RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXX	CASE:  PD-2014-03846
BRANCH OF SERVICE:  Navy	SEPARATION DATE:  20080125

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Aviation Structural Mechanic, medically separated for “chronic left groin pain,” with a disability rating of 10%.

CI CONTENTION:  Requested all conditions be considered in addition to several conditions not listed on the Medical Evaluation Board (MEB) or Physical Evaluation Board (PEB).  The CI’s 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 based upon a 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 - 20070828	VARD -20080409	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Left Groin Pain	8730	10%	Residual Numbness, Medial Upper Left Groin…	8629	10%	20080207	
			Scar S/P Left Inguinal Hernia Repair	7804	10%		
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:

Left Groin Pain.  According to service treatment record (STR) and the MEB narrative summary (NARSUM), the CI underwent a left-sided inguinal hernia repair in February 2001 and subsequently developed testicular and groin pain.  Additional surgery in June 2006 included a groin exploration with nerve transections.  Despite aggressive pain management and neurologic surgery, the CI’s condition could not be rehabilitated to meet the physical requirements of his military specialty and he was referred to an MEB.  The MEB forwarded “chronic left groin pain” to the PEB for adjudication.

At the MEB NARSUM in March 2007, 11 months before separation, the CI reported continued left groin pain with radiation to the medial upper thigh, as well as groin numbness.  The examiner opined this pain caused disability and inability to perform his duties.  His physical examination (PE) was significant for anesthesia of the overlying skin of the left groin and upper thigh.  At the VA Compensation and Pension (C&P) examination in February 2008, within a month of separation, the CI reported constant left groin pain as well as numbness in the upper thigh.  His PE revealed a slow ambulation favoring the left side.  There was severe tenderness of the left groin.  The left groin scar appeared depressed and was tender to touch.

The Board directed attention to its rating recommendation based on the above evidence.  The PEB assigned a 10% rating under 8730 code (neuralgia).  The VA also assigned a 10% rating using instead a 8629 code (neuritis) based on the VA C&P examination 13 days after separation, citing paralysis of the external cutaneous nerve of the [left] thigh which is severe.  Although coded differently, both the PEB and VA utilized VASRD codes associated with the groin and lower extremity nerves and rated the condition at 10%.  Board members first deliberated on the most appropriate and beneficial coding scheme in representing the CI’s condition.  The CI’s surgical approach and intervention in this case anatomically involved the Illio-inguinal nerve.  Despite the etiologic causation for the condition, the VASRD §4.124a has only 2 possible ratings for impairment of this nerve; 0% or 10%.  The maximum of 10% is for severe to complete paralysis.  The marked degree of groin tenderness/pain found on PE clearly rose above the description of ‘mild or moderate’ and therefore, 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 groin pain condition.  

BOARD FINDINGS:  In the matter of the left groin 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.  The Board, therefore, recommends that there be no modification or re-characterization of the CI’s disability and separation determination.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20140821, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

MEMORANDUM FOR DIRECTOR, SECRETARY OF THE NAVY COUNCIL OF REVIEW
               BOARDS 

Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS
 
Ref:   (a) DoDI 6040.44
       (b) CORB ltr dtd 11 Aug 16

      In accordance with reference (a), I have reviewed the cases forwarded by reference (b), and, for the reasons provided in their forwarding memorandums, approve the recommendations of the PDBR that the following individual’s records not be corrected to reflect a change in either characterization of separation or in the disability rating previously assigned by the Department of the Navy’s Physical Evaluation Board:

		- XXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXX, former USN

						  	XXXXXXXXXXXXXXXXXXXX
	     				  		Assistant General Counsel
						  	(Manpower & Reserve Affairs)