RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXXX	CASE:  pd-2014-02812
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20060803

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Common Ground Station (CGS) Operator, medically separated for “chronic left orchalgia” rated at 0%.  

CI CONTENTION: His bilateral knee pain continues to worsen.  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 - 20060616	VARD - 20070920	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Left Orchalgia	8730	0%	Chronic Orchalgia, Left Testicle	7599-7525	0%	STR	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Chronic Left Orchalgia.  According to service treatment records and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s left orchalgia condition began in May 2005 after falling and straddling a log.  He noted a small lump in his scrotum and had another groin injury in June 2005.  Ultrasound of the scrotum and testes documented small bilateral varicoceles.  Urology consult indicated the CI complained of activity-limiting chronic left testicular pain (left orchalgia) and that the CI also had a left spermatocele.  Conservative therapy, including inguinal nerve block, was not effective in decreasing the CI’s left testicular/groin pain and he declined surgery for the spermatocele.  

At the urology MEB NARSUM addendum examination dated 19 February 2006, 6 months prior to separation, the CI reported chronic left testicular pain.  Physical examination documented a small (<1cm) nodule on the left spermaticord above the epididymis.  There was tenderness to palpation of the left cord and testicle with increased pain severity with compression to the cord and testicle.  There was no hydrocele and no varicocele identified physically.  The right-sided examination was within normal limits.  Urinalysis was normal and radiographs (CT) of the abdomen were negative for abnormal kidneys or abnormal lymph nodes.  The NARSUM examination dated 19 May 2006, 3 months prior to separation, documented a normal gait and normal blood pressure.  There was no history or indication of surgeries/hospitalization or chronic medications related to the orchalgia condition.  

The Board directed its attention to its rating recommendation based on the above evidence.  The PEB assigned a 0% rating under the 8730 code (neuralgia of the ilio-inguinal nerve), citing orchalgia treated with nonsteroidal anti-inflammatories and scrotal support, “rated as moderate.”  The VA assigned a 0% rating using an analogous 7525 code (chronic epididymo-orchitis) based on the service treatment record, citing no VA examination and no evidence of long-term drug therapy, one or two hospitalizations per year, or intermittent intensive management.  

The “moderate” 0% rating under code 8730 is the maximum for neuralgia IAW VASRD §4.124, and there were no organic changes for any alternate higher rating analogously to a neuritis (IAW VASRD §4.123).  Alternate rating under code 7525 would be no higher than 0% and there were no other higher rating pathways under either ratings for neurological conditions or ratings of the genitourinary system.  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 for the left orchalgia condition.  

BOARD FINDINGS:  In the matter of the left orchalgia condition and IAW VASRD §4.124a and §4.115b, 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 20140515 with attachments
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 AR20160007937 (PD201402812)

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