DEPARTMENT OF TRANSPORTATION 

BOARD FOR CORRECTION OF MILITARY RECORDS 

 
Application for the Correction of 
the Coast Guard Record of: 
 
                                                                                BCMR Docket No. 1997-163 
 
 
   

 

 
 

FINAL DECISION 

 
ANDREWS, Attorney-Advisor: 
 
 
This  proceeding  was  conducted  according  to  the  provisions  of  section 
1552 of title 10, United States Code.  It was commenced on August 8, 1997, upon 
the BCMR’s receipt of the applicant’s application. 
 
 
appointed members who were designated to serve as the Board in this case. 
 

This  final  decision,  dated  October  22,  1998,  is  signed  by  the  three  duly 

REQUEST FOR RELIEF 

 
The  applicant,  a  former  xxxxxxxxxxxxxxxxx  in  the  United  States  Coast 
 
Guard,  asked  the  Board  to  correct  her  military  record  to  show  that,  on  xxxxx 
199x,  she  received  a  medical  discharge  based  on  a  diagnosis  of  disabling 
migraine headaches.  The correction would enable her to receive certain benefits 
for which her current discharge does not qualify her. 
 

APPLICANT’S ALLEGATIONS 

 
 
The  applicant  alleged  that  during  her  enlistment  she  “was  constantly 
plagued with migraine headaches, which were cause[d] by the pressures of [her] 
job.”    She  stated  that  the  doctors  had  found  she  suffered  from  papilledema 
(swelling of the optic papilla) and that analgesic (pain-relieving) medicines only 
partially relieved her headaches.  She stated that, in February 199x, five months 
before she was released into the Coast Guard Reserve from active duty, she had 
suffered episodes of numbness and dizziness.  She stated that, in May 199x, less 
than one month before her release, she was having daily headaches that were not 
relieved  by  taking  50  milligrams  of  Elavil,  an  anti-depressant.    Therefore,  she 

alleged, the Coast Guard erred in failing to convene a medical board to evaluate 
her disability and in failing to give her a medical discharge. 
 

The  applicant  alleged  that  since  her  release  from  active  duty  she  has 
suffered  headaches  two  or  three  times  each  week.    She  stated  that  the  De-
partment of Veterans Affairs (DVA) had found her migraines to be service con-
nected and had granted her a 50% disability rating.  To support her allegations, 
the applicant submitted copies of the findings of doctors for the DVA. 
 

VIEWS OF THE COAST GUARD 

 
 
that the Board deny the applicant the requested relief. 

On August 17, 1998, the Chief Counsel of the Coast Guard recommended 

 
The Chief Counsel stated that to receive a medical discharge, a member 
must  be  found  not  fit  for  duty  because  of  a  physical  disability.    However,  he 
argued, the applicant’s medical record “clearly shows that she was found fit for 
duty and agreed to this finding prior to her discharge from active-duty service.”  
The record also shows that the doctor who found her fit for release from active 
duty took into consideration her medical history of headaches. 

 
“Even  when  medical  records  or  evidence  indicate  that  a  member  may 
have  a  medical  condition  or  impairment,  a  member  is  presumed  fit  for  duty.”  
“[I]nadequate  performance  of  duty,  by  itself,  does  not  constitute  physical 
unfitness.    The  evidence  must  establish  a  cause  and  effect  relationship.”    “The 
only credible evidence on the record is the evaluation of the physician who per-
formed her RELAD [release from active duty] physical who concluded that the 
Applicant was fit for duty.  In fact, the Applicant was medically qualified to re-
enlist  if  she  so  chose.”    In  addition,  the  Chief  Counsel  stated  that,  because  the 
physician who performed her RELAD physical did not question the applicant’s 
fitness for duty, she was not entitled to a medical board evaluation in accordance 
with the Physical Disability Evaluation System (PDES). 

 
The Chief Counsel argued that the applicant’s 50% disability rating by the 
DVA “is insufficient to show that her impairments affected her past work per-
formance in the Coast Guard.”  “[T]he Applicant was diagnosed with stress and 
tension  headaches  but  was  never  found  to  have  a  disqualifying  or  ratable  dis-
ease.  The Applicant has provided no evidence that her work was affected by her 
impairments.”   

 
The Chief Counsel contended that the 50% disability rating by the DVA is 
not inconsistent with the Coast Guard’s finding of fitness for duty because “[t]he 
procedures  and  presumptions  applicable  to  the  DVA  evaluation  process  are 

fundamentally  different  from,  and  more  favorable  to  the  veteran  than  those 
applied  under  the  Coast  Guard’s  [PDES].”    The  DVA  “compensate[s]  former 
service  members  whose  earning  capacity  is  reduced,  at  any  time,  as  a  result  of 
injuries suffered incident to, or aggravated by, military service.” 

 

 
4/4/8x 

CHRONOLOGICAL SUMMARY OF THE RECORD 

The applicant enlisted in the Coast Guard for a term of four years.  On 
her  Report  of  Medical  History,  she  indicated  that  she  suffered  from 
frequent or severe headaches.   

 
7/18/9x  The applicant sought medical help for chronic headaches. She stated 
that she had been having frequent headaches for the past year but that 
they  had  increased  during  the  previous  two  months.    Her  primary 
physician diagnosed tension headaches. 

 
8/16/9x  The applicant sought help for chronic headaches, tiredness, and inter-
rupted  sleep.    She  told  her  primary  physician  she  had  a  history  of 
migraine  headaches.    The  doctor  diagnosed  a  “sleep  problem”  and 
prescribed doxepin (an anti-depressant). 

 
8/17/9x  The applicant complained to her primary physician that she could not 
sleep after taking the doxepin.  She asked to consult a specialist about 
her “migraines.” 

 
8/18/9x  The applicant sought help for chronic headaches.  Her primary physi-
cian  diagnosed  chronic  headaches;  prescribed  Fioricet,  an  analgesic 
for  tension  headaches;  ordered  neurological  testing;  and  told  her  to 
stay in her quarters for one day. 

 
8/19/9x  The  applicant  reported  that  her  headache  now  extended  over  her 
entire  head  and  that  light  hurt  her  eyes.    Her  primary  physician 
prescribed  Tylenol  and  consulted  a  neurologist,  who  suggested  she 
take a gradually increasing dosage of the anti-depressant Elavil. 

 
8/22/9x  The  applicant  reported  to  her  primary  physician  that  her  condition 
had not changed.  He prescribed a low level of Elavil for four weeks 
and told her to stay in her quarters for two days. 

 
8/24/9x  The  applicant  reported  that  her  headache  had  caused  her  to  vomit.  
Her primary physician told her to stay in her quarters for the rest of 
the day and to call about her condition the next morning. 

 
10/13/9x  After neurological testing, the neurologist diagnosed chronic tension 
headaches.  He reported that the applicant had stopped taking Elavil 
after two weeks because she thought it was not working.  The doctor 
told  her  to  stay  on  Elavil  for  three  or  four  months,  increasing  the 
dosage gradually to 50 milligrams per day. 

 
10/26/9x  The applicant sought relief for menstrual cramps, headaches, and an 
upper  respiratory  tract  infection.    Her  primary  physician  prescribed 
medication for her cramps and told her to stay in her quarters for two 
days. 

 
12/7/9x  The applicant sought help for a migraine headache, which she stated 
occurred  at  least  once  a  week.    Her  primary  physician  diagnosed 
“tension  headaches  vs.  migraines,”1  increased  her  dosage  of  Elavil, 
and prescribed Midrin, an analgesic prescribed for tension, vascular, 
and migraine headaches. 

 
1/17/9x  The applicant complained of having suffered from a migraine head-
ache for three days with dizziness, nausea, and sensitivity to light and 
sound.  An emergency room doctor diagnosed cephalgia (headache) 
and placed her on intravenous compazine,2 which stopped the nausea 
and headache. 

 
1/18/9x  The  final  performance  evaluation  marks  received  by  the  applicant 

averaged 4.1 on a scale of 1 to 7, with 7 being the best mark.  

 
1/19/9x  The applicant complained of tiredness, interrupted sleep, and chronic 
headaches  that  became  severe  once  or  twice  each  week.    She  was 
taking 50 milligrams of Elavil per day and between 40 and 50 doses of 
Midrin per month.  The neurologist reported that the headaches might 
be caused by “analgesic rebound” and told her not to take any Midrin 
for two weeks. 

 
2/2/9x  Upon  her  request,  the  applicant’s  primary  physician  allowed  her  to 

take Midrin again, but in limited quantities. 

 
2/8/9x 

The  applicant  complained  of  feeling  lightheaded  and  sick  to  her 
stomach.  Her primary physician diagnosed a possible vasovagal.3 

                                                 
1   A “migraine” is “an often familial symptom complex of periodic attacks of vascular headache, 
usually temporal and unilateral in onset, commonly associated with irritability, nausea, vomiting, 
constipation  or  diarrhea,  and  often  photophobia;  attacks  are  preceded  by  constriction  of  the 
cranial  arteries,  usually  with  resultant  prodromal  sensory  (especially  ocular)  symptoms,  and 
commence  with the vasodilation  that follows.”  DORLAND’S ILLUSTRATED MEDICAL DICTIONARY, 
25TH ED. (1974). 
 
2  Compazine is “used as a major tranquilizer and antiemetic” [anti-nausea drug].  Id. 
 
3      A  “vasovagal  attack”  is  “a  transient  vascular  and  neurogenic  reaction  marked  by  pallor, 
nausea,  sweating,  bradycardia,  and  rapid  fall  in  arterial  blood  pressure  which,  when  below  a 

 
2/10/9x  The  applicant  sought  medical  treatment  for  headaches  she  reported 
suffering  for  the  previous  nine  months.    She  said  that  none  of  the 
drugs she had been prescribed relieved her headaches.  She reported 
that once or twice each week her migraines caused her to stay at home 
in  bed.    She  also  complained  of  occasional  lightheadedness  and 
numbness in her hands and legs.  Her primary physician reported that 
the lightheadedness might be caused by the Elavil. 

 
2/22/9x  The  applicant  consulted  her  neurologist  and  complained  of  tension 
headaches, interrupted sleep, and analgesic rebound headaches.  The 
neurologist reported as follows: 

 

 
 

[The] low dose (50 mg) of Elavil QHS has helped her [sleep disorder], but 
not her [headaches], (possibly due to frequent analgesic use and subsequent 
rebound  mechanisms  that  render  [unreadable]  [headache]  medicines 
ineffective).    Patient  was  advised  to  [avoid]  all  analgesics  for  at  least  2 
weeks,  and  thereafter  limit  their  use  to  [less  than  or  equal  to]  2  times  per 
week, and then to return for follow-up here in March-April 199x.  However, 
she  returns  prematurely  at  this  time,  to  report  she  still  had  daily 
holocephalgic  [headaches],  generally  constant  low  grade  “nag”  that  does 
not interfere with [active duty], except at times when [it increases in] sever-
ity (about 1-2 times per week).  She has been having light-headedness “all 
the  time”  for  past  2-3  weeks,  non  arthostatic  (but  with  arthostatic  BP/HR 
changes on physical examination 10 February 199x by her primary doctor).  
She  recently  began  Provera  30  milligrams  per  day  on  13  January  199x  for 
dysmenorrhea  [painful  menstruation]  (dizziness  is  known  potential  side-
effect for Provera).  Volsalva not [known to change] headache, but patient 
may [have increased] headaches.  She denies any depressive symptoms, but 
states she is frustrated that she still has [headaches].  She also gets “tense” 
and  “frustrated”  in  traffic.    She  is  getting  out  of  the  Coast  Guard  soon  in 
order  to  join  her  fiancé  [a  member  of  the  Marine  Corps]  who  [was 
transferred]  3  months  ago  from  xxxxx  to  xxxxx.    Her  body  weight  has 
increased about 15 pounds over past 6 months, currently at her maximum 
body weight.  No transient visual obscurations. . . . 

The  neurologist  also  noted  that  the  onset  of  the  dizziness  was  coin-
cident  with  the  use  of  Provera  and  that  her  headaches  had  begun 
when  she  began  to  gain  weight,  which  raised  the  possibility  of  a 
pseudotumor cerebri.4  He diagnosed tension headaches and contin-
ued the prescription for Elavil. 

                                                                                                                                                 
critical level, results in loss of consciousness and characteristic electrocephalographic changes.  It 
is most often evoked by emotional stress associated with fear or pain.”  Id. 
 
4    A  “pseudotumor  cerebri”  is  “a  condition  caused  by  cerebral  edema  [swelling],  marked  by 
raised  intracranial  pressure  with  headache,  nausea,  vomiting,  and  papilledema  without 
neurological signs except occasional sixth-nerve palsy [paralysis].”  Id. 

 
3/10/9x  The applicant complained of feeling faint and underwent an EKG, but 

the results were normal. 

 
3/14/9x  A  radiological  examination  report  stated  that  the  applicant  had  re-
ported suffering “global [headaches] for past 10 months, probably ten-
sion etiology. . . .”  The doctor found “slight blurring of supp/nasal 
margins  of  optic  discs”  and  ordered  an  MRI  (magnetic  resonance 
imaging)  examination  of  her  head.    The  results  of  the  MRI  were 
reported to be “normal.” 

 
3/30/9x  The  applicant  was  found  not  fit  for  duty  for  one  day  because  of  an 

upper respiratory tract infection, which was resolved. 

The neurologist noted that staff from the applicant’s unit had called to 
discuss  her  condition,  which  he  listed  as  “chronic  tension  [head-
aches]”  with  “analgesic  rebound  [headaches]  superimposed.”    The 
staff told him that “her [primary physician] . . . has been giving her a 
lot of quarters and other duty restrictions.[5]  I advised them that no 
duty restrictions have been given this patient by this clinic.  Restric-
tions  imposed  by  [her  primary  physician]  must  be  addressed  with 
[her primary physician].” 

 
5/4/9x 

 
5/5/9x 

The  applicant’s  primary  physician  noted  that  he  had  discussed  her 
condition with the neurologist and that their diagnosis was migraines 
but that she was fit for duty. 

 
5/11/9x  The  neurologist  reported  that  the  applicant’s  neurological  and  MRI 
examinations  had  been  normal.  She  told  him  that  her  dizziness  had 
gone away since she stopped taking Provera.  He stated that there was 
a “need to rule out pseudotumor cerebri.” 

 
5/15/9x  The applicant underwent a spinal tap to rule out pseudotumor cere-
bri.  The neurologist found “mildly [increased intracranial pressure], 
[connected]  with  mild  pseudotumor  cerebri.”    He  prescribed  500 
milligrams of Diamox and told her to lose 30 pounds. 

 

                                                                                                                                                 
 
5  Except for March 30, 199x, when the applicant’s primary physician noted that he had found her 
not fit for duty for a day due to an upper respiratory tract infection, there is no notation in the 
applicant’s  military  and  medical  records  of  a  doctor  finding  her  to  be  not  fit  for  duty,  fit  for 
limited duty, or sick in quarters after October 26, 199x. 

5/15/9x  The  applicant  underwent  a  physical  to  determine  if  she  was  fit  for 
duty/release  from  active  duty.    She  complained  of  suffering  head-
aches  24  hours  a  day  and  migraines  two  or  three  times  each  week.  
She  was  taking  Midrin  for  these  symptoms.    Her  primary  physician 
noted a diagnosis of “pseudotumor cerebri” and signed a report stat-
ing that she was qualified for release from active duty. 

 
5/30/9x  The  applicant  signed  a  form  stating  that  she  agreed  that  she  was 
“reasonably able to perform [her] current duties, or [she has] a high 
expectation  of  recovery  in  the  near  term  from  illness,  injury,  or 
surgical  procedures  such  that  [she]  would  again  be  able  to  perform 
[her] usual duties.”   

The  applicant  was  released  from  active  duty  into  the  Coast  Guard 
Reserve with an “honorable” character of service, a reason for separa-
tion  of  “completion  of  required  active  service,”  and  a  reenlistment 
code of RE-1 (eligible to reenlist).  

 
3/23/9x  After  examining  the  applicant  four  times  between  September  and 
December 199x, the DVA granted the applicant “[s]ervice connection 
for migraine headaches . . . with an evaluation of 50 percent effective 
xxxxxx, 199x.”  The examiner reported the following: 

 
6/1/9x 

 

Service connection for migraine headaches has been established as directly 
related  to  military  service.    This  condition  is  evaluated  as  50  percent  dis-
abling  from  xxxxxx,  199x.    An  evaluation  of  50  percent  is  granted  if  the 
record shows very frequent, completely prostrating, and prolonged attacks 
productive of severe economic inadaptability. 
 
The  veteran  was  seen  on  numerous  occasions  while  on  active  duty  with 
severe headaches of a throbbing nature occurring on a daily basis.  She was 
evaluated and found to have papilledema, which led to computerized tomo-
graphy of the head.  Computerized tomography showed no hydrocephalus 
or mass affect or midline shift.  A lumbar puncture revealed elevated cere-
brospinal  fluid  pressure  and  a  normal  cerebrospinal  fluid  examination.  
Assessment  was  pseudo-tumor  cerebri.    She  was  treated  with  a  variety  of 
analgesic  therapy  with  only  partial  reduction  in  the  severity  of  her  head-
aches.    It  is  documented  in  report  of  February  10,  199x  that  veteran  com-
plained of having 1 or 2 attacks per week that cause her to stay at home in 
bed.    She  also  complained  of  numbness  in  both  hand  and  legs.    Approxi-
mately two weeks later, she gave a two [sic] history of dizziness, and light-
headedness.    It  was  noted  that  this  may  have  been  coincident  with  use  of 
Provera.  In May 199x, just before being discharged, veteran reported hav-
ing headaches daily with no relief after taking Elavil 50 mg.  On [D]VA ex-
amination, the veteran noted that she continues to  have headaches two  or 
three times a week, and have [sic] been refractory to somatropin and other 
nonsteroidal  analgesics.    A  history  of  nausea,  vomiting  or  seizures  is  not 

documented.    Objective  examination  revealed  blurring  of  the  optic  discs 
without  choking  of  the  vessels,  hemorrhages  or  narrowing  of  the  retinal 
veins.  Cerebellar and extrapyramidal neurological examinations were with-
in normal limits.  MRI  of the brain was essentially normal.  There was  no 
evidence of pseudo-tumor cerebri.  A definite diagnosis was not made. 
 
While there is no evidence of intracranial pathologic changes, diagnosis of 
migraine  headaches  is  supported  by  above  symptom  pattern.    A  future 
examination is scheduled for sustained improvement. 

 

The applicant was discharged from the Reserve upon the expiration of 
her enlistment. 

 
4/3/9x 

 

APPLICABLE REGULATIONS 

 
Applicable Provisions of the Personnel Manual 
 

Section 12-B-6 of the Personnel Manual (COMDTINST M1000.6A) requires 
each member not being discharged for a physical or mental disability to undergo 
a  physical  examination  prior  to  release  from  active  duty.    It  provides  the 
following: 

 
b.  When the physical examination is completed and the mem-
ber is found to be physically qualified for separation, the member 
will be so advised and will be required to make a signed statement 
as to agreement or disagreement with the findings. . . .   

(3) 

 
(4) 

• • • 

d.  When  disqualifying  physical  or  mental  impairments  are 
found . . . 
 

If the member does not desire to reenlist or is being 
discharged for reasons other than expiration of enlistment, and the 
physical  or  mental  impairment  is  deemed  to  be  of  a  permanent 
nature a medical board shall be held in accordance with chapter 17 
. . . . 

If the member does not desire to reenlist or is being 
discharged for other than expiration of enlistment, and the disabil-
ity  is  deemed  to  be  of  a  temporary  nature,  the  member  may  be 
retained,  with  personal  consent,  in  accordance  with  article  12-B-
11f.(1)(a),  in  order  that  the  necessary  treatment  may  be  provided 
the member and a medical board held if indicated . . . . 

 
Applicable Provisions of the Medical Manual 

 

The Medical Manual (COMDTINST M6000.1B) governs the disposition of 
members  with  physical  disabilities.    According  to  Section  3-B-3,  during  the 
medical examination a member must undergo prior to separation, 

 
.  .  .  the  examiner  shall  consult  the  appropriate  standards  of  this 
chapter to determine if any of the defects noted are disqualifying 
for the purpose of the physical examination. . . .   

• • • 

When the individual is not physically qualified for the purpose of 
the examination . . . , the reviewing authority will arrange for the 
examinee to be evaluated by a medical board and provide admin-
istrative action as outlined in [the PDES Manual]. 
 
According to Section 3-B-6 of the Medical Manual, which is entitled “Sep-

aration Not Appropriate by Reason of Physical Disability,” 
 

[w]hen a member has an impairment (in accordance with section 3-
F of this manual) an Initial Medical Board shall be convened only if 
the conditions listed in paragraph 2-C-2.(b) [of the PDES Manual] 
are also met.  Otherwise the member is suitable for separation. 
 
Section 3-F-1.c. of the Medical Manual states the following: 
 
Fitness  for  Duty.    Members  are  ordinarily  considered  fit  for  duty 
unless they have a physical impairment (or impairments) which in-
terferes with the performance of the duties of their grade or rating.  
A  determination  of  fitness  or  unfitness  depends  upon  the 
individual’s ability to reasonably perform those duties.  Members 
considered  temporarily  or  permanently  unfit  for  duty  shall  be 
referred to an Initial Medical Board for appropriate disposition. 
 
According to Sections 3-F-15 of the Medical Manual, the following neuro-
logical  disorders  “are  normally  disqualifying”  for  administrative  discharge  or 
retention  in  the  Service,  and  persons  with  disqualifying  conditions  “shall  be 
referred to an Initial Medical Board”: 

 
h. 
Migraine.  Manifested by frequent incapacitating attacks or 
attacks which last for several consecutive days and unrelieved [sic] 
by treatment. 

General.    Any  other  neurological  condition,  regardless  of 
o. 
etiology,  when  after  adequate  treatment,  there  remain  residuals, 

• • • 

such  as  persistent  severe  headaches,  .  .  .  of  such  a  degree  as  to 
definitely interfere with the performance of duty. 

 
Applicable Provisions of the PDES Manual  
 
 
The  PDES  Manual  (COMDTINST  M1850.2B)  governs  the  separation  of 
members due to physical disability.  Section 2-A-15 of the PDES Manual defines 
the  term  “fit  for  duty”  as  “ . .  .  the  status  of  a  member  who  is  physically  and 
mentally able to perform the duties of office, grade, rank, or rating. . . .” 
 
 

(a) 

Section 2-C-2 of the PDES Manual states the following: 
 
b.(1)  Continued  performance  of  duty  until  a  service  member  is 
scheduled for separation or retirement for reasons other than phys-
ical disability creates a presumption of fitness for duty.  This pre-
sumption may be overcome if it is established by a preponderance 
of the evidence that: 
 
 
the service member, because of disability, was phys-
ically unable to perform adequately the duties of office, grade, rank 
or rating; or 
 
 
acute, grave illness or injury, or other deterioration of 
the member’s physical condition occurred immediately prior to or 
coincident with processing for separation or retirement for reasons 
other than physical disability which rendered the service member 
unfit for further duty. 
 
    (2)  Service members who are being processed for separation or 
retirement  for  reasons  other  than  physical  disability  shall  not  be 
referred  for  disability  evaluation  unless  their  physical  condition 
reasonably prompts doubt that they are fit to continue to perform 
the duties of their office, grade, rank or rating. 

(b) 

• • • 

i. 
The existence of a physical defect or condition that is ratable 
under  the  standard  schedule  of  rating  disabilities  in  use  by  the 
[Department  of  Veterans  Affairs]  does  not  of  itself  provide  justi-
fication  for,  or  entitlement  to,  separation  or  retirement  from 
military service because of physical disability.  Although a member 
may  have  physical  impairments  ratable  in  accordance  with  the 
VASRD,  such  impairments  do  not  necessarily  render  the  member 
unfit for military duty. . . . 
 

FINDINGS AND CONCLUSIONS 

 
 
The Board makes the following findings and conclusions on the basis of 
the applicant's military record and submissions, the Coast Guard's submissions, 
and applicable law: 
 

1. 

The Board has jurisdiction concerning this matter pursuant to sec-

tion 1552 of title 10 of the United States Code.  The application was timely. 
 

2. 

The applicant alleged that she should have been referred to a med-
ical  board  and  given  a  disability  discharge  because,  at  the  time  of  her  release 
from active duty, she suffered disabling migraines. 

The  Chief  Counsel  argued  that  the  applicant  had  been  diagnosed 
with tension headaches.  He said that the physician who performed her physical 
examination  prior  to  her  release  from  active  duty  had  taken  into  account  her 
chronic headaches and still found her fit for duty.  The Chief Counsel also stated 
that the applicant had not presented any proof that she was not fit for duty at the 
time of her release.   He argued that the disability rating granted to her by the 
DVA did not prove she was not fit for duty. 

 
3. 

 
4. 

 
5. 

 According to Section 3-F-2 of the Medical Manual, if a member is 
found  to  have  a  “disqualifying”  physical  impairment  during  a  medical  exam-
ination, a medical board “shall” be held to determine the member’s disposition.  
However,  Section  3-B-6  states  that  the  Coast  Guard  shall  convene  an  IMB  for 
members with disqualifying impairments only if the requirements of Section 2-
C-2.b. of the PDES Manual are met.  That section requires members to prove by a 
preponderance  of  the  evidence  that  they  are  not  fit  for  duty  because  of  a 
disability.  It also states that members such as the applicant, who are being proc-
essed  for  separation  for  reasons  other  than  physical  disability,  shall  not  be 
referred to a medical board “unless their physical condition reasonably prompts 
doubt  that  they  are  fit  to  continue  to  perform  the  duties  of  their  office,  grade, 
rank or rating.”  Therefore, the Board finds that, to prove that the Coast Guard 
erred by not convening a medical board to evaluate her for disability discharge, 
the applicant must prove that, at the time of her release from active duty, (a) she 
had a disqualifying physical impairment which rendered her unfit for duty or (b) 
her physical condition reasonably prompted doubt as to her fitness for duty. 

Disqualifying Physical Impairment.  Section 3-F-15 of the Medical 
Manual lists migraines among those medical conditions that are “normally dis-
qualifying”  for  retention  in  service. 
  However,  the  migraines  must  be 
“[m]anifested by frequent incapacitating attacks or attacks which last for several 
consecutive days and [are] unrelieved by treatment.” The record shows that the 

applicant  suffered  from  chronic  headaches  at  the  time  she  left  active  duty  in 
order  to  join  her  fiancé  in  xxxxx.  During  her  last  year  on  active  duty,  the 
applicant’s  doctors  ascribed  various  etiologies  to  the  headaches,  including 
tension, analgesic rebound, sinusitis, and pseudotumor cerebri.  On May 5, 199x, 
just  26  days  before  her  release  from  active  duty,  the  applicant’s  primary 
physician consulted with her neurologist and concluded that she had migraines.  
The applicant reported that the migraines kept her in bed two or three times each 
week.  In addition, the doctors determined that the applicant’s headaches were 
only partially relieved by the medications they were prescribing.  However, the 
applicant continued to perform her duties until the date of her release. 

Fitness for Duty.  Section 2-C-2.b.(1) of the PDES Manual states that 
“[c]ontinued  performance  of  duty  until  a  service  member  is  scheduled  for 
separation  or  retirement  for  reasons  other  than  physical  disability  creates  a 
presumption  of  fitness  for  duty.”    The  applicant  may  overcome  this  pre-
sumption,  however,  if  she  establishes  by  a  preponderance  of  the  evidence  she 
was unable to perform her duties adequately.   

 
The applicant continued to perform her duties until the date of her release.  
Although  the  staff  of her  unit  apparently  believed  that  she  had  been  receiving 
frequent  duty  restrictions  from  her  doctors,  neither  her  primary  physician  nor 
her  neurologist  noted  a  duty  restriction  in  her  records  due  to  her  headaches 
during her last nine months of active duty.  The last record of her being ordered 
to stay in quarters due to a headache is dated August 24, 199x.  In addition, there 
are  no  indications  in  the  applicant’s  service  records  that  she  had  been  missing 
work or that her commanding officer was dissatisfied with her work.   

 
On May 5, 199x, after consulting the applicant’s neurologist, her primary 
physician noted in her medical record that, despite the diagnosis of migraines, 
she  was  fit  for  duty.    On  May  22,  199x,  upon  the  completion  of  her  physical 
examination  prior  to  release  from  active  duty,  he  found  her  qualified  for 
separation.  In light of these records, the Board finds that the applicant has not 
proven by a preponderance of the evidence that she was unable to perform her 
duty adequately at the time of her release from active duty. 

 
6. 

 
7. 

Reasonable Doubt of Fitness for Duty.  The applicant asked to be 
discharged in order that she might join her fiancé in xxxxx.  Section 2-C-2.b.(2) of 
the PDES Manual states that members who are being administratively separated 
shall  be  referred  to  a  medical  board  if  “their  physical  condition  reasonably 
prompts doubt that they are fit to perform the duties of their office, grade, rank 
or rating.”    The record  shows  that  less  than  a  month  prior  to  her  release  from 
active  duty,  the  applicant’s  primary  physician  and  neurologist  discussed  her 
condition  and  concluded  that  she  was  fit  for  duty.    Given  (1)  her  doctors’ 

discussion and conclusion, (2) the fact that she actually performed her duty until 
the date of her release, and (3) the fact that she had not been found unfit for duty 
(except for two short instances of upper respiratory tract infection) in over nine 
months, the Board finds that the applicant was not entitled to a medical board 
under the terms of Section 2-C-2.b.(2) of the PDES Manual. 

 The  applicant  argued  that  the  disability  rating  she  received  from 
the DVA proved she should have received a medical discharge.  However, as the 
Chief Counsel of the Coast Guard stated, pursuant to Section 2-C-2.i. of the PDES 
Manual, the applicant’s VASRD rating does not prove that she would have been 
found unfit for duty by a medical board.  The Court of Federal Claims has held 
that “[d]isability ratings by the Veterans Administration [now the Department of 
Veterans Affairs] and by the Armed Forces are made for different purposes.  The 
[DVA] determines to what extent a veteran’s earning capacity has been reduced 
as a result of specific injuries or combination of injuries. . . .  The Armed Forces, 
on the other hand, determine to what extent a member has been rendered unfit 
to perform the duties of his office, grade, rank, or rating because of a physical 
disability.  .  .  .    Accordingly,  [DVA]  ratings  are  not  determinative  of  issues 
involved in military disability retirement cases.”  Lord v. United States, 2 Cl. Ct. 
749, 754 (1983). 
 
 
Therefore, the Board finds that the applicant has not proved by a 
preponderance  of  the  evidence  that  the  Coast  Guard  committed  any  error  or 
injustice  by  not  convening  a  medical  board  or  by  not  giving  her  a  medical 
discharge.  
 
 
 
 

The applicant’s request should be denied. 

[ORDER AND SIGNATURES APPEAR ON FOLLOWING PAGE] 

 
8. 

9. 

10. 

 

 

ORDER 

 

The application for correction of the military record of former XXXXXX, 

 
 

 
 

USCG, is hereby denied. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 
 

 
 

 
 

 
 

 
 

 
 

 
 

 

 
 
David H. Kasminoff 

 

 

 
 
Jacqueline L. Sullivan 

 

 

 
Edmund T. Sommer, Jr.