RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2016-01191
BRANCH OF SERVICE:  Marine Corps	SEPARATION DATE:  20040515

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Organizational Automotive Mechanic, medically separated for “chronic inguinal pain syndrome status post orchiectomy” with a disability rating of 10%.  

CI CONTENTION:  No specific contention made.  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 Medical Evaluation Board (MEB), but determined by the PEB 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.  The panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections when appropriate.  The panel’s assessment of the PEB rating determination is based on review of medical records and all available evidence relevant to application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards for 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, which operates 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 disability at the time of separation.  

RATING COMPARISON:  

SERVICE PEB - 20040324	VARD - 20040915	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Inguinal Pain Syndrome Status Post Orchiectomy	8530	10%	Status Post Left Epididymectomy and Orchiectomy with Residual Ilioinguinodynia and Erectile Dysfunction 	7599-7524	10%	20040415	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Chronic Inguinal Pain Syndrome.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s left inguinal pain syndrome condition began approximately 9 months after an uncomplicated vasectomy (August 2000).  He underwent a left epididyectomy in September 2001, and subsequent left orchiectomy in June 2002.  After initial resolution, left inguinal neuropathic pain returned and was not relieved by medication.  

The 25 September 2003 MEB NARSUM examination, 8 months prior to separation, noted complaints of chronic inguinal pain.  Physical examination showed tenderness along both the left and right epididymis, with a granuloma at the left vasectomy site.  During the 4 February 2004 MEB examination (recorded on DD Forms 2807-1 and 2808), 3 months prior to separation, the CI reported left inguinal pain.  Physical examination revealed a missing left testicle with a small scrotal scar.  There was pain in the left inguinal area.  

At the 15 April 2004 VA Compensation and Pension (C&P) examination, 1 month before separation, the CI reported a history of left epididymitis, orchiectomy, and left inguinal pain and erectile dysfunction.  Physical examination showed absence of the left testicle with mild to moderate tenderness in the left inguinal area.  There was no evidence of hernia and the scrotal scar was well healed and not tender.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left inguinal pain syndrome condition 10%, coded 8530 (paralysis of Ilio-inguinal nerve).  The VA also rated the left inguinal pain syndrome condition 10%, analogously coded 7599-7524 (testis, removal), based on the C&P examination, citing residual tenderness in the left inguinal post epididymectomy and orchiectomy along with erectile dysfunction.  

The 10% rating adjudicated by the PEB is the highest VASRD rating available under code 8530.  Alternative rating analogous to 7524 or 7525 (epididymo-orchitis, chronic only) would offer no benefit as only one testis was removed, and there was no evidence of recurrent symptomatic infection requiring drainage/frequent 	hospitalization (greater than two times/year), and/or requiring continuous intensive management.  After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded there was insufficient cause to recommend a change in the PEB adjudication for the left inguinal pain syndrome condition.  

BOARD FINDINGS:  In the matter of the left inguinal pain syndrome condition and IAW VASRD §4.124a, the panel recommends no change in the PEB adjudication.  There are no other conditions within the panel’s scope of review for consideration.  Therefore, the panel recommends 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 20160921, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs 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 USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC