MED BOARD APPEAL FOR MIGRAINES HELPPP

Nala2493

PEB Forum Regular Member
Registered Member
So I went on med board for chronic migraines and I was sure I'd get an unfit due to not being able to be on a ship and missing up to 20 hours of work a week, even my doctor recommended to get out. Well I got a call last week stating that they found me "Fit" for duty. I am extremely upset. The reason was that due to my condition there was no reason why I couldn't continue. Has anyone else had this happen?? Is it worth appealing?
 
So I went on med board for chronic migraines and I was sure I'd get an unfit due to not being able to be on a ship and missing up to 20 hours of work a week, even my doctor recommended to get out. Well I got a call last week stating that they found me "Fit" for duty. I am extremely upset. The reason was that due to my condition there was no reason why I couldn't continue. Has anyone else had this happen?? Is it worth appealing?
What evidences do you have to proof your case at formal board? I will advice you to get statements from your buddies or supervisors and start documenting your migraines on a log. Good luck!
 
When you say doctor, do you mean neurologist?

What have they tried for Migraine relief? Medicines? Boxtox injections? Dry needling of the shoulders and neck?
 
So I went on med board for chronic migraines and I was sure I'd get an unfit due to not being able to be on a ship and missing up to 20 hours of work a week, even my doctor recommended to get out. Well I got a call last week stating that they found me "Fit" for duty. I am extremely upset. The reason was that due to my condition there was no reason why I couldn't continue. Has anyone else had this happen?? Is it worth appealing?

Wow. Can you give more detail, a timeline, background, etc? It sounds like you had a MEB initiated but the MEB found you fit for duty and so you never made it to the PEB phase - is this correct?

If so, I wonder about the nature, severity and circumstances of your migraines. Did they start when you were a kid, teenager, etc? If your migraines started before you entered the military, the PEB will usually rate you but give you a 0% for existing prior to service. For you to not even get to that point, I really have to wonder about your specific case. Were you formally diagnosed by a neurologist? Are you on migraine treatment and prevention medications? Did you have an MRI and if so what were the results? Was the migraine the result of an injury that occurred (like a concussion/traumatic brain injury)? What meds are you on and for how long, and did you have a military neurologist who formally diagnosed you with chronic migraines? By "your doctor" I'm not sure if you mean a board certified military neurologist or someone else like a GP or a civilian doc.

If your migraines didn't exist prior to your service, if they were related to something like a documented head injury that happened while you were active duty, if you were diagnosed by a qualified neurologist at a military treatment facility and if you've been on the usual migraine meds like imitrex for 6+ months and get seriously bad migraines regularly, I sincerely doubt they'd find you fit for duty. Something is off here and doesn't add up or they wouldn't have done this. Maybe something in your med notes or record suggests these are just severe headaches instead of migraines, in which case you may want to view your own records and try to correct them.
 
When you say doctor, do you mean neurologist?

What have they tried for Migraine relief? Medicines? Boxtox injections? Dry needling of the shoulders and neck?
They have tried 7 different medications and two sessions of Botox every 3 months. Nothing worked and even now they are still giving me medication and I currently have a migraine now.
 
Wow. Can you give more detail, a timeline, background, etc? It sounds like you had a MEB initiated but the MEB found you fit for duty and so you never made it to the PEB phase - is this correct?

If so, I wonder about the nature, severity and circumstances of your migraines. Did they start when you were a kid, teenager, etc? If your migraines started before you entered the military, the PEB will usually rate you but give you a 0% for existing prior to service. For you to not even get to that point, I really have to wonder about your specific case. Were you formally diagnosed by a neurologist? Are you on migraine treatment and prevention medications? Did you have an MRI and if so what were the results? Was the migraine the result of an injury that occurred (like a concussion/traumatic brain injury)? What meds are you on and for how long, and did you have a military neurologist who formally diagnosed you with chronic migraines? By "your doctor" I'm not sure if you mean a board certified military neurologist or someone else like a GP or a civilian doc.

If your migraines didn't exist prior to your service, if they were related to something like a documented head injury that happened while you were active duty, if you were diagnosed by a qualified neurologist at a military treatment facility and if you've been on the usual migraine meds like imitrex for 6+ months and get seriously bad migraines regularly, I sincerely doubt they'd find you fit for duty. Something is off here and doesn't add up or they wouldn't have done this. Maybe something in your med notes or record suggests these are just severe headaches instead of migraines, in which case you may want to view your own records and try to correct them.
So let me break it down. I have been seeing the neurologist for about 2 years now. And no I never had them before the navy, they started around deployment 2015. The neurologist diagnosed me with migraines mid last year, and she has given me the following: rizatriptan, amitriptyline, metoclopramide, magnesium, topiramate, a anti depressant which I forgot the name and Botox. I was on a ship, but wasn't able to stand watch,go underway, or do any drills so my doctor gave me a first limdu which was from September 2016-February 2017. After that she saw my migraines weren't getting any better so she put me up for a med board. I get them every other day but she stated I get prostrating ones twice a month. When the med board lawyer looked at why they made me fit they stated there were "minimal neurology visits", which isn't true since I've been seeing her for so long and have done everything she has asked. I've been to the emergency room multiple times. I'm hoping I had a captain that wasn't in the mood that day and made me fit. Even the lawyer swore and is still confused as to why they found me fit. So I'm going to try and appeal if they let me. My command wrote a letter stating how much my condition interferes with my job and I am waiting for my doctor to write one as well.
 
So let me break it down. I have been seeing the neurologist for about 2 years now. And no I never had them before the navy, they started around deployment 2015. The neurologist diagnosed me with migraines mid last year, and she has given me the following: rizatriptan, amitriptyline, metoclopramide, magnesium, topiramate, a anti depressant which I forgot the name and Botox. I was on a ship, but wasn't able to stand watch,go underway, or do any drills so my doctor gave me a first limdu which was from September 2016-February 2017. After that she saw my migraines weren't getting any better so she put me up for a med board. I get them every other day but she stated I get prostrating ones twice a month. When the med board lawyer looked at why they made me fit they stated there were "minimal neurology visits", which isn't true since I've been seeing her for so long and have done everything she has asked. I've been to the emergency room multiple times. I'm hoping I had a captain that wasn't in the mood that day and made me fit. Even the lawyer swore and is still confused as to why they found me fit. So I'm going to try and appeal if they let me. My command wrote a letter stating how much my condition interferes with my job and I am waiting for my doctor to write one as well.

That is really strange. So, you didn't even get to the IPEB phase. Sounds like your command is on board, which is good.

Was there an event that caused the migraines, such as a blast, head injury, etc? Or were these just migraines that randomly started? I'm guessing they randomly started and that's why you don't have an MRI. This is tough because there's no definitive, objective way to prove the existence or severity of a migraine on its own. If you didn't have an event/injury that would cause the migraine and people who witnessed your injury, MRI results, other residuals, etc., then basically it's the honor system and the military has to take your word on it.

Not at all implying you're malingering or lying; I'm sure you're telling the truth. Just trying to say that it's more difficult to get unfit for duty when the aforementioned things aren't present. Additionally, what the med board looks at is whether you can still serve in some capacity; not necessarily whether you have to miss shifts or your ability to get underway. Remember, although the military uses the VASRD criteria for rating your conditions, it only considers whether your conditions make you fit or unfit for any duty, not how they affect your quality of life or ability to get a future job. The latter is what the separate VA rating is for, and the good news is that if you've been diagnosed with chronic migraines by a neurologist, and you get them as often as you mentioned, the VA should give you a 50% rating.

You could always suck it up and give it more time to appeal the decision and/or initiate a new MEB at some point but if you've already served your minimum required active duty time and can get out, my advice to you is to get out and take your chances with the VA because life is short and unless you think you have a good chance with your appeal or another MEB, you'd probably be a lot happier out of the Navy. I imagine you'd probably also be eligible for Social Security Disability Income (SSDI) and you should talk to a counselor on your base about that too.
 
So I went on med board for chronic migraines and I was sure I'd get an unfit due to not being able to be on a ship and missing up to 20 hours of work a week, even my doctor recommended to get out. Well I got a call last week stating that they found me "Fit" for duty. I am extremely upset. The reason was that due to my condition there was no reason why I couldn't continue. Has anyone else had this happen?? Is it worth appealing?
Not sure how many years of service you have. If you are very close to 20 years, it may be advantageous to continue to serve until at least 20 years of service.

If so, I wonder about the nature, severity and circumstances of your migraines. Did they start when you were a kid, teenager, etc? If your migraines started before you entered the military, the PEB will usually rate you but give you a 0% for existing prior to service.
I get you may be trying to be helpful, but the question is not only as to when the condition was incurred. Every member enters the service under the presumption of "sound condition," so, even if it did exist prior to service, the condition is also presumed to have been service aggravated. Absent a notation on entrance medical records, the condition is presumed to have been incurred while entitled to basic pay. Past that, it is also presumed to have been service aggravated. These presumptions can only be overcome by "clear and unmistakable evidence." This is a very high evidentiary standard to overcome.


For you to not even get to that point, I really have to wonder about your specific case. Were you formally diagnosed by a neurologist? Are you on migraine treatment and prevention medications? Did you have an MRI and if so what were the results? Was the migraine the result of an injury that occurred (like a concussion/traumatic brain injury)? What meds are you on and for how long, and did you have a military neurologist who formally diagnosed you with chronic migraines? By "your doctor" I'm not sure if you mean a board certified military neurologist or someone else like a GP or a civilian doc.

Lots of "issues" with these questions. First, while it is definitely helpful to have a well-credentialed provider (including a neurologist, be it a military or civilian provider) diagnose or treat you, it is not a requirement to getting an unfit finding or a rating. (Many years ago, there was a whole rigamarole with getting migraines deemed "prostrating" which included a diagnosis and treatment plan that said that you did not need to go to seek medical care each migraine....that is not the case now). An MRI will not diagnose or impact a migraine case. Injury that is causally connected may help with some issues, but is not required at all. Meds are helpful, I guess, as it shows a physician/providers believes you have a severe enough condition, but, this is not required for either an unfit finding or a VA rating.

If your migraines didn't exist prior to your service, if they were related to something like a documented head injury that happened while you were active duty, if you were diagnosed by a qualified neurologist at a military treatment facility and if you've been on the usual migraine meds like imitrex for 6+ months and get seriously bad migraines regularly, I sincerely doubt they'd find you fit for duty. Something is off here and doesn't add up or they wouldn't have done this. Maybe something in your med notes or record suggests these are just severe headaches instead of migraines, in which case you may want to view your own records and try to correct them.

As for the "in the line of duty" issue, see my previous answer regarding the presumptions and the evidentiary standards required to overcome them.

I don't mean to be purely critical or push back on your efforts to help. My reaction is that you have described many factors (when the migraines were incurred, who diagnosed them, medications, etc.) that, if are present and favorable, would help in making a case. But, none of these factors are strictly needed. I have seen many cases without the factors cited that still resulting in the grant of an unfit finding and a high rating. Each case is different and the facts and circumstances of each case are key in the outcome. I just mean to suggest that a lot of cases are improperly or poorly addressed and it is not a "requirement" that each of the points you raised are needed to be (favorably) present in order to get a rating. I have personally had many cases where none of the factors suggested in your post (time of incurrence, military neurologist providing the diagnosis, medications present) and have gotten a favorable finding. I actually have a current case in Federal Court that is settling with a retirement finding in the absence of the majority of these issues).

I would say that you have identified helpful findings to get a favorable outcome, but, I don't want people to think that the points you raised are neccessary to get a favorable finding.

Additionally, as @Nala2493 stated, he is a member of the USN....well, the Navy has a habit of finding members fit inappropriately, in my opinion, and experience.

So let me break it down. I have been seeing the neurologist for about 2 years now. And no I never had them before the navy, they started around deployment 2015. The neurologist diagnosed me with migraines mid last year, and she has given me the following: rizatriptan, amitriptyline, metoclopramide, magnesium, topiramate, a anti depressant which I forgot the name and Botox. I was on a ship, but wasn't able to stand watch,go underway, or do any drills so my doctor gave me a first limdu which was from September 2016-February 2017. After that she saw my migraines weren't getting any better so she put me up for a med board. I get them every other day but she stated I get prostrating ones twice a month. When the med board lawyer looked at why they made me fit they stated there were "minimal neurology visits", which isn't true since I've been seeing her for so long and have done everything she has asked. I've been to the emergency room multiple times.

My guess is that your NMA probably was not very strong, or you are relatively senior in grade and have had good evalutions, have had good duty performance, and may have had relatively weak statements from your physicians about impact on your duty performance. Those factors would weigh towards an erroneous fit finding.

I'm hoping I had a captain that wasn't in the mood that day and made me fit. Even the lawyer swore and is still confused as to why they found me fit. So I'm going to try and appeal if they let me. My command wrote a letter stating how much my condition interferes with my job and I am waiting for my doctor to write one as well.

Sounds like a good idea/plan.

Was there an event that caused the migraines, such as a blast, head injury, etc? Or were these just migraines that randomly started? I'm guessing they randomly started and that's why you don't have an MRI.
I don't know why an MRI would be needed or indicated for a migraine diagnosis. An MRI does not factor into a migraine diagnosis. http://www.webmd.com/migraines-headaches/making-diagnosis-mri#1 . This is just not a factor or exam for migraines.

As for cause, recall, the presumptions I stated above.

You don't need an MRI and one won't help your case.

If you didn't have an event/injury that would cause the migraine and people who witnessed your injury, MRI results, other residuals, etc., then basically it's the honor system and the military has to take your word on it.

See all of my above posts.

No, you don't need a cause, you don't need an MRI and the it is not the "honor system." It is the application of the presumptions and the law.

The issue I would guess is that you may have had a weak Non-Medical Assessment, you may have had very good recent performance, or you just had a poorly written NARSUM.

Not at all implying you're malingering or lying; I'm sure you're telling the truth. Just trying to say that it's more difficult to get unfit for duty when the aforementioned things aren't present.

See my above posts. The issues you raised would certainly help. But they are not needed.

Additionally, what the med board looks at is whether you can still serve in some capacity; not necessarily whether you have to miss shifts or your ability to get underway.

All due respect, this is FLAT WRONG. The standard for fitness is your ability to perform the duties of your "grade, rank, rate, or office." It is not whether you can serve in ANY CAPACITY. This is an erroneous standard.


You could always suck it up and give it more time to appeal the decision and/or initiate a new MEB at some point but if you've already served your minimum required active duty time and can get out, my advice to you is to get out and take your chances with the VA because life is short and unless you think you have a good chance with your appeal or another MEB, you'd probably be a lot happier out of the Navy. I imagine you'd probably also be eligible for Social Security Disability Income (SSDI) and you should talk to a counselor on your base about that too.

I am not going to write a long response here. I disagre with most of it. The thoughts and input may have been heartfelt and have come from a good place and sentiment. Just most of it is wrong.
 
Not sure how many years of service you have. If you are very close to 20 years, it may be advantageous to continue to serve until at least 20 years of service.


I get you may be trying to be helpful, but the question is not only as to when the condition was incurred. Every member enters the service under the presumption of "sound condition," so, even if it did exist prior to service, the condition is also presumed to have been service aggravated. Absent a notation on entrance medical records, the condition is presumed to have been incurred while entitled to basic pay. Past that, it is also presumed to have been service aggravated. These presumptions can only be overcome by "clear and unmistakable evidence." This is a very high evidentiary standard to overcome.




Lots of "issues" with these questions. First, while it is definitely helpful to have a well-credentialed provider (including a neurologist, be it a military or civilian provider) diagnose or treat you, it is not a requirement to getting an unfit finding or a rating. (Many years ago, there was a whole rigamarole with getting migraines deemed "prostrating" which included a diagnosis and treatment plan that said that you did not need to go to seek medical care each migraine....that is not the case now). An MRI will not diagnose or impact a migraine case. Injury that is causally connected may help with some issues, but is not required at all. Meds are helpful, I guess, as it shows a physician/providers believes you have a severe enough condition, but, this is not required for either an unfit finding or a VA rating.



As for the "in the line of duty" issue, see my previous answer regarding the presumptions and the evidentiary standards required to overcome them.

I don't mean to be purely critical or push back on your efforts to help. My reaction is that you have described many factors (when the migraines were incurred, who diagnosed them, medications, etc.) that, if are present and favorable, would help in making a case. But, none of these factors are strictly needed. I have seen many cases without the factors cited that still resulting in the grant of an unfit finding and a high rating. Each case is different and the facts and circumstances of each case are key in the outcome. I just mean to suggest that a lot of cases are improperly or poorly addressed and it is not a "requirement" that each of the points you raised are needed to be (favorably) present in order to get a rating. I have personally had many cases where none of the factors suggested in your post (time of incurrence, military neurologist providing the diagnosis, medications present) and have gotten a favorable finding. I actually have a current case in Federal Court that is settling with a retirement finding in the absence of the majority of these issues).

I would say that you have identified helpful findings to get a favorable outcome, but, I don't want people to think that the points you raised are neccessary to get a favorable finding.

Additionally, as @Nala2493 stated, he is a member of the USN....well, the Navy has a habit of finding members fit inappropriately, in my opinion, and experience.



My guess is that your NMA probably was not very strong, or you are relatively senior in grade and have had good evalutions, have had good duty performance, and may have had relatively weak statements from your physicians about impact on your duty performance. Those factors would weigh towards an erroneous fit finding.



Sounds like a good idea/plan.


I don't know why an MRI would be needed or indicated for a migraine diagnosis. An MRI does not factor into a migraine diagnosis. http://www.webmd.com/migraines-headaches/making-diagnosis-mri#1 . This is just not a factor or exam for migraines.

As for cause, recall, the presumptions I stated above.

You don't need an MRI and one won't help your case.



See all of my above posts.

No, you don't need a cause, you don't need an MRI and the it is not the "honor system." It is the application of the presumptions and the law.

The issue I would guess is that you may have had a weak Non-Medical Assessment, you may have had very good recent performance, or you just had a poorly written NARSUM.



See my above posts. The issues you raised would certainly help. But they are not needed.



All due respect, this is FLAT WRONG. The standard for fitness is your ability to perform the duties of your "grade, rank, rate, or office." It is not whether you can serve in ANY CAPACITY. This is an erroneous standard.




I am not going to write a long response here. I disagre with most of it. The thoughts and input may have been heartfelt and have come from a good place and sentiment. Just most of it is wrong.

Oi... Thanks for responding mostly just to disagree. Wish you had responded to this member with such useful information last week, I wouldn't have tried to help at all, but no one was responding to this person. I myself just went through a MEB and currently in the IPEB for migraines and a few other things and what I wrote was my experience, although I'm not in the Navy. And with that, I'm dropping the mike and never responding to anything else in here again. Good luck, Nala!
 
What evidences do you have to proof your case at formal board? I will advice you to get statements from your buddies or supervisors and start documenting your migraines on a log. Good luck!
So I have went under med board for my chronic migraines, and I was diagnosed with them a year ago. I have done everything that I can when it came to my doctor giving me medication, and Botox injections. I get them every other day, but she stated on my paperwork I get prostrating ones twice a month. After all the appointments and stress, my packet was sent off to Washington to see if I would get a FIT or UNFIT for duty. Well, I had finally received a call that they had found me FIT, which I was highly upset so was my lawyer because I had all the evidence in the world that I couldn't continue with my duty. I received a letter from my job, and now waiting on one from my doctor. My lawyer said that whoever checked my packet in Washington stated I had 'minimal neurology apts and compliance', which is not true at all.
Long story short, I am going to appeal it because I find that it is unfair that they found me fit. Has anyone had this experience where they were found fit and then appealed and got an unfit? If so, can you state your opinion because I am really hoping they find me unfit after the letters I am going to send them and the pictures my lawyer asked of my medication that they have given me over the past two years. Thank you!
 
So I went on med board for chronic migraines and I was sure I'd get an unfit due to not being able to be on a ship and missing up to 20 hours of work a week, even my doctor recommended to get out. Well I got a call last week stating that they found me "Fit" for duty. I am extremely upset. The reason was that due to my condition there was no reason why I couldn't continue. Has anyone else had this happen?? Is it worth appealing?

Absolutely appeal. As @Jason Perry mentioned, sometimes the Navy drops the ball and makes an error. Fortunately you can request a formal evaluation board to give them the opportunity to make things right.
 
I actually have had the opposite experience.. have migraines (occipital neuralgia) and did not want to even go through a board considering I can still do my job and I was at almost 18 years when this whole board thing started.. I was actually found unfit and couldn't believe it!! I never routinely missed work and although I was being treated with Botox it never affected anything.. so I'm actually fighting for a return to duty.. I'm at the SECAF appeal level now..
 
So I have went under med board for my chronic migraines, and I was diagnosed with them a year ago. I have done everything that I can when it came to my doctor giving me medication, and Botox injections. I get them every other day, but she stated on my paperwork I get prostrating ones twice a month. After all the appointments and stress, my packet was sent off to Washington to see if I would get a FIT or UNFIT for duty. Well, I had finally received a call that they had found me FIT, which I was highly upset so was my lawyer because I had all the evidence in the world that I couldn't continue with my duty. I received a letter from my job, and now waiting on one from my doctor. My lawyer said that whoever checked my packet in Washington stated I had 'minimal neurology apts and compliance', which is not true at all.
Long story short, I am going to appeal it because I find that it is unfair that they found me fit. Has anyone had this experience where they were found fit and then appealed and got an unfit? If so, can you state your opinion because I am really hoping they find me unfit after the letters I am going to send them and the pictures my lawyer asked of my medication that they have given me over the past two years. Thank you!
In my opinion, I think you have a very good case. When I went through my own C&P, the PA wrote in my evaluation that I don't have prostrating attack and I get the headache twice a month. I was found unfit but awarded 0%. I put in a VARR and presented two letters from co workers, headache log of 6 months and a note from my treating neurologist. When my VARR result came back, I was awarded 50%. I will advise you to start an headache log if you have not already done so, it will help you in a long run. Good luck!
 
Oi... Thanks for responding mostly just to disagree. Wish you had responded to this member with such useful information last week, I wouldn't have tried to help at all, but no one was responding to this person. I myself just went through a MEB and currently in the IPEB for migraines and a few other things and what I wrote was my experience, although I'm not in the Navy. And with that, I'm dropping the mike and never responding to anything else in here again. Good luck, Nala!

I am sorry if you felt that my purpose was to respond in order to disagree. It was not. My purpose was to make sure the original poster you responded to did not get information that would lead them to make a poor decision or to be confused about the issues they face. I did not mean to embarrass you or hurt your feelings. I needed to correct the issues with your post so that errors or misunderstandings would not be repeated by other readers in the future.

As for your wish that I had responded earlier, I, too, wish that were the case. But, I have work and family obligations that keep me from spending as much time here on the forums as I would if I had more time.

I won't ask you to continue to post or try to convince you otherwise. It is up to you as to how much or if at all you want to post or participate. You are welcome to post or not. And, if I did hurt your feelings, I apologize for that.
 
In my opinion, I think you have a very good case. When I went through my own C&P, the PA wrote in my evaluation that I don't have prostrating attack and I get the headache twice a month. I was found unfit but awarded 0%. I put in a VARR and presented two letters from co workers, headache log of 6 months and a note from my treating neurologist. When my VARR result came back, I was awarded 50%. I will advise you to start an headache log if you have not already done so, it will help you in a long run. Good luck!
I just sent my appeal packet up yesterday. I had a letter from work, as well as my own letter, along with pictures of the medication I have been given over the past year. I hope they sincerely read what I write and take a deeper look into things. I have to wait 30-45 days for an approved or disapproved. They said it'll most likely come back disapproved but we shall see. If it does, I'll be upset but at least I tried.
 
I just sent my appeal packet up yesterday. I had a letter from work, as well as my own letter, along with pictures of the medication I have been given over the past year. I hope they sincerely read what I write and take a deeper look into things. I have to wait 30-45 days for an approved or disapproved. They said it'll most likely come back disapproved but we shall see. If it does, I'll be upset but at least I tried.
You have nothing to worry about if you have the correct documentations. I went from 0% to 50% when I did my VARR because I know I have all the documentation that I need to support my claim. Good luck!
 
You have nothing to worry about if you have the correct documentations. I went from 0% to 50% when I did my VARR because I know I have all the documentation that I need to support my claim. Good luck!
I just feel like it won't go in my favor and they will deny my appeal, being that I was already doing fit once.
 
I just feel like it won't go in my favor and they will deny my appeal, being that I was already doing fit once.
I understand the anxiety that comes with this but, since you have done everything you are supposed to do on your end, all I can tell you is just relax and hope for the best. Good luck!
 
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