RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00641
BRANCH OF SERVICE:  Marine Corps 	SEPARATION DATE:  20091129

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 “left testicular pain,” with a disability rating of 10%.

CI CONTENTION:  “Review all conditions.”  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 on 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 - 20090916	VARD 	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Testicular Pain	8630	10%	No VA examination in evidence	
Varicocele – Left S/P Ligation	Cat II		
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS: 	

ANALYSIS SUMMARY:  

Left Testicular Pain.  According to service treatment records and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s left testicular pain condition began in November 2008 after he was kicked in the scrotum while wrestling with a fellow Marine.  The CI had sharp 9/10 pain in his left testicle radiating to the abdomen.   Ultrasound showed a left varicocele.  Left varicocele ligation was performed 2 December 2008 and post-surgery, a dull, throbbing 5/10 pain remained.   A nerve block and electrical therapy did not relieve symptoms.  Physical activity exacerbated the pain.  Another ultrasound revealed a retained left varicocele.  Another surgical intervention was recommended but delayed due to the risk of sterility.  Despite treatment, the left 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 an MEB.  The MEB forwarded “scrotal varices,” “unspecified disorder of male genital organs,” and “neuralgia” for PEB adjudication.

At the MEB examination (recorded on DD Forms 2807 and 2808) dated 17 June 2009, 5 months prior to separation, the physical examination showed a left epididymis 2x2 cm mass, tender and soft.  Left varicocele was diagnosed.  The MEB NARSUM examination on 23 June 2009, 5 months prior to separation, noted complaints of testicular pain.  The CI was unable to lift heavy objects, walk or run for distances greater than a half mile, perform sit-ups or participate in daily duties as a rifleman.  He was not taking any medications.  Physical examination of the genitourinary area showed a left hemi scrotum (blood in the scrotum) with varicocele and tenderness but no tenderness of mass of the epididymis.  
 
There was no VA Compensation and Pension evaluation in evidence, the CI has not submitted for VA disability.

The Board directed attention to its rating recommendation based on the above evidence. The PEB rated the testicular pain, left condition 10%, coded 8630 (neuritis, ilio inguinal nerve.) The PEB also listed “varicocele – left s/p ligation” as a related Category II condition (a condition that contributed to the primary unfitting condition but was not separately ratable).  The impairment from the “varicocele – left s/p ligation” was properly subsumed under the overall rating for the “testicular pain, left” condition IAW §4.14 (avoidance of pyramiding; more than one rating based on the same impairment is prohibited).  There was no pathway to a higher rating.  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.  

BOARD FINDINGS:  In the matter of the left testicular 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 re-characterization of the CI’s disability and separation determination.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150603, w/attachments
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 16 Nov 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:

		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC

						  XXXXXXXXXXXXXXXXXX
	     				  	  Assistant General Counsel
						  (Manpower & Reserve Affairs)