RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXX	CASE:  PD-2014-04068
BRANCH OF SERVICE:  Marine Corps 	SEPARATION DATE:  20011015

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Rifleman, medically separated for “bilateral orchialgia,” rated 10% for the left and 0% for the right, with a combined disability rating of 10%.

CI CONTENTION:  The CI made no specific contention.  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 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 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 - 20010830	VARD - 20040910	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Orchialgia (Left)	8730	10%	Orchialgia	7599-7523	NSC	STR	
Orchialgia (Right)	8730	0%					
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NSC	

ANALYSIS SUMMARY:  

Bilateral Orchialgia Condition.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI had surgery of the left testis in 1995 which was reported and cleared prior to accession.  On 15 January 2001 he presented to the emergency room (ER) with right testicular pain.  It resolved and he was referred to urology where he was diagnosed with intermittent torsion of the testes.  On 25 January 2001 he underwent surgery.  The left testis was found to be scarred in place from the earlier surgery; orchiopexy surgery to fix the testis in place was then done on the right.  Following surgery, he continued to have left greater than right testicular pain refractory to medications other than narcotics.  The latter precluded working as he was drowsy from the medication.  A block was offered, but declined.  He was then referred into the MEB process.  The MEB NARSUM examination dated 20 June 2001, 4 months prior to separation, showed both testes were descended (normal) and fixed to the scrotal wall (desired surgical outcome).  The left epididymis was tender globally and there was mild tenderness on the right.  It was noted that there had been very little improvement with medications and limited duty.  The VA adjudicated the orchialgia condition using the service treatment records without accomplishing a separate evaluation.  

The Board directed its attention to its rating recommendation based on the above evidence.  The PEB rated the left testis at 10% and the right at 0%, both coded 8730 (neuralgia of the ilio-inguinal nerve).  The VA determined that the bilateral orchialgia was a pre-existing condition and adjudicated it as not service connected (NSC), coded 7599-7523 (analogous to testicular atrophy).  Under the 8730 code, mild to moderate “paralysis” supports a 0% rating.  Neuralgia is limited to a rating comparable to moderate paralysis.  A 0% rating is supported for each testis under this code.  Atrophy was not present to support a rating under the 7523 code.  Epididymo-orchitis, coded 7525, is rated as a urinary tract infection.  A 10% rating is supported by long term drug therapy, 1-2 hospitalizations a year, and/or intermittent intensive management.  Other than the surgery in January 2001, the CI only required ongoing pain medications.  The Board found no route to a higher rating for either testis.  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 bilateral chronic orchialgia condition.   

BOARD FINDINGS:  In the matter of the bilateral chronic orchialgia 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, 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 9 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 USMC
		- XXXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXXX, former USMC