RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01959
BRANCH OF SERVICE:  Marine Corps 	SEPARATION DATE:  20020630

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an  E3, Field Radio Operator, medically separated for “history of orchalgia” with a disability rating of 10%.    

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 - 20020429	VARD - 20030922	
Condition	Code	Rating	Condition	Code	Rating	Exam	
History of Orchalgia	8730	10%	Testalgia	7599-7523	NSC	STR	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Orchalgia (Testicular Pain).  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI developed an atraumatic onset of right testicular pain in early 2001.  The pain persisted and an extensive evaluation consisting of multiple imaging modalities and specialty consultations did not identify an etiology.  Hematuria (blood in the urine) was reported to some examiners, but multiple urinalyses were normal (no blood or infection); and, there was no documentation in STR clinical entries of any other significant symptoms, hospitalizations, or other VASRD-ratable criteria.  The CI refused offers of nerve blocks, and various analgesics were prescribed without improvement.  

The 4 March 2002 NARSUM examination, 4 months prior to separation, documented constant pain (not quantified but rated 7/10 in a contemporary STR entry) that had not improved and that rendered the CI “not able to do the normal activities that it takes to be a Marine.”  The physical examination was reported as normal, except for some right testicular tenderness, and specified normal testicular size (no atrophy).  There was no VA rating examination or other post-separation evidence in this case.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB’s 10% rating under the anatomically applicable nerve code 8730 (neuralgia of the ilio-inguinal nerve) is the highest possible rating for the code.  The VA applied code 7599-7523 (analogous to testicular atrophy), but did not service connect the condition, citing the CI’s failure to report for examination and the absence of evidence supporting a current disability.  The 7523 code is neither clinically applicable nor advantageous to the CI.  

The panel notes that there is no precise rating mechanism for testicular pain in the VASRD.  The only code other than the 8730 code used by the PEB that might be considered for analogous application is 7525 (chronic epididymo-orchitis), which defaults to the VASRD §4.115a rating formula for urinary tract infection, and none of those criteria are applicable to this case.  There is thus no code available in the VASRD that reflects the clinical picture and impairment in this case as well as the PEB’s peripheral nerve code, and no route to a rating higher than the PEB’s 10%.  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 right testicular condition.

BOARD FINDINGS:  In the matter of the right testicular 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 20150606, w/atchs
Exhibit B.  Service 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 USN
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USN

	
						  XXXXXXXXXXXXXXXXXX

	     				  Acting