RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:  XXXXXXXXXXXXXXXXXX	CASE: PD-2017-05878
BRANCH OF SERVICE: ARMY	SEPARATION DATE: 20061006

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Infantryman, medically separated for “chronic right groin and anterior thigh pain” with a disability rating of 0%.

CI CONTENTION: Review of all conditions requested. 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 - 20060804	VARD - 20070305	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Groin and
Anterior Thigh Pain	8729	0%	Right Femoral Nerve Neuropathy
Secondary to Lymph Node Removal	8526	20%	20061115	
COMBINED RATING: 0%	COMBINED RATING OF ALL VA CONDITIONS: 30%	

ANALYSIS SUMMARY:

Chronic Right Groin and Anterior Thigh Pain. According to the service treatment record and MEB narrative summary (NARSUM), the CI’s right groin condition began in November 2005 after a right inguinal lymph node biopsy was performed. Immediately after surgery the CI reported numbness of the inner right thigh and tingling on the medial aspect of the foot and electric “shock-like” pain from the right inguinal area to the right foot that was unrelated to activity. The procedure was complicated by hematoma formation that had to be drained multiple times. Pelvic MRI in April 2006 showed multiple enhancing lymph nodes and was otherwise normal.

During the 4 May 2006 MEB examination (recorded on DD Forms 2807-1 and 2808), 5 months prior to separation, the CI reported numbness and tingling of the right thigh and foot and decreased mobility of the right hip and foot. Physical examination showed decreased hip flexion and extension and decreased motion of the right foot. There was decreased strength of the right lower extremity (RLE) including the ankle and foot. The CI was unable to heel/toe walk on the right. There was decreased sensation of the right foot. Physical medicine and rehabilitation (PM&R) was consulted for electrodiagnostic studies. Physical therapy measured hip range of motion (ROM) in degrees for the MEB on 6 days later and after repetition hip flexion was 40, extension was 10, abduction was 35, and external rotation was 25, all with pain..

The 24 May 2006 MEB NARSUM examination, 4 months prior to separation, noted complaint of persistent groin pain with RLE pain. The decreased sensation since surgery was noted to have somewhat improved. Physical examination by the general surgery clinic performed on 17 May 2006 was cited. There was tenderness of the right groin without radiating pain and decreased sensation in the RLE.

At the 15 November 2006 VA Compensation and Pension (C&P) examination, one month after separation, the CI reported right groin pain aggravated by activity with shooting pain to the medial right foot. Physical examination showed a “moderate limping gait.” There was no muscle atrophy of the RLE but there was decreased sensation of the medial right thigh to the knee, and normal sensation in the groin and right foot.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the right groin pain condition 0%, coded 8729 (neuralgia of the external cutaneous nerve of thigh [lateral femoral cutaneous nerve]), citing neuropathy of the femoral cutaneous nerve. The VA rated the right groin pain condition 20%, coded 8526 (paralysis of the femoral nerve), based on the C&P examination, citing moderate incomplete paralysis. There was evidence of femoral nerve neuropathy on electrodiagnostic studies supported by clinical findings of RLE pain, weakness, and decreased sensation. The VA examination, the most proximate examination to separation and the furthest from the nerve injury, showed some improvement in groin pain, RLE strength and a more localized area of decreased sensation. The panel agreed this was most appropriately rated 20% and coded 8526 for moderate incomplete paralysis of the femoral nerve. The panel considered other VASRD nerve and analogous codes, but all were less applicable and/or not advantageous for rating. After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 20% for the right groin condition, coded 8526.

BOARD FINDINGS: In the matter of the right groin condition, the panel recommends a disability rating of 20% coded 8526 IAW VASRD §4.124a. There are no other conditions within the panel’s scope of review for consideration.

The panel recommends the CI’s prior determination be modified as follows, effective the date of medical separation:

CONDITION	VASRD CODE	PERMANENT RATING	
Chronic Right Groin and Anterior Thigh Pain	8526	20%	

2	PD-2017-05878

DEPARTMENT OF THE ARMY
ARMY REVIEW BOARDS AGENCY 251 18TH STREET SOUTH, SUITE 385
ARLINGTON, VA 22202-3531

AR20200004306, 

Dear XXXXXXXXXXXXXXX:

The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found that your disability rating should be modified but not to the degree that would justify changing your separation for disability with severance pay to a permanent retirement with disability. I have reviewed the Board’s recommendation and record of proceedings (copy enclosed) and I accept its recommendation. This will not result in any change to your separation document or the amount of severance pay. A copy of this decision will be filed with your Physical Evaluation Board records. I regret that the facts of the case did not provide you with the outcome you may have desired.

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.

A copy of this decision has also been provided to the Department of Veterans Affairs.

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