RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01436
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20060822

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty, E4, Utility Equipment Repairer, medically separated for “chronic left groin pain following inguinal hernia repair in Jan 05,” with a disability rating of 0%.  

CI CONTENTION:  “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 - 20060519	VARD - 20070316	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Left Groin Pain Following Inguinal Hernia Repair… 	8799-8730	0%	Left Inguinal Hernia	7338	0%	 STR	
			Chronic Pain Syndrome	6399-6354	NSC	STR	
Adjustment Disorder	Not Unfitting	No VA Placement	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Chronic Left Groin Pain….  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s left groin pain condition began in January 2005 after a left inguinal hernia repair.  Surgery and nerve blocks were reasonably declined.  The MEB forwarded “chronic pain syndrome (left groin), resistant to modalities of nonsteroidal inflammatory medications” for PEB adjudication.  

The MEB NARSUM examination on 7 March 2006, 6 months prior to separation, noted complaints of chronic disabling left groin pain resistant to treatment.  Physical exam showed a well-healed surgical incision in the left groin with no palpable hernia defect.  There was no inducible pain associated with the evaluation.  There were no abnormalities of the cord structures, epididymis or testes.  There was also no hernia on the right side.  

There was no VA Compensation and Pension (C&P) evaluation in evidence proximate to separation and VA records indicated the CI failed to report for scheduled examinations.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left groin pain condition 0%, coded 8799-8730 (neuralgia - ilioinguinal nerve), citing rating as analogous to ilioinguinal neuralgia - moderate.  The VA rated the left inguinal hernia condition 0% coded 7338 (hernia, inguinal), based on the STR, citing no evidence of a recurrent hernia.  The VA also adjudicated the left groin chronic pain syndrome as not compensable (6399-6354 - chronic fatigue syndrome) citing that the chronic pain of the left groin was considered in the evaluation of residuals of left inguinal hernia repair and were not a separate and distinct disability for which compensation was payable.  

IAW VASRD §4.124 (neuralgia), there is a maximum equal to moderate incomplete paralysis; which for the ilioinguinal nerve is 0%.  There were no organic changes in the ilioinguinal nerve and a neuritis rating, versus neuralgia rating, also has a maximum equal to moderate incomplete IAW VASRD §4.123 (neuritis).  There was no evidence of recurrent hernia (code 7338), painful or unstable scar (code 7804), or evidence of chronic epididymo-orchitis (code 7525) for any alternative rating higher than the 0% awarded by the PEB.  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 left groin pain condition.  

Contended PEB Condition:  Adjustment Disorder.  The panel’s main charge is to assess the fairness of the PEB’s determination that the contended condition was not unfitting.  The contended condition was not profiled or 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.  The adjustment disorder is a condition not constituting a physical disability, IAW DoDI 1332.38.  Therefore, the panel has no basis for recommending it as unfitting.  After due deliberation, the panel 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 left groin pain condition and IAW VASRD §4.124a, the panel unanimously recommends no change in the PEB adjudication.  In the matter of the contended adjustment disorder condition, the panel unanimously agrees that it cannot recommend it for additional disability rating.  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 20150602, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170007474, XXXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXX:

	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