RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2016-00225
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20060922

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E5, Signal Support System Specialist, medically separated for “chronic right testicular pain,” with a disability rating of 0%.

CI CONTENTION:  The CI contends other conditions not adjudicated by the service.  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 - 20060523	VARD - 20070810	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Testicular Pain	5009-5003	0%	Chronic Right Testicular Pain…	7523-7529	0%	20070514	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  40%	

ANALYSIS SUMMARY:  

Chronic Right Testicular Pain.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s right testicular pain condition in 2004.  Initial treatment with antibiotics was unsuccessful and the CI began an extensive evaluation to identify the cause of the pain.  An ultrasound on 25 January 2005 was unremarkable other than a large epididymal cyst or spermatocele; it was not thought to be the source of his pain.  In 2006, both a CT scan of the abdomen and MRIs of the thoracic and lumbar spine also failed to identify an etiology.  A right cord nerve block did not provide relief.  The physical examination was unremarkable other than subjective tenderness to palpation.  A trial of a chronic pain management medication also failed to provide relief.  No etiology was determined and no further treatment options were available.  The CI was then referred for an MEB.  The MEB NARSUM examination was performed on 24 March 2006, 2 months prior to separation.  The CI reported no improvement with treatment, but noted that his pain diminished with both urination and ejaculation.  The examination was significant for right testicular pain greater than right epididymal pain.  During the MEB examination (recorded on DD Forms 2807 and 2808) dated 18 April 2006, 1 month prior to separation, the CI reported pain with standing and running.  On examination, he had tenderness, but other pathology was not documented.  Slight tenderness of the right testicle and epididymis was present on examination.  It was otherwise unremarkable.  

A VA urology C&P evaluation was performed on 14 May 2007, 8 months after separation.  The CI reported persistent pain.  The examination was unremarkable other than the spermatocele which was noted to not be causal of his symptoms.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right testicular pain condition 0%, coded 5009-5003 (analogous to degenerative arthritis) citing the US Army Physical Disability Agency pain policy.  The VA the chronic right testicular pain (due to spermatocele and prostate adenoma) at 0%, coded 7523-7529 (complete atrophy of one testis-benign neoplasms of the genitourinary system), based on the urology C&P examination 8 months after separation, noting that there was no evidence of a disabling condition at that time.  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 chronic right testicular pain condition.  

BOARD FINDINGS:  In the matter of the chronic testicular pain condition and IAW VASRD §4.71a and 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 modification or re-characterization of the CI’s disability and separation determination.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20160412, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170014139, 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,					      
						      					
Enclosure