RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXXXXX		CASE: PD-2017-02933 BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20090830

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Basic Infantryman, medically separated for “chronic left groin pain status post [s/p] left inguinal herniorrhaphy with mesh and residual disfiguring and tender scar with ilioinguinodynia” with a disability rating of 10%.

CI CONTENTION: Review all conditions.  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 - 20090708	VARD - 20090909	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Left Groin Pain…	7338-7804	10%	S/P Left Inguinal Herniorrhaphy, Residual Disfiguring and Tender Scar, with Ilioinguinodynia	7338-7804	10%	20090225	
S/P Bilateral Tibial Stress Fractures, Resolved	Cat III	S/P Bilateral Tibial Stress Fractures	5299-5262	NSC	20090225	
Facial Acne, Disfiguring	Cat III	Acne	7828-7800	10%	20090225	
Acne…Back, Disfiguring	Cat III					
Thoracolumbar Strain with Thoracic Dextroscoliosis, and Transitional S1	Cat III	Thoracolumbar Strain with Thoracic Dextroscoliosis, and Transitional S1	5237	20%	20090225	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 40%	

ANALYSIS SUMMARY:

Left Groin Pain. According to the service treatment record and MEB narrative summary (NARSUM), the CI’s groin condition was first diagnosed in boot camp in early 2008 after fitness training, and on 27 June 2008, he underwent a surgical left inguinal hernia repair with mesh, and cord lipoma excision. During the convalescent period, he reported to the emergency room complaining of persistent postoperative pain with radiation to the left testicle and anterior thigh. An initial ilioinguinal nerve block provided some thigh pain relief, and the CI was referred to the pain management clinic. However, medication and additional nerve blocks did not provide significant relief. He was placed on limited duty for chronic groin pain and offered new surgery.

The 7 January MEB NARSUM examination, 8 months prior to separation, noted CI complaints of left groin pain with radiation to the left leg and testicle since undergoing surgery in June 2008. He elected to not undergo any further medical therapy and reported pain radiating into the base of the penis and to the left anterior thigh. Physical examination showed a well-healed inguinal incision with tenderness localized to the medial aspect. During the 11 February 2009 MEB examination (recorded on DD Forms 2807-1 and 2808), the CI reported left leg numbness and tingling following hernia repair.

At the 25 February 2009 VA Compensation and Pension (C&P) examination, 6 months before separation, the CI reported chronic left inguinal area pain, and that he had to go to the bathroom about every 30 minutes. He could achieve an erection, but sexual intercourse was somewhat painful. He was not taking medication and denied any periods of incapacitation, had some difficulty with instrumental activities of daily living. Physical examination showed a 5-cm, disfiguring, elevated, hyperpigmented and tender scar. There was hypersensitivity at the distal portion with extension to and tenderness of the left inguinal area. Functional limitations included avoidance of heavy lifting, extensive running and crawling activities.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the groin condition 10%, dual coded 7338-7804 (hernia, inguinal-scar(s), unstable or painful). The VA also rated the groin condition 10%, dual coded 7338-7804, based on the C&P examination, citing a painful superficial scar on examination. Panel members agreed that there was no evidence of 3-4 unstable or painful scars to achieve a higher 20% rating under code 7804 code, nor was there evidence of a “small, postoperative recurrent, or unoperated irremediable, not well supported by truss or not readily reducible” hernia to achieve a higher rating under code 7338. 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 groin condition.

Contended PEB Conditions: Bilateral Tibial Stress Fractures, Resolved; Facial Acne, Disfiguring; Acne of the Back, Disfiguring; and Thoracolumbar Strain with Thoracic Dextroscoliosis, and Transitional S1. The panel’s main charge is to assess the fairness of the PEB determination that the contended conditions were not unfitting. None of the conditions were noted on limited duty forms or implicated in the commander’s non-medical assessment, and did not fail retention standards. There was no performance-based evidence from the record that any of the conditions 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 any of the contended conditions, so no additional disability ratings are recommended.

BOARD FINDINGS: In the matter of the groin condition and IAW VASRD §4.114 and 4.118, the panel recommends no change in the PEB adjudication.  In the matter of the contended bilateral

shin splints, facial and back acne, and thoracolumbar strain conditions, the panel recommends no change from the PEB determinations 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 20170327, w/atchs Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

 	 	

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 <ltd 1 May 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.