RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXX	     CASE:  PD-2014-04118
BRANCH OF SERVICE:  MARINE CORPS                                                 SEPARATION DATE:  20080715

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Aircraft Electrical Systems Technician, medically separated for “chronic orchalgia/chronic testicular pain…” with a disability rating of 10%.  

CI CONTENTION:  The CI contends that his condition continues to worsen and negatively impact daily activities, and that the coding the VA used is not advantageous.  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 - 20080514	VARD - 20080827 	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Orchalgia/Chronic Testicular Pain…	8630	10%	Orchialgia	7599-7525	10%	20080716	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:   

Testicular Pain.  According to service treatment records (STRs) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s testicular pain condition began in July 2007.  Many different medications were tried in an attempt to alleviate his pain.  In spite of all treatment efforts, the testicular pain persisted and an MEB was initiated.  On the MEB NARSUM dated 16 April 2008, 3 months before separation, the CI reported that he was unable to do any running, squatting, or heavy lifting without having severe right testicular pain.  On physical examination (PE), he was in no acute distress.  There was tenderness to palpation (TTP) of the posterior right testis, but the urological exam was otherwise unremarkable.  For a diagnostic impression, the NARSUM examiner wrote: “CI is a 20 year old USMC active duty Lance Corporal with chronic orchalgia/testicular pain that has failed current medical management up to this point.” 

The CI separated from service on 15 July 2008.  On the day after separation, he had a VA Compensation and Pension (C&P) examination.  He reported that the pain would flare up approximately 10-20 times per week.  During a flare-up, he was unable to lift, walk, or wash a car.  On PE his posture and gait were normal.  On urological exam, the corpus of the right testis was normal, without significant tenderness.  There was TTP of the epididymal and vascular structures of the right scrotum.  For diagnosis, the C&P examiner wrote: “Orchialgia, right, etiology unknown.”     

The Board directed attention to its rating recommendation based on the evidence.  The Navy PEB and the VA chose different coding options for the orchalgia condition, but both assigned a 10% disability rating.  The PEB used VASRD code 8630 (neuritis of the ilio-inguinal nerve).  The VA coded it 7599-7525 (analogous to chronic epididymo-orchitis).  The Board determined that both of these approaches were valid ways to code and rate the CI’s chronic testicular pain.  There was no path to a higher rating, because there was insufficient evidence that would justify a rating higher than 10%.  

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 found insufficient cause to recommend a change in the PEB adjudication of the chronic right testicular pain.  IAW VASRD §4.124a, the CI’s condition meets criteria for the 10% rating level. 

BOARD FINDINGS:  In the matter of the chronic orchalgia/chronic testicular pain, 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 19 Sep 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