RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXXXXX CASE: PD1200680 

BRANCH OF SERVICE: ARMY BOARD DATE: 20130403 

SEPARATION DATE: 20030819 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty SGT/E-5 (19D/Calvary Scout) medically separated for 
chronic bilateral groin pain. The CI had recurrent episodes of bilateral inguinal adenopathy. He 
underwent an extensive workup and multiple studies ruled out infectious or inflammatory 
etiology. The groin pain could not be adequately rehabilitated to meet the physical 
requirements of his Military Occupational Specialty (MOS). He was issued a permanent P3 
profile and referred for a Medical Evaluation Board (MEB). The groin condition, characterized 
as “idiopathic inguinal lymphadenopathy,” was forwarded to the Physical Evaluation Board 
(PEB) IAW AR 40-501. No other conditions were submitted by the MEB. The PEB adjudicated 
the chronic bilateral groin pain as unfitting, rated 0% citing criteria of the US Army Physical 
Disability Agency (USAPDA) pain policy. The CI made no appeals, and was medically separated 
a 0% disability rating. 

 

 

CI CONTENTION: “feeling like people are shooting at me feelings the bullets but seeing no 
blood. Please help me! Problems has gotten a lot worse unable to work PTSD” [sic] 

 

 

SCOPE OF REVIEW: The Board’s scope of review is defined in DoDI 6040.44, Enclosure 3, 
paragraph 5.e. (2). It is limited to those conditions determined by the PEB to be unfitting for 
continued military service and those conditions identified but not determined to be unfitting by 
the PEB when specifically requested by the CI. The rating for the unfitting bilateral groin 
condition is addressed below; and, no additional conditions are within the DoDI 6040.44 
defined purview of the Board. The contended posttraumatic stress disorder (PTSD) condition 
was not identified by the MEB or PEB and thus is not within the DoDI 6040.44 defined purview 
of the Board. Any conditions or contention not requested in this application, or otherwise 
outside the Board’s defined scope of review, remain eligible for future consideration by the 
respective Army Board for Correction of Military Records. 

 

 

RATING COMPARISON: 

 

Service PEB – Dated 20030617 

VA - (5 Mos. Post-Separation) 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Bilateral Groin Pain 

5099-5003 

0% 

Idiopathic Inguinal 
Lymphadenopathy 

7799-7710 

0% 

20040113 

No Additional MEB/PEB Entries 

Other x 11 

20040113 

20040106 

Combined: 0% 

Combined: 40% 



 

 

ANALYSIS SUMMARY: The Board acknowledges the CI's contention suggesting that ratings 
should have been conferred for other conditions documented at the time of separation and for 
conditions not diagnosed while in the service (but later determined to be service-connected by 
the VA). While the Disability Evaluation System considers all of the member's medical 
conditions, compensation can only be offered for those medical conditions that cut short a 


member’s career, and then only to the degree of severity present at the time of final 
disposition. The Department of Veterans Affairs, however, is empowered to compensate all 
service-connected conditions and to periodically re-evaluate said conditions for the purpose of 
adjusting the veteran’s disability rating should the degree of impairment vary over time. 

 

Bilateral Groin Pain. The CI sought care for a 4 to 5 year history of recurrent bilateral inguinal 
pain associated with adenopathy that worsened with any strenuous activity. He underwent an 
exhaustive evaluation from 1997-2000 by multiple specialists to include infectious disease, 
allergy immunology, internal medicine, pain management, general surgery, and 
gastroenterology. These evaluations included physical exams, special laboratory and 
radiographic studies and even biopsies of the right axilla and right inguinal lymph nodes. The 
biopsies revealed nonspecific changes and lymphoma was not identified. The remainder of the 
studies did not identify a clear cause for his symptoms, to include an infectious, inflammatory, 
gastrointestinal, or vaccine etiology. In April 2000 he was issued a permanent profile for 
adenopathy and fevers of unknown origin with the following limitations, run at own pace and 
distance, march up to two miles, and no jumping activities. He could do unlimited walking, 
biking, and swimming, push-ups and sit-ups and any of the alternate events for the Army 
Physical Fitness Tests (APFT). The profile further recommended a MOS/Medical Review Board 
(MMRB). The service treatment record documented that CI returned back to his unit in 
Germany from his evaluations at WRAMC in April 2000 and that his unit would be 
recommending an MMRB. The CI however left the service in May 2001 and reenlisted in 
November 2001. The July 2001 reenlistment physical exam form did not document any 
adenopathy. In July 2002 he began experiencing the same symptoms. This led to more 
evaluations for which no cause was identified. Another permanent profile was written in 
March 2003 which was the same as before but additionally added able to lift up to 25 pounds 
and recommended an MMRB. The commander’s statement corroborated the medical 
condition, limitations and further documented, while he was non deployable he could do 
routine garrison duties and was a quality NCO. There were two APFTs in evidence, one in 2000 
and one in May 2002, both of which reflected the maximum passing score of 300 in spite of his 
ongoing symptomatology. The MMRB convened March 2003 and recommended a MEB. 

 

The MEB physical exam focused on the genitourinary and inguinal regions. The exam 
demonstrated no hernias or swollen lymph nodes, bilateral tenderness at the inguinal ring and 
otherwise normal genitourinary male findings. At the VA Compensation and Pension (C&P) 
exam performed 5 months after separation, the CI additionally reported 3 months after 
receiving the anthrax vaccine and after his return from the war in the Balkan Mountains he 
developed intermittent fevers, night sweats, frontal headaches, pain in the joints (knees, wrists, 
back and shoulders), muscular pain, atypical chest pain, abdominal pain, nausea and diarrhea 
with weight loss of 10 pounds. He was evaluated and found to have multiple painful lymph 
nodes and otherwise his extensive workup did not reveal an etiology for his symptoms. The 
C&P exam demonstrated the inguinal regions revealed "shotty" palpable inguinal lymph nodes 
and proximal femoral lymph nodes. The most painful on the right and left measured 
approximately 0.5 cm diameter with pain radiating into the right and left testicle respectively. 
The examiner documented the CI had an undiagnosed illness which had resulted in the 
symptoms referenced and opined as likely as not secondary to anthrax injections. In support of 
this opinion he referenced “the dictation by Dr. xxxxx citing an article in the Journal of the 
American Medical Association of December 8th, 1999, describing post anthrax immunization 
syndrome.” 

 

The Board directs attention to its rating recommendation based on the above evidence. The 
PEB and VA chose different coding options for the condition, but this did not bear on rating. 
The PEB’s DA Form 199 reflected application of the USAPDA pain policy for rating, and its 
coding choice, 5003 (arthritis, degenerative) was inconsistent with the pain pathology in this 
case. The Board discussed likely his bilateral groin pain was due to systemic lymph node 


adenitis, inflammation of the lymph node without a clear etiology. The VA assigned a 0% rating 
coded analogous to 7710 (Adenitis, non-pulmonary tuberculous) which is IAW VASRD §4.88c 
which states “rate residuals under the specific body system or systems affected. The Board 
considered the VA’s chosen code and agreed this diagnostic code is the most clinically 
appropriate code as the disability is not specifically listed in the rating schedule, but the 
anatomical localization and symptoms, are closely related.” There is no evidence of 
documentation of incapacitating episodes or ratable peripheral nerve impairment which would 
provide for additional or higher rating. The Board prefers the 7799-7710 coding route as this 
clinically captures the bilateral groin adenitis pathology even though rating is unaffected. After 
due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), 
the Board concluded that there was insufficient cause to recommend a change in the PEB rating 
adjudication for the bilateral groin condition. 

 

 

BOARD FINDINGS: IAW DoDI 6040.44, provisions of DoD or Military Department regulations or 
guidelines relied upon by the PEB will not be considered by the Board to the extent they were 
inconsistent with the VASRD in effect at the time of the adjudication. The Board did not 
surmise from the record or PEB ruling in this case that any prerogatives outside the VASRD 
were exercised. As discussed above, PEB reliance on the USAPDA pain policy for rating the 
bilateral groin pain was operant in this case and the condition was adjudicated independently 
of that policy by the Board. In the matter of bilateral groin pain condition and IAW VASRD 
§4.88c, the Board unanimously recommends no change in the PEB rating of 0% but a change in 
VASRD code to 7799-7710. There were no other conditions within the Board’s scope of review 
for consideration. 

 

 

RECOMMENDATION: The Board recommends that the CI’s prior VASRD code be modified as 
follows, effective as of the date of his prior medical separation: 

 

UNFITTING CONDITION 

VASRD CODE 

RATING 

Bilateral Groin Pain 

7799-7710 

0% 

RATING 

0% 



 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120605, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 xxxxxxxxxxxxxxxxxxxxxxx, DAF 

 Director of Operations 

 Physical Disability Board of Review 

 


SFMR-RB 


 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency 

(TAPD-ZB / xxxxxxxxxxxxxx), 2900 Crystal Drive, Suite 300, Arlington, VA 22202-3557 

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation for 
xxxxxxxxxxxxxxxxxxxxxxx, AR20130009622 (PD201200680) 

 

 

I have reviewed the enclosed Department of Defense Physical Disability Board of Review (DoD 
PDBR) recommendation and record of proceedings pertaining to the subject individual. Under 
the authority of Title 10, United States Code, section 1554a, I accept the Board’s 
recommendation and hereby deny the individual’s application. 

This decision is final. The individual concerned, counsel (if any), and any Members of Congress 
who have shown interest in this application have been notified of this decision by mail. 

 

 BY ORDER OF THE SECRETARY OF THE ARMY: 

 

 

 

 

Encl xxxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)