RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01557
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20031219

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E2, Trainee, medically separated for “chronic left testicular pain” with a disability rating of 0%.  

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 - 20031027	VARD - 20041025	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Left Testicular Pain	8799-8730	0%	Residuals of Varicocele Repair…	7599-7804	10%	20040317	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Chronic Left Testicular Pain.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI was first evaluated for a varicocele condition on 20 May 2003, 6 weeks after accession, when he went to sick call for a “bump” on his left testicle.  The next record in evidence was another sick call appointment for left testicular pain on 25 June 2003.  He reported worsening pain.  He was referred to urology and then underwent surgical repair on 1 July 2003.  He was placed on convalescent leave for 30 days, but had persistent pain which precluded a return to training.  He was again seen in urology on 6 August 2003 and reported ongoing left groin and testicular pain aggravated by activity.  He had no pain at rest.  He also reported a 2-3 week history of urinary hesitancy and dribbling.  The left testis was tender on examination, but the examination was otherwise unremarkable without clinical evidence of a surgical complication.  Three weeks later, during a 27 August 2003 urology visit, he was noted to have failed medical treatment and an MEB was recommended for persistent pain.  During the 17 September 2003 MEB NARSUM examination, 3 months prior to separation, the CI reported that the pain was worse than prior to surgery.  On examination, the surgical scar and left testis were mildly tender.  The examination was otherwise unremarkable and the varicocele remained decompressed.  The MEB forwarded chronic non-specific left orchalgia for PEB adjudication.  No VA Compensation and Pension evaluation was performed.  On 4 March 2004, the CI’s mother called the VA stating that he had increased pain and swelling.  The VA returned the call the next day and the CI denied any problems.  On a 12 March 2004 general health assessment, 3 months after separation, the CI denied any genitourinary symptoms including pain in the testis.  At the 17 March 2004 internal medicine clinic evaluation performed to establish care in the VA system, the CI denied the urinary symptoms documented above.  No pathology was documented on the examination, but it is not clear if the genitalia were examined.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the chronic left testicular pain condition 0%, coded 8799-8730 (analogous to ilio-inguinal neuralgia at a moderate level).  Based on the service and VA treatment records, the VA rated the residuals of varicocele repair at 10%, coded 7599-7804 (analogous to painful scars).  The Board considered the evidence.  The MEB NARSUM documented residual tenderness of the testis and scar, but this examination was accomplished less than 3 months from surgery.  Post- separation evidence, more than 8 months after the surgery, showed that the CI was asymptomatic.  This examination and the MEB NARSUM were equally proximate to separation.  The former supports the PEB 0% adjudication.  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 chronic left testicular condition.  

BOARD FINDINGS:  In the matter of the chronic left testicular 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 20150608, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170006638, XXXXXXXXXXXXXXXXXX 

XXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXX
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