RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01380
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20060523

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E6, Chemical Operations Specialist, medically separated for bilateral orchalgia, with a disability rating of 0%.

CI CONTENTION:  The CI requests review all conditions.  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 - 20060207	VARD - 20070612	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Bilateral Orchalgia	8799-8730	0%	Orchalgia, Bilateral…	7599-7525	0%	20070327	
			Erectile Dysfunction…	7599-7522	0%	20070327	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Bilateral Orchalgia.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI was first treated for left testicular pain in 1997 with an epididymectomy.  He enjoyed resolution of pain and returned to full activities including jump status.  In 2004, his pain recurred.  No etiology for the pain was found on evaluation including ultrasounds and a CT scan.  The pain was refractory to treatment including pain medications, antibiotics, and nerve blocks.  Laparoscopic cord stripping was offered, but declined.  The CI was issued a P3 profile and referred for an MEB.  The MEB forwarded bilateral orchalgia for PEB adjudication.  

The MEB NARSUM examination on 12 January 2006, 4 months prior to separation, noted complaints of pain limiting activity including physical fitness training and the his duties.  The left testis was noted to be slightly contracted compared to the right and tender.  The right testis and epididymis were unremarkable.  The gait was normal.  At the VA Compensation and Pension (C&P) evaluation performed on 27 March 2007, 10 months after separation, the CI reported ongoing pain which limited activity.  The examination was deferred due to extreme tenderness of the scrotum; however, the gait was normal.  The panel observed that a normal gait would not be expected in the presence of “extreme tenderness of the scrotum.”  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the orchalgia condition 0%, analogously coded 8799-8730 (Neuralgia).  The VA also rated the orchalgia condition 0%, analogously coded 7599-7525 (Epididymo-orchitis, chronic only), based on the VA C&P examination 10 months after separation and STRs, citing no long-term drug therapy, hospitalizations or intermittent intensive management.  The VA additionally assigned a non-compensable rating for erectile dysfunction coded 7599-7522 (penile deformity with loss of erectile power), noting that the CI could achieve an erection, but not have sexual relations due to the scrotal pain.  The panel observed that the CI had chronic pain without a definitive diagnosis.  Other than a history of surgery in 1997, there had been no trauma.  The gait was noted to be normal on both the MEB and VA examinations.  The testis was tender.  The panel determined that this was not consistent with a severe level of pain and that this code was limited to a moderate level regardless.  The 7525 code used by the VA is also limited to a non-compensable rating in the absence of ongoing treatment.  The panel found no route to a compensable rating under any other coding option.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends no change in the PEB adjudication for the bilateral orchalgia condition.  

BOARD FINDINGS:  In the matter of the bilateral orchalgia condition and IAW VASRD §4.115 and VASRD §4.124a, the panel unanimously recommends no change in the PEB adjudication.  There were no other conditions within the panel’s scope of review for consideration.  The panel, therefore, recommends that there be no modification or 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

AR20170007571, XXXXXXXXXXXXXXXXXXXXX 

XXXXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXXXX:

	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