RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXX	CASE:  PD-2014-03240
BRANCH OF SERVICE:  Army	BOARD DATE:  20150605
SEPARATION DATE:  20021204

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-2 (Food Service Specialist) medically separated for intractable bilateral scrotal pain.  The bilateral scrotal 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.  He was issued a permanent P3 profile and referred for a Medical Evaluation Board (MEB).  The “chronic bilateral orchialgia, unremitting,” was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501.  No other condition was submitted by the MEB.  The Informal PEB adjudicated “intractable bilateral scrotal pain” as unfitting, rated 0%, with likely 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.”

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 20021018	VA* - (~10 Mos. Post-Separation)  	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Intractable Bilateral Scrotal Pain	8799-8730	0%	Chronic Bilateral Orchialgia, Unremitting	7599-7523	0%	20030923	
Other x 0 (Not In Scope)	Other x 0	
RATING:  0%	RATING:  0%	
*Derived from VA Rating Decision (VARD) dated 20031211 (most proximate to date of separation [DOS]).

ANALYSIS SUMMARY:

Bilateral Scrotal Condition.  Early in basic training, the CI presented to the emergency room on 5 July 2001 with testicular pain secondary to torsion (a twisting of the spermatic cord) and was referred for emergent surgery.  Both testes were then sutured to the scrotum (orchiopexy) to prevent recurrence.  Following surgery, he did well until 13 May 2002 when he had recurrent right testicular pain following a morning run.  Torsion was suspected clinically and confirmed at surgery that day.  Bilateral orchiopexy was again accomplished.  However, he continued to have right testicular pain despite medications and duty limitations.  His physical examination was normal as were multiple ultrasounds, a CT scan, and other studies.  Nerve entrapment was considered as a possible diagnosis.  The narrative summary was dated 6 August 2002.  It recorded that the CI was taken to surgery for left testicular pain rather than recurrent right testicular symptoms.  This had no impact on the adjudication.  The CI reported that even walking caused significant discomfort.  The physical examination was normal.  Tenderness was not documented.  An evaluation in the pain clinic on 9 September 2002 showed a tender right testis, but the remainder of the examination, including the right spermatic cord and epididymis (the structures that actually twist in torsion), was normal and non-tender.  The CI failed to report to his VA Compensation and Pension examination scheduled in September of 2003.  This was subsequently accomplished on 6 September 2012, almost 10 years after separation and not probative for rating at separation.

The Board directed attention to its rating recommendation based on the above evidence.  The PEB and VA both rated the bilateral scrotal pain condition at 0% using the analogous code 8799-8730 (ilio-inguinal nerve neuralgia) and 7599-7523 (testis, atrophy complete), respectively.  The Board found no route to a higher rating.  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 bilateral scrotal 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 intractable bilateral scrotal pain 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.

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 20140422, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAMR-RB	0 6 JUL 2016

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, AR20160003051  (PD201403240)

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