Current Army PDA Guidance on Rating Migraines?

[Pandora's Box]

I was able to get a copy of the Army PDA Guidance on Adjudication of Soldiers with Migraine Headaches. It directs that a headache can be found prostrating even if the soldier does not seek medical treatment for that headache, where the soldier must cease his activities during the occurence and has been under medical care, e.g., prescribed medications, for those headaches. The Fort Lewis PEB now claims that this document is not official Army policy and was merely "a basis for discussion" during training - and that the PEBs are still relying on the language in VASRD Diag Code 8100 (which was reflected in the now rescinded DoDI 1332.39) requiring medical treatment for a headache to be prostrating. So what's the ground truth here?

 

[Jason Perry]

There is no requirement that a member must seek treatment for a migraine before it is "prostrating." The VASRD code 8100 is binding (along with applicable cases from the US Court of Appeals for Veterans Claims) and there is no definition included in the rating criteria.


8100 Migraine:

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

There are BVA opinions, which I have used to get PEB's to adopt, that state "prostrating" is defined by Dorland's Medical Dictionary as "extreme exhaustion or powerlessness."
One BVA opinion is Citation Nr: 0923692.

As an interesting aside, APDA guidance is binding on the PEB's.

All of the above may not persuade or change the ruling of a particular PEB. But, if they fail to follow the law, it will mean that you will prevail on appeal (perhaps administratively, but more likely in court).

 

[maparker]

You should request the PEB to provide the defintion of "completely prostrating" (used in the 50% rating) and "prostrating" used in the 10% and 30% ratings. I have a 30% rating from the VA and do not seek medical attention.

I sent a note to the USAPDA on the Fort Lewis PEB prostrating definition. I will let you know what I hear.

Mike