RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-02479
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 active duty E3, Basic Marine, medically separated for “chronic postoperative right inguinal pain” with a disability rating of 10%.

CI CONTENTION:  The CI requested a review of 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 - 20020425	VARD - 20030402	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Postoperative Right Inguinal Pain	8730	10%	PO Right Inguinal Hernia with Chronic Ilioinguinal Neuralgia	7338-8730	10%	20021217	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Chronic Postoperative Right Inguinal Pain.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s right inguinal pain condition began in January 2001 when he underwent emergency hernia repair surgery.  An Abbreviated Limited Duty Medical Report (LIMDU) date 15 May 2001, cited post-operative pain after surgical repair of right inguinal hernia.  

The 25 February 2002 MEB NARSUM examination, 4 months prior to separation, noted complaints of chronic worsening progressive inguinal groin pain that was exacerbated by strenuous physical activity.  The CI stated that the pain radiated from the incision site into his right testicle.  The CI had various treatment modalities and regimens including pharmacological with corticosteroids and local anesthetics, nerve blocks and an exercise program.  The pain did not resolve.  The CI was offered non-operative neuroablative therapy as well as surgical groin exploration.  The examiner noted that the long term consequences of either treatment were permanent anesthesia and possible loss of the testicle on the affected side.  The CI declined either treatment.  Physical examination showed diffuse tenderness around the operative scar in the right inguinal region.  There was no evidence of a recurrent hernia.  The rest of the genital examination was documented as normal.  

At the 17 December 2002 VA Compensation and Pension (C&P) evaluation, performed 6 months after separation, the CI reported persistent right inguinal hernia pain.  The CI described the pain as dull, aching in nature, rated as 1/10 in severity.  However, the CI stated that when he did have flare-ups the severity was increased to 7/10 and sharper in nature.  He stated that the flare-ups occurred 1 -2 times per month and lasted several hours up to a day.  The CI worked in a machine shop, lost 4 – 5 days of work in five months because of the pain.  Physical examination showed a 4.0 centimeter, obliquely oriented, linear, surgical scar that was slightly tender to palpation.  There was not a bulge or recurrence of the hernia with Valsalva maneuver or cough.  The remainder of the genital examination was noted as normal.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right inguinal pain condition 10%, coded 8730 (ilio-inguinal nerve) citing postoperative right inguinal pain.  The VA also rated the right inguinal pain condition 10% dual coded 7338-8730 (inguinal hernia and ilio-inguinal nerve neuralgia), based on the VA C&P examination 6 months after separation, citing severe paralysis of the ilioinguinal nerve.  The PEB’s 10% rating was consistent with the VASRD rating for ilio-inguinal nerve neuralgia coded 8730 with an additional diagnostic code, 7338, inguinal hernia.  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 inguinal pain condition.  

BOARD FINDINGS:  In the matter of the right inguinal pain condition and IAW VASRD §4.124a, 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 modification or re-characterization of the CI’s disability and separation determination.

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20151015, 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 USN
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USN

		
		XXXXXXXXXXXXXXXXXX