RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

BRANCH OF SERVICE:  MARINE CORPS 
SEPARATION DATE:  20020331 

 
NAME:  XXX 
CASE NUMBER:  PD1200632 
BOARD DATE:  20130214 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered individual (CI) was an Active Duty LCpl/E-3 (4066/Small Computer System), medically 
separated for post-concussive migraine headaches (HA).  The CI did not respond adequately to 
treatment and was unable fulfill the physical demands of her Military Occupational Specialty, 
meet worldwide deployment standards or satisfy physical fitness standards.  The CI was placed 
on limited duty and referred for a Medical Evaluation Board (MEB).  Mild traumatic brain injury 
(TBI) and post concussive migraine HA were forwarded to the Physical Evaluation Board (PEB) 
IAW NAVMED P-117, Chapter 15-5.  No other conditions appeared on the MEB’s submission.  
The PEB adjudicated the post-concussive migraine HA condition as unfitting, rated 10%, with 
application of the SECNAVINST 1850.4D and the Veterans Affairs Schedule for Rating Disabilities 
(VASRD).  The mild TBI condition was determined to be Category II.  The Navy defines CAT II 
conditions as contributing to the unfit.  The CI made no appeals and was medically separated 
with a 10% disability rating.   
 
 
CI CONTENTION:  The CI elaborated no specific contention in her application.   
 
 
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  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:   
 

 
 
ANALYSIS SUMMARY:   
 
Post-Concussive Migraine Headache Condition.  In March 2001 the CI was wearing her Kevlar 
helmet during drill when a rifle hit the forehead over the helmet and she developed an instant 
HA without loss of consciousness.  She was evaluated in the emergency room for HA, nausea 
and vomiting and diagnosed with a concussion and released for further evaluation.  She was 
then seen four times under the care of her primary care manager who was managing migraine 

Service IPEB – Dated 20020206 
Condition 
Post-Concussive  Migraine 
Headaches 

Code 
8045-9304 

Rating 
10% 

↓No Additional MEB/PEB Entries↓ 

Combined:  10% 

VA (5 Mos. Post-Separation) – All Effective Date 20020401 
Condition 
Post-Concussive 
Headaches 
6513 
Chronic Sinusitis w/ Sinus Cyst 
0% X N/A / Not Service-Connected x N/A 
Combined:  40% 

Code 
8045-8100 

Rating 
30% 

Migraine 

10% 

Exam 
20020909 

20020909 

HA with multiple classic abortive and preventive medications which were ineffective.  She was 
seen by neurology 6 months later and was diagnosed with migraine HA likely secondary to mild 
head trauma.  The non-medical assessment documented the CI missed duty an average of 24 
hours  a  week  and  she  had  been  reassigned  from  her  primary  duties  in  communications,  to 
working in the mail room because of her HA. 
 
At the MEB exam, the CI reported experiencing HA approximately 3-4 times per week with the 
typical associated migraine symptoms, which increased in intensity in the past 3 months, she 
had to be released from work at least once a week because of severe HA.  The MEB physical 
exam and magnetic resonance imaging of the brain obtained 20 August 2001 were normal.  At 
the VA Compensation and Pension (C&P) exam, the CI additionally reported having mild HA 2 
times per week which responded to Midrin.  She had a severe debilitating HA once a week for 
which  she  took  Imitrex  injections,  but  noted  the  HA  still  lasted  up  to  8  hours  and  she  was 
unable to function.  The C&P exam was normal, but not complete.  Furthermore, no physical 
exam findings were cited in the rating decision.  The examiner opined her functional limitations 
were due to migraine HA.  
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
PEB and VA chose different coding options for the condition, which have significant implications 
on  the  rating  for  the  Board  to  consider.    The  PEB  chose  to  code  analogously  to  8045  code 
(Residuals  of  traumatic  brain  injury  (TBI)  which  falls  under  §4.124a—Schedule  of  ratings–
neurological  conditions and  convulsive disorders  with  the  9304  code  (Dementia due  to  head 
trauma), which falls under §4.130 Schedule of ratings-mental disorders.  The VA coded 8100 
(Migraine HA) analogous to 8045 and assigned a 30% rating for monthly prostrating HA.  The 
Board  agreed  while  the  VA  used  the  analogous  TBI  code  to  subsume  the  concussion  they 
primarily  rated  migraine  HA  as  the  diagnostic  disabling  condition.    Furthermore,  the  VA 
examiner 9 years later opined current migraine HA were not likely related to brain injury during 
service.  A lengthy deliberation ensued whether the evidence supports a significant head injury 
which  clinically  is  synonymous  to  a  TBI  or  whether  in  fact  the  HA  condition  is  primarily  a 
migraine condition for consideration of the DC 8100.  By a 2:1 vote the Board majority agreed 
while  the  evidence  clearly  did  not  support  dementia,  the  evidence  did  support  a  significant 
head injury which clinically is synonymous to a TBI.  The Board majority agreed the PEB was 
consistent  with  applying  the  8045  code  to  classify  the  disabling  migraine  HA  and  the  Board 
notes  that  the  maximum  allowable  for  this  code  is  10%  for  the  CI’s  separation  date.    The 
Board’s  rating  recommendation  for  8045  (TBI)  in  this  case  is  subject  to  the  following  policy 
(established  by  precedent  and  prior  legal  opinion).    As  an  implied  extension  of  the  DoDI 
6040.44 and National Defense Authorization Act (NDAA) 2008 mandates, the Board will comply 
with applicable VA disability rating policy changes issued via “Fast” or Training Letters effective 
at  the  time  of  separation.    The  VA  Training  Letter,  TL06-03  (dated  13  February  2006), 
specifically addressed the complexity of TBI and recommended coding “outside” of 8045 when 
a  more  favorable  rating  could  be  achieved  under  an  alternate  code.    Additionally,  the  VA 
Training letter TL07-05 (dated 31 August 2007) went further in recommending separate ratings 
under the applicable codes for each ratable component of TBI in evidence; e.g., HA, tinnitus, 
dizziness,  etc.    Therefore  the  Board  majority  agreed  based  on  the  CI’s  date  of  separation 
(31 March  2002)  that  the  8045-9304  coding  is  correctly  applied  the  8100  code  could  not  be 
considered  for  a  higher  rating.    After  due  deliberation,  considering  all  of  the  evidence  and 
mindful  of  VASRD  §4.3  (Resolution  of  reasonable  doubt),  the  Board  majority  concluded  that 
there  was  insufficient  cause  to  recommend  a  change  in  the  PEB  adjudication  for  the  post-
concussive migraine HA 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 

2                                                           PD1200632 
 

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 post-concussive migraine HA condition and IAW VASRD 
§4.124a and the Board by a vote of 2:1 recommends no change in the PEB adjudication.  The 
single  voter  for  dissent  (who  recommended  assigning  the  VA  rating  of  30%  coded  8100) 
submitted  a  minority  opinion.    There  were  no  other  conditions  within  the  Board’s  scope  of 
review for consideration.   
 
 
RECOMMENDATION:  The Board, therefore, recommends that there be no recharacterization of 
the CI’s disability and separation determination, as follows:   
 

VASRD CODE  RATING 
8045-9304 
COMBINED 

10% 
10% 

UNFITTING CONDITION 
Post-Concussive Migraine Headaches 

 
 
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 
 
 
 
 
 

 

 

XXX 
Acting Director 
Physical Disability Board of Review 

3                                                           PD1200632 
 

Minority Opinion: 
 
The PEB reasonably applied the 8045 code to classify the disabling post-concussive migraine HA 
likely due to the persistence of this diagnosis even by the consulting neurologist, likely without 
consideration  if  the  disabling  HA  were  indeed  primarily  migraine  in  origin.    The  historical 
account of head trauma documented in the emergency visit for HA, for which there is a final 
diagnosis  of  concussion,  is  not  consistent  with  significant head  trauma, and at  best  supports 
mild head trauma that would not be expected to produce residuals deficits.  The HA described 
were typical of migraine symptomatology responding to appropriate migraine treatment and 
the mild head trauma would be classified as a mild head injury that would not be expected to 
produce residual deficits.  Clinically first time mild head injury usually resolves within 7-10 days 
and do not worsen.  The service treatment record reflects Emergency Room visits for evaluation 
and  treatment  of  recurrent  migraines  prior  to  separation  and  these  visits  were  4,  7  and  8 
months  after  the  original  head  injury.    The  Board’s  operative  instruction,  DoDI  6040.44, 
specifies a 12-month interval for special consideration to VA findings.  This does not mean later 
VA evidence is disregarded, but the Board’s recommendations are directed to the severity and 
fitness implications of conditions at the time of separation.  The VA primarily coded the HA as 
migraines 5 months prior to separation and 9 years later the VA examiner opined the HA were 
not related to the mild head trauma in service.  Therefore, based on all evidence and associated 
conclusions  just  elaborated,  the  minority  recommended  consideration  of  the  8100  code 
(migraine HA) for a higher rating and agreed the evidence did not support the 50% criteria for 
very  frequent,  completely  prostrating,  and  prolonged  attacks  productive  of  severe  economic 
inadaptability.  The number of prostrating HA, once a week requiring her to leave work, was 
recorded in service by a neurologist for diagnostic confirmation.  I respectfully submit that the 
Secretary consider the minority recommendation 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 her prior medical separation: 
 

VASRD CODE 
8100 
COMBINED 

RATING 
30% 
30% 

UNFITTING CONDITION 
Post-Concussive Migraine Headaches 

 
 

 

4                                                           PD1200632 
 

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 8 Mar 13 
 

      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 USMC 
-    former USMC 
-    former USN   
-   former USMC 
-   former USMC 
-   former USN  
-   former USMC 
  
 

 
      
 

 
 
 

 
 
 

 
 
 

 
 
 

  XXXXXX 
  Assistant General Counsel 
     (Manpower & Reserve Affairs) 

5                                                           PD1200632