RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXXXXXXX		CASE: PD-2017-02677 BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20050715

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Infantryman, medically separated for “left testalgia” with a disability rating of 10%.

CI CONTENTION: The CI contended for a higher rating his unfitting condition. 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 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 - 20050404	VARD - 20051019	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Testalgia	7599-7525	10%	Left Varicocele with Left Testalgia	7599-7120	NSC	STR	
Persistent Left Varicocele	Cat II					
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:

Left Testalgia. According to the service treatment record and MEB narrative summary (NARSUM), the CI’s testalgia began in August 2004 with complaints of 1 to 2 months of left testicular pain without trauma. The CI was diagnosed with a varicocele (enlarged veins in the scrotum) and underwent a left inguinal spermatic vein ligation on 22 September 2004. Following surgery his pain was unchanged and physical examination showed a persistent varicocele. An embolization procedure was recommended, but the CI elected not to proceed due to the risks, which the surgeon considered reasonable.

At a urology examination on 25 October 2004, 9 months prior to separation, the CI reported increased pain and sensitivity in the left testicle. Physical examination showed a persistent scrotal varicocele that reduced when supine. There were no masses. The spermatic cord was supple and the surgical incision was healing well. The 24 February 2005 MEB NARSUM examination, 5 months prior to separation, noted complaints of persistent left testicular pain.

No additional physical examination was performed. There was no VA examination proximate to separation in evidence.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the testalgia condition 10%, analogously coded 7599-7525 (chronic epididymo- orchitis). The PEB listed left varicocele as a related Category II diagnosis contributing to the disability in this case. The panel concluded the Category II diagnosis was not a separate condition which could be reasonably justified as separately unfitting; nor would separate ratings be achievable without violation of VASRD §4.14 (avoidance of pyramiding). The VA did not service connect the condition because the CI failed to report to a scheduled VA Compensation and Pension examination.

There is no VASRD code specifically for scrotal varices and the panel considered rating the CI’s condition analogous to varicose veins (7199-7120). Although the varicose veins in this case were in the scrotum and not the lower extremity, the panel agreed the 10% rating criteria of intermittent aching with being upright or walking and symptoms reduced in the supine position were closely analogous to the CI’s symptoms. The panel considered other VASRD analogous codes, but all were less applicable or not advantageous for rating. Although the panel’s rating recommendation is based on a different code than that of the PEB, there is no ratings benefit, and therefore no change to the PEB’s coding choice is recommended. 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 testalgia condition.

BOARD FINDINGS: In the matter of the testalgia condition and IAW VASRD §4.115b, 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 20170320, w/atchs Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

2	PD-2017-02677

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

IN   REPLY   REFER TO:
1850
CORB: 003 20May20

From: Director, Secretary of the Navy Council of Review Boards 

Subj:  PHYSICAL DISABILITY BOARD OF REVIEW  (PDBR)

Ref:	(a) DoDI 6040.44
(b) PDBR ltr dtd 28 Oct 19

1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation (reference (b)) to the Department of the Navy on 5 Mar 2020 for appropriate  action.

2.	On 20 March 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.