 
 
 
 

 

           XXXXXXXXXXXXXXX 
           President 
           Physical Disability Board of Review 

   3                                                           PD1200513 
 

MEMORANDUM FOR DIRECTOR, COUNCIL OF REVIEW BOARDS 

Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATION 

    ICO XXXXXXXXXXX FORMER USMC 
 

 

 
 
 
 
 
 
 
 
 

Ref:   (a) DoDI 6040.44 

             (b) PDBR ltr dtd 25 Jan 13 
 

      I have reviewed subject case pursuant to reference (a) and non-concur with the recommendation 
of  the  PDBR  as  set  forth  in  reference  (b).    I  found  the  disability  rating  awarded  by  the  Physical 
Evaluation Board in February 2002, to have been supported by the evidence or record.  Therefore, 
Mr.  XXXXXXXXXXX  naval  records  will  be  not  be  corrected  to  reflect  a  change  in  either  his 
disability rating or characterization of discharge. 

 
 
 
 
 

 
 
 
 
 

 
 
 
 
 

 
 
 
 
 

 
 
 
 
 

  XXXXXXXXXX 
  Principal Deputy 
  Assistant Secretary of the Navy  
     (Manpower & Reserve Affairs) 
   

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