RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01715
BRANCH OF SERVICE:  Marine corps 	SEPARATION DATE:  20030815

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Basic Marine, medically separated for “chronic inguinal/testicular pain post left varicocelectomy” with a disability rating of 10%.

CI CONTENTION:  The CI contends that his unfitting condition warrants a higher rating because it has worsened and is now causing depression.  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 - 20030619	VARD - 20040219	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Inguinal/Testicular Pain	8730	10%	Residual of Left [Varicocele] Ligation Aggravation	7599-7525	0%	20040120	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Chronic Inguinal/Testicular Pain.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI underwent surgical correction for a painful left-sided scrotal varicocele (benign vascular mass within the scrotum) in August 2002.  Despite surgical intervention as well as numerous local anesthetic nerve blocks to various branches of the ilio-inguinal nerve, the CI’s pain remained about his groin and left testicle.  He was referred to an MEB. 

At the 20 May 2003 MEB NARSUM examination, 3 months prior to separation, the CI’s chief complaint was “left scrotal and inguinal pain and swelling”.  His physical examination (PE) revealed left-sided scrotal tenderness without a palpable varicocele.  At the 20 January 2004 VA Compensation and Pension (C&P) evaluation, 5 months after separation, the CI reported an intermittent aching pain about his left scrotum, testicle, and the inside of his left thigh.  His PE revealed him as “markedly uncomfortable” upon palpation of the left sided scrotum.  Tenderness was also present along the spermatic cord extending into the left groin.     

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left groin/testicular pain condition at 10%, coded 8730 (neuralgia of the ilioinguinal nerve).  The VA rated the left groin condition at 0%, coded 7599-7525, (analogous to chronic epididymo-orchitis), based on the C&P examination 5 months after separation, citing the failure to establish any significant occupational impairment that indicated a service connected disability preventing gainful employment.

Panel members first deliberated on the most appropriate and beneficial coding scheme in representing the CI’s condition.  The CI’s pathologic intervention and persistent painful symptoms clearly indicated anatomical involvement of the left Ilio-inguinal nerve and therefore, VASRD codes of either 8530 (paralysis of Ilio-inguinal nerve) or 8730 (neuralgia of ilio-inguinal nerve) were considered.  VASRD §4.124a has only two possible ratings for impairment (paralysis) of this nerve; 0% (mild or moderate) or 10% (severe to complete paralysis), which equates to the maximum rating if the condition was coded as neuralgia of the same nerve.  Either way, there is no additional benefit to the CI and therefore, 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’s adjudication for the left groin/testicle pain condition. 

BOARD FINDINGS:  In the matter of the left groin/testicle condition and IAW VASRD §4.124a, the panel unanimously recommends no change in the PEB adjudication.  There are 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 20150311, 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

      In accordance with reference (a), I have reviewed the cases listed below and 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:

		- XXXXXXXXXXXXXXXXXX, former USMC
		-XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
	 	- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		-XXXXXXXXXXXXXXXXXX, former USN
		-XXXXXXXXXXXXXXXXXX, former USMC

		
		
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	     				  Acting