RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-00709
BRANCH OF SERVICE:  army 	SEPARATION DATE:  20050503

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Attack Helicopter Repairer, medically separated for “chronic inguinal pain” with a disability rating of 0%.  

CI CONTENTION:  The condition continues to worsen.  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 - 20050415	VARD - 20050914	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Inguinal Pain	8799-8730	0%	Residuals of Right Inguinal Hernia Repair	7338-8530	0%	20050831	
	COMBINED RATING OF ALL VA CONDITIONS:  10% 	

ANALYSIS SUMMARY:  

Chronic Inguinal Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent right inguinal hernia repair on 5 February 2003.  During the 3 March 2005 MEB examination (recorded on DD Forms 2807-1 and 2808), 2 months prior to separation, the CI reported that heavy lifting caused his groin to swell, which made urination painful.  Evaluation of the CI’s abdomen and viscera (to include hernia) was normal.  At the 28 March 2005 MEB NARSUM examination, 1 month prior to separation, the CI reported he was pain free as long as he complied with the restrictions of his profile, but noted sharp, 4-5/10 inguinal pain over the incision site with heavy lifting that occasionally radiated to the “other side.”  Repetitive lifting of as little as 20 pounds caused pain with swelling/bulging.  Running also caused pain and he was unable to wear his combat gear.  Physical examination showed a left lower quadrant scar with no erythema or ecchymosis, but there was a mild bulge with Valsalva maneuver (moderate forceful attempt to exhalation against a closed airway).  

At the 31 August 2005 VA Compensation and Pension (C&P) evaluation, 4 months after separation, the CI reported being pain free since his military separation.  Physical examination was normal.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the inguinal pain 0%, coded 8799-8730 (analogous to neuralgia of the ilio-inguinal nerve), citing successful treatment with Neurontin, rated as mild.  The VA also rated the inguinal pain 0%, coded 7338-8530, (inguinal hernia causing paralysis of the ilio-inguinal nerve), based on the C&P examination, citing groin pain, particularly with lifting.  There was no evidence of a recurrent hernia bulge palpated and only intermittent inguinal pain when engaging in heavy or repetitive lifting.  The panel evaluated the rating and also compared it to the rating for inguinal hernia, but was unable to find justification for a rating greater than 0%.  After due deliberation, considering all of 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 inguinal pain.  

BOARD FINDINGS:  In the matter of the inguinal pain 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 20170221, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record 

AR20180004752, 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