DEPARTMENT  OF THE NAVY
SECRETARY OF THE NAVY COUNCIL OF REVIEW BOARDS 720 KENNON STREET SE STE 309
WASHINGTON NAVY YARD DC 20374-5023

20

IN REPLY REFER TO

1850
CORB:003
X12 Feb

From: To:

Director, Secretary of the Navy Council of Review Boards 
PD-2017-01149

Subj:	PHYSICAL DISABILITY BOARD OF REVIEW (PDBR)

Ref:	(a) DoDI 6040.44
(b) PDBR ltr dtd 5 Feb 19

1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation (reference (b)) to the Department of the Navy of 15 October 2019 for appropriate action.

2.	On 31 January 2020, the Assistant Secretary of the Navy (Manpower & Reserve Affairs) accepted the recommendation of the PDBR of no change to your characterization of separation or disability rating assigned by the Department of the Navy's Physical Evaluation Board.

3.	The Secretary's decision on your PDBR application is final and is not subject to appeal or additional review by the Board for Correction of Naval Records.

RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:  XXXXXXXXXXXXXXXXXXXXXXX	CASE: PD-2017-01149
BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20080415

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

CI CONTENTION: The condition continues to worsen and negatively affects daily activities. 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 - 20080118	VARD - 20080610	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Left Testicular Pain	8730	10%	Status Post Varicocele Surgery with Resulting Scars	
8530	
10%	
20080514	
Azoospermia	Cat II					
Recurrent Left Varicocele	Cat III					
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 30%	

ANALYSIS SUMMARY:

Chronic Left Testicular Pain. According to the service treatment record and MEB narrative summary (NARSUM), the CI’s testicular pain began insidiously while in basic training and worsened with increased activity and running. After a definitive diagnosis of a left-sided testicular varicocele (varicose veins surrounding the testicle) was established, the CI underwent two separate surgical procedures in April 2006 and July 2007. Despite the repetitive surgery and physical restrictions, his scrotal and groin pain continued.

The 10 November 2007 MEB NARSUM examination, 5 months prior to separation, noted an inability to run or perform strenuous physical activities. The physical examination (PE) revealed no evidence of an inguinal hernia and the testicles appeared normal. A very subtle varicocele was present on the left side of the scrotum.

At the 14 May 2008 VA Compensation and Pension (C&P) examination, 1 month after separation, the CI reported recurrent groin pain radiating down the leg. The pain was worse with prolonged walking and standing.  His PE revealed tenderness about the left scrotum and testicle.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the testicular pain 10%, coded 8730 (neuralgia; ilio-inguinal nerve), citing chronic pain. Additionally, the Navy PEB’s Category II diagnosis of azoospermia and category III diagnosis of recurrent left varicocele were intrinsic to the rated primary condition and separate ratings cannot be supported without pyramiding (VASRD §4.14). Thus, these conditions were appropriately subsumed under the rating for testicular pain. The VA rated the testicular pain 10%, coded 8530 (paralysis of: ilio-inguinal nerve, [severe to complete]), based on the C&P examination, citing “constant pain and flare-ups in the left groin area due to left varicocele.”

After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel agreed that the movement or radiation of painful symptoms extending from the groin into and surrounding the testicle provided clear and convincing evidence that there existed a neuronal component to the painful condition. Therefore, such rating under a VASRD nerve code was most appropriate. The anatomic nerve traversing this body area was appropriately identified as the ilio-inguinal nerve and the highest rating under that code was 10%, corresponding to the PEB’s current rating. Therefore, panel members concluded there was insufficient cause to recommend a change in the PEB’s adjudication for the testicular pain.

BOARD FINDINGS: In the matter of the left testicular 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.