RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXX	CASE:  PD-2014-03123
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20020310

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-2 (Unit Supply Specialist) medically separated for chronic bilateral testicular pain, rated at 0%.  

CI CONTENTION:  The CI requests the Board consider all conditions.  He adds that he was not evaluated for the right knee or lumbosacral strain.  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 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 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 20011206	VA* – (~2 Mos. Post-Separation)  	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Bilateral Testicular Pain	8799-8730	0%	Chronic Epididymitis 	7525	10%	20020507	
Other MEB/PEB Conditions x 0 (Not In Scope)	Other x 2 	
RATING:  0%		COMBINED RATING:  20%	
*Derived from VA Rating Decision (VARD) dated 20020712 (most proximate to date of separation [DOS])  

ANALYSIS SUMMARY:  

Bilateral Testicular Pain.  In October 2000, this CI experienced onset of bilateral testicular pain.  There was no specific trauma or injury associated with the onset of pain.  He was seen by Urology and was diagnosed with epididymitis.  He was treated with antibiotics, but the pain persisted.  Many different tests were done, in an attempt to discover the cause of his pain.  The CI was found to have thickening and induration of his epididymi, both left and right.  There also were some small calcifications in the scrotum, suggestive of chronic inflammation.  In May 2001, while deployed overseas, he was medically evacuated from theater due to bilateral testicular pain.  When he arrived back at home station, a Medical Evaluation Board (MEB) was initiated.
The MEB physical examination (PE) was on 16 October 2001.  The CI reported that he was unable to do his job.  Simple activities such as lifting, standing, or walking would bother him.  The pain affected him at least once a day and lasted the majority of the day.  When pain occurred, he would try to stop what he was doing and lie down.  He was not taking any pain medications at that time.  On PE of the scrotum, the testes were normal size.  There was no mass or testicular tenderness.  The right epididymis was slightly tender and thickened, but the left was totally normal.  The MEB narrative summary (NARSUM) diagnosis was “chronic, bilateral testicular pain.”

The CI was medically separated from service in March 2002.  Eight weeks later, on 7 May 2002, he had a VA Urology Compensation and Pension (C&P) exam.  He was not employed at that time.  He reported that his scrotal pain was bilateral, but swelling occurred on the right.  The pain occurred every day, and he had to go to bed almost every other day.  He was using ibuprofen 400mg every 8 hours as needed for pain.  On PE of the scrotum, there was no obvious swelling visible.  The vas deferens on both sides was rather thickened, left greater than right.  The testes were well descended and smooth.  The epididymis was enlarged on both sides, approximately 1.5 times normal.  There was no significant tenderness and no additional swellings were noted.

The Board carefully reviewed all available information and directed attention to its rating recommendation based on the evidence.  The PEB and the VA chose different coding and rating options for the chronic genitourinary (GU) condition.  The PEB used diagnostic code (DC) 8799-8730 (analogous to ilio-inguinal neuralgia), rated 0%.  The VA chose DC 7525 (epididymo-orchitis, chronic) rated 10%. The Board deliberated at length with regard to the appropriate disposition of this case.  The Board determined that GU code 7525 was an acceptable code for describing the CI’s condition, since the chronic testicular pain was analogous to chronic epididymo-orchitis.  IAW VASRD §4.115b, when using DC 7525, the rater should rate as urinary tract infection (UTI).  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt) and §4.7 (higher of two evaluations), the Board recommends a rating of 10% for the chronic bilateral testicular pain.  The Board recommends using DC 7599-7525 (analogous to chronic epididymo-orchitis).

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 bilateral testicular pain, the Board unanimously recommends a disability rating of 10%, coded 7599-7525, IAW VASRD §4.115a and §4.115b.  There were no other conditions within the Board’s scope of review for consideration.  

The Board, therefore, recommends that the CI’s prior determination be modified as follows, effective as of the date of his prior medical separation:  

CONDITION	VASRD CODE	RATING	
Chronic Bilateral Testicular Pain 	7599-7525	10%	
RATING	10%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20140621, 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, AR20160004035 (PD201403123)

1.  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 to modify the individual’s disability rating to 10% without recharacterization of the individual’s separation.  This decision is final.  

2.  I direct that all the Department of the Army records of the individual concerned be corrected accordingly no later than 120 days from the date of this memorandum.   

3.  I request that a copy of the corrections and any related correspondence be provided to the individual concerned, counsel (if any), any Members of Congress who have shown interest, and to the Army Review Boards Agency with a copy of this memorandum without enclosures.

BY ORDER OF THE SECRETARY OF THE ARMY:

Enclosure

CF: 
(  ) DoD PDBR
(  ) DVA