RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00566
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20090430

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E1, Basic Trainee, medically separated for “chronic left testicular pain” with a disability rating of 0%.

CI CONTENTION:  Contends his testicular, lumbar spine, and mental pain continue to worsen and negatively impacts his daily activities.  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 - 20090408	VARD - 20090915	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Left Testicular Pain	8799-8730	0%	Chronic Left Testicular Pain	7599-7525	NSC	STR	
Lumbar Spine Pain	Not Unfitting	No VA Placement	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:

Chronic Left Testicular Pain.  According to service treatment records and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s testicular pain condition began in January 2009 after lifting heavy military gear.  Radiographic imaging (ultrasound, CT) in February 2009 (3 months pre-separation) showed a central calcification with normal testicular imaging and no evidence of hernia, mass, inflammatory process, torsion, persistent hydrocele, or varicocele.  Despite treatment, the testicular pain condition could not be adequately rehabilitated to meet the physical requirements of the CI’s military specialty and the CI was referred for MEB.  The MEB forwarded “chronic left testicular pain” for PEB adjudication.

At the MEB examination on 4 March 2009 (2 months pre-separation), the CI reported chronic testicular pain with inability to lift, train, and walk at times.  Physical examination showed tenderness of the left scrotum and testing without evidence of swelling, mass, or hernia.  At the MEB NARSUM examination on 27 March 2009 (1 month pre-separation), the physical examination showed tenderness of the testicle and inguinal area without hernia or other abnormality.  There was no VA Compensation and Pension (C&P) examination in evidence for review.

The Board directed attention to the rating recommendation based on the above evidence.  The PEB rated the chronic left testicular pain condition 0%, analogously coded 8799-8730 (neuralgia), citing moderate incomplete paralysis.  The VA did not service connect the left testicular pain condition, citing no permanent residual or chronic disability subject to service connection was shown by the service treatment records or demonstrated by evidence following service.  The Board considered rating the testicular pain with analogous code 7525 (epididymo-orchitis, chronic only) which specifies rating as a urinary tract infection.  There was no evidence of urinary frequency, obstructed voiding, or voicing dysfunction.  There was no evidence of long term drug therapy or frequent hospitalizations (greater than 2 times per year), or continuous intensive management for this condition for a higher rating.  The Board considered analogous code 7120 (varicose veins) but there was no evidence of persistent edema or changes in the skin associated with chronic varicosities to support a higher rating.  

The Board agreed VASRD neuralgia and neuritis codes under the ilioinguinal nerve were the most appropriate codes given the testicular symptoms located at the groin area.  Analogous code 8730 (neuralgia) under VASRD §4.124 (neuralgia, cranial and peripheral) permits a maximum rating of 0% for “moderate incomplete paralysis;” therefore, affording no rating benefit to the CI.  The Board also considered analogous code 8630 (neuritis) under §4.123 (neuritis, cranial and peripheral) which permits a maximum rating of ‘moderate’ when not characterized by organic changes (such as inflammation or non-injury).  Board members agreed that there was no paralysis and no evidence of organic changes (for a ‘severe’ rating of 10%).  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 testicular pain condition.  

Contended PEB Conditions:  Lumbar Spine Pain.  The Board’s main charge is to assess the fairness of the PEB’s determination that the contended condition was not unfitting.  The contended condition was profiled; however, the condition was not implicated in the commander’s statement or judged to fail retention standards.  There was no performance-based evidence from the record that the condition significantly interfered with satisfactory duty performance at separation.  After due deliberation, the Board concluded that there was insufficient cause to recommend a change in the PEB fitness determination for the contended condition and so no additional disability rating is recommended.

BOARD FINDINGS:  In the matter of the chronic left testicular pain condition and IAW VASRD §4.124a, the Board unanimously recommends no change in the PEB adjudication.  In the matter of the contended lumbar spine pain condition, the Board unanimously recommends no change from the PEB determination as not unfitting.  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 20150531, w/attachments
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAMR-RB						

MEMORANDUM FOR Commander

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for 
XXXXXXXXXXXXXXXXXX, AR20160018758  (PD201500566)

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
(  ) DVA