RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-02285
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20050428

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Human Resources Specialist, medically separated for “bilateral orchialgia” with a disability rating of 0%.

CI CONTENTION: Submitted an extensive contention to include multiple other 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 -20050315	VARD - 20060503	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Bilateral Orchialgia	8799-8730	0%	Residuals, Orchioplexy for Bilateral Orchialgia with Numbness and Hematuria	7599-7523	0%	STR	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:

Bilateral Orchialgia.  According to service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s bilateral orchialgia condition began spontaneously in August 2004.  The MEB NARSUM examination on 18 January 2005 (3 months prior to separation) noted complaints of daily intermittent bilateral testicular pain that is occasionally severe.  He complained of pain “80% of his day” and was awakened nightly after 3 hours due to pain.  Physical examination showed bilateral testicular tenderness and an otherwise normal evaluation.  The CI had at least two computerized tomography scans of the abdomen and pelvis and at least three ultrasounds of the scrotum without an identifiable cause of the scrotal pain.  There was no VA Compensation and Pension evaluation performed.
The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the bilateral orchialgia condition 0%, analogously coded 8799-8730 (neuralgia of the ilio-inguinal nerve).  The VA also rated the bilateral residuals of orchiopexy condition 0%, analogously coded 7599-7523 (testis, atrophy complete) based on the CI’s STR.  The Board agreed the CI’s bilateral testicular pain condition began with an initial episode of severe left sided testicular pain in August of 2004 that resolved after approximately 3 hours after receiving morphine.  He had a complete evaluation including ultrasound with Doppler flow which was normal.  He underwent bilateral orchiopexy (sewing the testicle down to the floor of the scrotum so that testicular torsion cannot occur); however, his pain became worse and bilateral.  The CI did not have either testicle removed (code 7524) nor was there evidence of testicular atrophy (code 7523).  There was evidence of neuralgia of the ilio-inguinal nerve, mild or moderate, supporting a 0% rating (code 8730), but this affords no rating benefit to the CI.  There was no evidence of complete paralysis of the ilio-inguinal nerve (code 8530) to support a higher 10% rating.  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 bilateral orchialgia condition.

BOARD FINDINGS:  In the matter of the bilateral orchialgia 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 20150824, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170004226, XXXXXXXXXXXXXXXXXX 

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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