RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX 	CASE:  PD-2017-02898
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20040728

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was a Reserve E5, Military Police Officer, medically separated for “chronic left testicular pain” with a disability rating of 0%.  

CI CONTENTION:  There were several other service-related conditions related to the CI’s Medical Evaluation Board (MEB), but not added to his unfitting disabilities.  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 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 - 20040514	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Left Testicular Pain	8799-8730	0%	No VA Examination Proximate to Separation in Evidence	
Right Sided Hearing Loss	Not Unfitting		
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Chronic Left Testicular Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s left testicular pain began in 1994 after endoscopic surgery done for a varicocele while the CI was on active duty.  The testicular pain was believed to be secondary to scar tissue that formed in the scrotum.  The pain felt like someone was squeezing the testicle and infrequently he would have a severe episode.  In September 2003 the pain became constant and incapacitating paroxysms of pain became more frequent and severe.  Ultrasound showed benign cysts but not enough to explain the pain.  He was treated with Neurontin for “nerve pain.”  Pain Management switched his medication to a lidocaine patch which helped him during the day and to Topamax, which was better for pain control.  

The 30 March 2004 MEB NARSUM examination, 4 months prior to separation, noted two marked exacerbations of pain per week that lasted for approximately 1 hour.  Severe episodes of pain that caused him to double over and be nonfunctional were rare.  He was under consideration for surgery.  Physical examination showed wear of a lidocaine patch in the left inguinal area.  The left testicle was markedly tender to light touch but without warmth and swelling.  Pain was rated as slight and constant, but was intermittently severe.  He was unable to run, jump, crawl or do sit-ups and could only stand for 20 minutes at a time.  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 left testicular pain 0%, analogously coded 8730 (neuralgia), citing moderate disability.  The NARSUM noted about two exacerbations per week, but severe episodes were rare.  The panel agreed the condition was moderate and did not meet the severe level to warrant a 10% rating.  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 testicular pain.  

Contended PEB Condition:  Right Sided Hearing Loss.  The panel’s main charge is to assess the fairness of the PEB determination that the contended right sided hearing loss condition was not unfitting.  Although it was profiled (H2) and implicated in the commander’s statement, it did not fail retention standards.  Speech discrimination was 100% and hearing loss caused no appreciable dysfunction.  The NARSUM addendum noted the CI denied any appreciable hearing loss and no change in ability to perceive sound or understand words.  There was no performance-based evidence from the record that the condition significantly interfered with satisfactory duty performance at separation.  After due deliberation, the panel concluded there was insufficient cause to recommend a change in the PEB fitness determination for the contended condition, so no additional disability rating is recommended.  

BOARD FINDINGS:  In the matter of the left testicular pain and IAW VASRD §4.124, the panel recommends no change in the PEB adjudication.  In the matter of the contended right sided hearing loss, the panel recommends no change from the PEB determination as not unfitting.  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 20170323, w/atchs  
Exhibit B.  Service Treatment Record  

 AR20190008795, XXXXXXXXXXXXXXXXXX

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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.