RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX 	CASE:  PD-2017-02896
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20081228

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Motor Transport Operator, medically separated for “neuralgia right ilioinguinal nerve” and “neuralgia left ilioinguinal nerve” rated 0% each with a combined disability rating of 0%.   

CI CONTENTION:  “The VA rated at 30% upon discharge and I have since lost that body part and Army wouldn’t include PTSD which VA rated at 50%.”  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 - 20050421	VARD - 20050823	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Neuralgia Right Ilioinguinal Nerve	8730	0%	Chronic Orchitis, Right Testis	7525	10%	20050823	
Neuralgia Left Ilioinguinal Nerve	8730	0%	Small Hydrocele and Epididymal Cyst, Left Testis	7522-7523	0%	20050823	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  70%	

ANALYSIS SUMMARY:  

Neuralgia Right Ilioinguinal Nerve and Neuralgia Left Ilioinguinal Nerve.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s right scrotal pain began in June 2007 after being treated for epididymitis.  He was referred to urology and placed on anti-inflammatory medications due to persistent scrotal swelling and pain.  The medication initially helped, but his symptoms recurred in June 2008 when he again reported swelling and pain in the right testicle.  Urology also diagnosed a left-sided scrotal hydrocele, which was also painful.    

The 21 October 2008 MEB NARSUM examination, 2 months prior to separation, noted continued complaints of bilateral testicular pain, right greater than left, which limited his ability to run, ruck, march, carry a fighting load, construct a fighting position or perform a 3-5 second rushes.  Physical examination (PE) revealed bilateral testicular tenderness without scrotal swelling or discoloration.  Tenderness on the left was in the area of the epididymis whereas the right-sided tenderness was within the testicle itself.  The right testicle was enlarged in comparison with the left testicle.

At the 9 February 2009 VA Compensation and Pension (C&P) examination, 2 months after separation, the CI reported right greater than left testicular pain.  The PE revealed a firm, enlarged and minimally tender right testicle.  No hydrocele was present on the right testicle and no significant lymph node swelling in the groin.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right and left scrotal pain 0% each side, coded 8730 (neuralgia of the ilioinguinal nerve), citing moderate impairment.  The VA rated the left-sided scrotal pain 0%, dual coded 7522-7523 (penis deformity-testis, atrophy complete), based on the C&P examination.  The VA rated the right-sided scrotal pain 10% coded 7525  (epididymo-orchitis), based on the C&P examination, citing requirement for long term drug therapy, one or two hospitalizations per year, or intermittent intensive management.  

Panel members first considered the various clinical findings in this case and agreed that the wavering diagnostic findings could easily be attributed to either a nerve (neuralgia) condition as listed by the PEB or an epididymo-orchitis condition as listed by the VA.  Either way, absent the need for long-term drug therapy, hospitalizations or intermittent intensive management, or less than severe to complete impairment involving the ilio-ingunal nerve, no greater than a 0% impairment for either testicle is supported.  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’s adjudication for right or left scrotal pain.  

BOARD FINDINGS:  In the matter of the right scrotal pain and IAW VASRD §4.124a, the panel recommends no change in the PEB adjudication.  In the matter of the left scrotal 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 20170427, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

AR20190008797, 

Dear XXXXXXXXXXXXX:

	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.