RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXX	    CASE:  PD-2014-02463
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20050805  

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Light Wheeled Vehicle Mechanic, medically separated for left groin pain, with a disability rating of 0%.  

CI CONTENTION:  The CI contends that he was not evaluated for conditions that the VA service connected; flat feet, nerve damage in his neck, shoulders, and back.  His complete submission is at Exhibit A.

SCOPE OF REVIEW:  The Board’s scope of review is defined in DoDI 6040.44.  It is limited to those conditions determined by the Physical Evaluation Board (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 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 Veterans Affairs Schedule for Rating Disabilities (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:  

SERVICE PEB - 20050715	VARD - 20051108	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Left Groin Pain (Residual Left Inguinal Hernia Repair)	8799-8730	0%	Surgical Scar, Left Inguinal Hernia	7338	0%	20050926	
COMBINED RATING:  0%	COMBINED RATING FOR ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:    

Left Inguinal Hernia Condition.  The service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM) documented the diagnosis of a left inguinal hernia in 2003 during basic training.  The pre-operative evaluation identified a bleeding disorder (factor XI deficiency) which was ultimately determined to be mild, and the hematology consultant opined that an MEB for the condition was not indicated at the time.  A surgical hernia repair ensued in August 2003 (24 months pre-separation) without complications.  There was persistent post-operative pain in the left groin which did not respond to conservative measures.  No recurrent hernia was identified by physical examinations or ultrasound imaging; surgery opined that further intervention was not indicated; and, an MEB was initiated.  The CI subsequently complained of umbilical and right inguinal pain for which an ultrasound and examinations were negative for hernias.  
  
The NARSUM was conducted 11 June 2005 (7 weeks pre-separation) and documented persistent left groin pain rated as “slight and frequent,” to which was ascribed “extreme limitations” with MOS requirements.  The commander’s performance statement documented that the CI’s “job performance has not been diminished ... [and] ... he is still able to function in his MOS and training activities.”  The NARSUM physical examination recorded a healed surgical scar without indication of recurrent hernia or defect.

A VA Compensation and Pension (C&P) examination was conducted 26 September 2005 (7 weeks post-separation) and documented “intermittent but nearly daily occurring left groin pain” which was exacerbated by lifting and twisting; and, did not interfere with the CI’s full-time occupation as a student but did impede heavy lifting or straining (domestic chores).  The VA physical examination recorded a non-tender surgical scar without ratable findings, and did not identify the presence of inguinal hernias by strain maneuvers; with the examiner stating, “The veteran does not have by my exam today either a left or a right inguinal hernia.”

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated analogously under code 8799-8730 (neuralgia of the ilio-inquinal nerve) and conferred 0% for “mild or moderate” impairment.  The highest available 10% rating under 8730 is for “severe to complete” impairment.  Although the VA provided a 0% rating for an umbilical hernia, there was no inguinal hernia rating other than the surgical scar (based on the C&P findings).  The specific code for inguinal hernia under VASRD §4.114 is 7338, and the 10% criteria are “postoperative recurrent, readily reducible and well supported by truss or belt.”  These criteria were not supported by the evidence, and there was no other VASRD code (analogous or otherwise) which was applicable to this case.  The Board considered concession of a 10% rating under 8799-8730, but members agreed that the functional impairment in evidence could not be reasonably characterized as severe.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board concluded that there was insufficient cause to recommend a change in the PEB adjudication of the left inguinal hernia condition. 

BOARD FINDINGS:  In the matter of the left inguinal hernia condition and IAW VASRD §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.  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 20140523, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAMR-RB

MEMORANDUM FOR Commander

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation
for XXXXXXXXXXXXXXXXXXXX, AR20160007497 (PD201402463)

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
( ) DVA