RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00936
BRANCH OF SERVICE:  Navy 	SEPARATION DATE:  20020807

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E2, Recruit, medically separated for “chronic left scrotal pain” and “left-sided varicocele (Cat II),” with a disability rating of 10%.  

CI CONTENTION:  “Never received compensation at 10% level.”  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 - 20020613	VARD - 20080214	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Left Scrotal Pain	8730	10%	Chronic Left Scrotal Pain with Left Sided Varicocele	7599-7529	NSC	STR	
Left-Sided Varicocele	Cat II					
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Left Scrotal Pain.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI had had internal spermatic vein ligation procedures attempted two times at civilian hospitals prior to entering military service.  Entry physical in June 2001 documented asymptomatic varicocele and hydrocele on the left side.  The CI had increased left scrotal symptoms and a scrotal ultrasound showed a large varicocele on the left with a normal abdominal CT scan.  In January 2002, the CI underwent two attempts of left-sided internal vein embolization in service that increased his pain.  The CI declined further surgery and the MEB forwarded “chronic left scrotal pain” and “left-sided varicocele” for PEB adjudication.  The MEB NARSUM examination on 4 February 2002, 6 months prior to separation, noted complaints of chronic left scrotal pain with a left varicocele and reasonable refusal for further intervention.  
There was no VA C&P examination in evidence.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the chronic left scrotal condition 10%, coded 8730 (neuralgia of the ilioinguinal nerve) indicating a 0% deduction for EPTS (existed prior to service).  The PEB also adjudged the left-sided varicocele as a Category II condition, a condition that contributes to the unfitting condition.  The PEB’s Category II diagnosis of left-sided varicocele is intrinsic to the rated condition and a separate rating cannot be supported without pyramiding (VASRD §4.14); thus, it is appropriately subsumed in the same rating.  

The VA did not service connect the “chronic left scrotal pain with left sided varicocele” condition based on the STRs, citing EPTS (existed prior to service) with no objective evidence of permanent worsening as a result of service.  The PEB 10% rating is the maximum rating available under VASRD code 8730.  There was no voiding dysfunction or renal dysfunction, abnormal urinalysis, hypertension, frequent urination or urine leakage for any rating higher than under code 7529 or any alternative coding under the genitourinary system (VASRD §4.115a and §4.115b).  Alternative rating analogous to 7120 (varicose veins; §4.104—cardiovascular system) was considered, but would rate no higher than 10% and offer no benefit to the CI.  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 left scrotal condition.  

BOARD FINDINGS:  In the matter of the left scrotal 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 20150609, 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 14 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:

		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USN

						  XXXXXXXXXXXXXXXXXXXXX
	     				  Assistant General Counsel
						  (Manpower & Reserve Affairs)