RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXX	CASE:  PD-2014-02135
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20060512

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-2 (Infantryman) medically separated for right groin/inguinal pain.  The condition could not be adequately rehabilitated to meet the physical requirements of his Military Occupational Specialty but was authorized to perform an alternate physical fitness test (per profile).  He was issued a permanent P3/L3 profile and referred for a Medical Evaluation Board (MEB).  The “chronic right groin/inguinal pain that is refractory to all medical treatment” was the only condition forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501.  The Informal PEB adjudicated “chronic right groin/inguinal pain following testicular surgery” as unfitting, existed prior to service with service aggravation rated 10%, with application of the Veterans Affairs Schedule for Rating Disabilities (VASRD).  The CI made no appeals and was medically separated.  

CI CONTENTION:  “Please consider all conditions…also requesting a diagnosis of PTSD should be considered due to exhibiting signs while still in service.”  The CI’s complete submission is at Exhibit A.

SCOPE OF REVIEW:  The Board’s scope of review is defined in DoDI 6040.44, Enclosure 3, paragraph 5.e. (2).  It is limited to those conditions determined by the PEB to be unfitting for continued military service and when specifically requested by the CI, those conditions identified by the PEB, but determined to be not unfitting.  Any conditions outside the Board’s defined scope of review and any contention not requested in this application may remain eligible for future consideration by the Board for Correction of Military/Naval Records.  Furthermore, the Board’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate.  The Board’s assessment of the PEB rating determinations is confined to review of medical records and all available evidence for application of the VASRD standards to the unfitting medical condition at the time of separation.  The Board has neither the role nor the authority to compensate for post-separation progression or complications of service-connected conditions.  That role and authority is granted by Congress to the Department of Veterans Affairs, operating under a different set of laws.  The Board gives consideration to VA evidence, particularly within 12 months of separation, but only to the extent that it reasonably reflects the severity of the disability at the time of separation.  

RATING COMPARISON:

 IPEB – Dated 20060418	VA* - (~2 Mos. Pre-Separation)	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic R Groin/Inguinal Pain Following Testicular Surgery	8799-8730	10%	Right Testicle Atrophy Following Traumatic Injury W/Chronic Pain S/P Orchiopexy	7523	0%	20060308	
Other x 0 (Not In Scope)	Other x 0	
RATING:  10%	RATING:  0%	
*Derived from VA Rating Decision (VARD) dated 20060629 (most proximate to date of separation (DOS)).

ANALYSIS SUMMARY:  

Chronic Right Groin/Inguinal Pain Following Testicular Surgery.  The record showed that the CI injured his right testicle prior to service and required surgery.  He was accessed in October 2004 and apparently had no problems until he reinjured himself in training in April 2005.  An ultrasound was unremarkable other than a right testis slightly smaller than the left.  He was unable to meet duty requirements despite medications and duty restrictions and had repeat surgery on 3 August 2005.  The right testis was noted to be boggy and slightly atrophied compared to the left.  There was also scarring from the previous trauma and surgery present.  His pain persisted after surgery.  He deployed later that year, but was returned from theater due to ongoing symptoms which limited his ability to perform his duties.  Further surgery was not thought to be indicated and the CI declined injections.  He requested an MEB which was then initiated.  

At the VA Compensation and Pension examination performed on 8 March 2006, 2 months before separation, the CI reported that his right groin pain began in 2005 in Air Assault School.  The gait was noted to be normal.  No specific findings for the testis were cited.  The narrative summary was dated 10 March 2006 and noted that the CI had failed medical management and declined nerve blocks.  As noted, he was not a surgical candidate.  He had a normal gait on examination.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the chronic right groin pain condition at 10% for severe incomplete paralysis, coded 8799-8730 (analogous to neuralgia of the ilio-inguinal nerve).  This is the highest rating available under this code.  The VA rated the condition at 0% for atrophy of one testis, coded 7523 (testis, complete atrophy).  The Board considered the findings and found no route to a rating higher than the 10% adjudicated by the PEB.  After due deliberation in consideration of the preponderance of the evidence, the Board concluded that there was insufficient cause to recommend a change in the PEB fitness determination for the right groin/inguinal pain 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 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 chronic right groin/inguinal pain condition and IAW VASRD §4.115 and §4.124a, the Board unanimously recommends no change in the PEB adjudication.  There were no other conditions within the Board’s scope of review for consideration.  

RECOMMENDATION:  The Board, therefore, recommends that there be no re-characterization of the CI’s disability and separation determination. 

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20140514, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

MEMORANDUM FOR Commander, US Army Physical Disability Agency (AHRC-DO), 2900 Crystal Drive, Suite 300, Arlington, VA  22202-3557

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for XXXXXXXXXXXXXXXXXXXX, AR2016000281 O (PD201402135)

I have reviewed the enclosed Department of Defense Physical Disability Board of Review (DoD PDBR) recommendation and record of proceedings pertaining to the subject individual.  Under the authority of Title 10, United States Code, section 1554a, I accept the Board's recommendation and hereby deny the individual's application.
This decision is final.  The individual concerned, counsel (if any), and any Members of Congress who have shown interest in this application have been notified of this decision by mail.

BY ORDER OF THE SECRETARY OF THE ARMY:

Enclosure CF:
( ) DoD PDBR ( ) OVA