RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00709
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20050120

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty, E3, Infantryman, medically separated for “chronic left testicular pain” with a disability rating of 0%.

CI CONTENTION:  The CI contends he was medically separated and never given a rating.  The complete submission is at Exhibit A.

SCOPE OF REVIEW:  The panel’s scope of review is defined in DoDI 6040.44.  It is limited to review of disability ratings assigned 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 or non-compensable.  Any conditions outside the panel’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 panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate.  The panel’s assessment of the PEB rating determination 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(s) at the time of separation.  The panel 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 panel 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 - 20041209	VARD - 20060515	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Left Testicular Pain	8799-8730	0%	Chronic Epididymitis	7599-7525	NSC	STR	
Acute Adjustment Disorder	Not Unfitting	No VA Placement	
Substance Induced Mood Disorder	Not Unfitting		
Bilateral Knee Pain	Not Unfitting		
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:

Chronic Left Testicular Pain.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI presented for care in February 2004 with a 1-year history of chronic left testicular pain.  He was diagnosed with left epididymitis and treated with antibiotics.  The left testicular pain persisted with intermittent relief from cord blocks.  The CI declined surgical intervention due to the risk of infertility.

At the 15 October 2004 MEB NARSUM examination, 3 months prior to separation, the CI reported 4-5/10 left testicular pain.  The pain worsened with exercise and heavy lifting.  Rest and relaxation relieved the pain.  Physical examination showed an “exquisitely” tender left epididymis.  The genitourinary examination was otherwise normal.

There was no VA Compensation and Pension examination performed for this panel to review.  The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the chronic left testicular pain 0%, analogously coded 8730 (moderate ilioinguinal neuralgia).  The VA did not service connect the condition.  

The panel noted that there was no avenue to a higher rating under 8730 because IAW §4.124 the maximum rating for neuralgia is equal to moderate incomplete paralysis which is 0% for 8730.  The panel noted that the VASRD code for chronic epididymitis (7525) rates the condition under the criteria for urinary tract infection.  A 10% rating requires long-term drug therapy, one to two hospitalizations per year and/or intermittent intensive management.  There was no evidence of hospitalizations.  The panel noted that the MEB NARSUM examiner documented that the CI did not require chronic narcotic medications for pain management.  Panel members agreed that the evidence did not support a 10% rating.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded that there was insufficient cause to recommend a change in the PEB adjudication for the chronic left testicular pain condition.

Contended PEB Conditions:  Acute Adjustment Disorder, Substance Induced Mood Disorder, and Bilateral Knee Pain.  The panel’s main charge is to assess the fairness of the PEB’s determination that the contended conditions were not unfitting.  Adjustment disorder is a condition not constituting a physical disability, IAW DoDI 1332.38.  Therefore, the Board has no basis for recommending it as unfitting.  The substance induced mood disorder and bilateral knee pain conditions were not profiled or implicated in the commander’s statement and were not judged to fail retention standards.  They were reviewed and considered by the panel.  There was no performance-based evidence from the record that any of these conditions significantly interfered with satisfactory duty performance at separation.  After due deliberation, and in consideration of the preponderance of the evidence, the panel concluded that there was insufficient cause to recommend a change in the PEB fitness determination for the any of the contended conditions and so no additional disability ratings are recommended.

BOARD FINDINGS:  In the matter of the chronic left testicular pain condition and IAW VASRD §4.124a, the panel unanimously recommends no change in the PEB adjudication.  In the matter of the contended acute adjustment disorder, substance induced mood disorder, and bilateral knee pain conditions, the panel unanimously recommends no change from the PEB determinations as not unfitting.  There were no other conditions within the panel’s scope of review for consideration.  The panel, 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 20150604, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170004781, XXXXXXXXXXXXXXXXXX. 

Dear XXXXXXXXXXXXXXXXXX:

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found your separation disability rating and your separation from the Army for disability with severance pay to be accurate.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed), and I accept its recommendation.  I regret to inform you that your application to the DoD PDBR is denied.  

	This decision is final.  Recourse within the Department of Defense or the Department of the Army is exhausted; however, you have the option to seek relief by filing suit in a court of appropriate jurisdiction.

Sincerely,					       
						      					
Enclosure