RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME: XXXXXXXXXXXXXXXXXX	CASE: PD-2015-02270
BRANCH OF SERVICE: ARMY	SEPARATION DATE: 20041208

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E6, Apache Helicopter Crew Chief, medically separated for “chronic testicular pain” with a disability rating of 0%.

CI CONTENTION: The CI’s contends his conditions continues to worsen and negatively affect his daily activities.  The CI’s 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 - 20040903		VARD - 20050121	
Condition	Code	Rating		Condition	Code	Rating	Exam	
Chronic Testicular Pain	5099-5003	0%		Chronic Left Orchialgia…	7525	0%	20040924	
COMBINED RATING: 0%		COMBINED RATING OF ALL VA CONDITIONS: 0%	

ANALYSIS SUMMARY:

Chronic Testicular Pain. According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s testicular pain on 4 December 2002 after lifting a 40-60 pound bag. The CI underwent surgery the same day for testicular torsion. Following surgery, he had an uneventful recovery other than persistent pain refractory to medications. A testicular ultrasound on 30 October 2003 and again on 4 March 2004 was normal other than a small cyst of the epididymis on the second study. The CI was referred for MEB due to persistent pain.

During the 4 May 2004 MEB examination (recorded on DD Forms 2807-1 and 2808), 6 months prior to separation, the CI reported ongoing tenderness.  On examination, the left testis was

tender. The scar was well healed and the examination otherwise unremarkable. The MEB NARSUM examination was dated 12 July 2004, 5 months prior to separation. The CI reported that his pain had improved since surgery, but chronic pain persisted. A well healed scar and tenderness to light palpation, left > right, was noted. The examination was unremarkable otherwise.

At the 24 September 2004 VA Compensation and Pension (C&P) evaluation, performed 2 months before separation, the CI reported chronic left testicular pain. He denied voiding or sexual complications. On examination, the testes were descended normally and the epididymis normal (implying normal size and non-tender). The examiner noted that there was no current pathology. After separation, a third ultrasound showed decreased vascular flow to the left lower pole compared to the superior pole. It was noted that this “may represent sequlae [sic] of the prior torsion.” At a urology evaluation on 25 August 2005, 9 months after separation, he reported left testicular pain off and on. Slight tenderness of the left epididymis was present. He was asymptomatic at the time of the examination.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the testicular pain 0%, analogously coded 5003 (degenerative arthritis), citing the US Army Physical Disability Agency (USAPDA) pain policy. It also noted that the CI had not refilled his prescriptions for a year. The VA also rated the testicular pain 0% coded 7525 (Epididymo- orchitis, chronic only), based on the C&P examination 2 months before separation, noting an absence of pathology. The VA examination was supported by the urology evaluation 9 months after separation. The panel noted that there was no specific code for testicular torsion and sequelae. The code used by the VA, 7525, better described the condition, but provided no rating advantage to the CI. 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 testicular pain.

BOARD FINDINGS: In the matter of the chronic testicular pain and IAW VASRD §4.115b, 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 re-characterization of the CI’s disability and separation determination.

The following documentary evidence was considered:

Exhibit A. DD Form 294, dated 20150825, with attachments Exhibit B. Service Treatment Record
Exhibit C. Department of Veterans Affairs Treatment Record

AR20170012166, 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,