RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW
SEPARATION DATE: 20011116
NAME: XXXXXXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY
CASE NUMBER: PD1200844
BOARD DATE: 20121204
SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this
covered individual (CI) was an active duty SPC/E‐4 (14T/Patriot Launch Crewmember), medically
separated for chronic right groin pain. The CI developed right groin pain at the site of a
previously repaired right inguinal hernia after a military motor vehicle accident. The chronic
right groin pain condition could not be adequately rehabilitated for the CI to meet the physical
requirements of his Military Occupational Specialty (MOS) or satisfy physical fitness standards.
He was issued a permanent L3 profile and referred for a Medical Evaluation Board (MEB). The
MEB forwarded no other conditions for Physical Evaluation Board (PEB) adjudication. The PEB
adjudicated the chronic right groin pain condition as unfitting, rated 0%, with application of the
Veteran’s Affairs Schedule for Rating Disabilities (VASRD). The CI made no appeals, and was
medically separated with a 0% disability rating.
CI CONTENTION: “Nerve damage to groin and right leg vericous (sic) veins. Reaccuring (sic)
inguinal hernias. Now herniated discs messed up shoulder and hip and neck.”
SCOPE OF REVIEW: The Board wishes to clarify that the scope of its review as defined in DoDI
6040.44, Enclosure 3, paragraph 5.e. (2) is limited to those conditions which were determined
by the PEB to be specifically unfitting for continued military service; or, when requested by the
CI, those condition(s) “identified but not determined to be unfitting by the PEB.” The ratings
for unfitting conditions will be reviewed in all cases. The contended hernia condition will be
discussed with the groin pain condition. 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 Army Board for Correction of Military Records.
RATING COMPARISON:
Service IPEB – Dated 20011010
Condition
Code
Chronic Right Groin Pain
8799‐8730
Rating
0%
Condition
Scar, Residuals of Right Inguinal
Hernia Repair
VA – All Effective Date 20011117
Code
7338‐7804
Rating
10%
Exam
STR, MEB,
STR, MEB,
PEB
PEB
↓No Addi(cid:415)onal MEB/PEB Entries↓
0% X 2
Combined: 0%
Combined: 10%
ANALYSIS SUMMARY: The Disability Evaluation System (DES) is responsible for maintaining a fit
and vital fighting force. While the DES 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 DES
has neither the role nor the authority to compensate members for anticipated future severity
or potential complications of conditions resulting in medical separation nor for conditions
determined to be service‐connected by the Department of Veterans Affairs (DVA) but not
determined to be unfitting by the PEB. However, the DVA, operating under a different set of
laws (Title 38, United States Code), 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 his degree of impairment vary over time. The Board’s role is
confined to the review of medical records and all evidence at hand to assess the fairness of PEB
rating determinations, compared to VASRD standards, based on severity at the time of
separation.
Chronic Right Groin Pain Condition. The CI underwent mesh repair of an incarcerated right
inguinal hernia (RIH) 23 November 1998, prior to his enlistment in the military. On enlistment
examination, 20 February 1999, this repair was intact and asymptomatic with a well healed
surgical scar. The CI developed pain at the surgical site after doing the ‘splits’ in a humvee
accident July 2000. On clinic visit 10 July 2000, the CI reported a 2 month history of right groin
pain. On examination, tenderness to palpation along the surgical incision site without mass or
recurrence was noted. The CI was subsequently treated with multiple injections of the incision
site, and oral medication with reduction of pain symptoms by 70%. On pain clinic evaluation
performed on 16 January 2001, pain was described as episodically persistent, but, further
improved. By 6 February 2001, pain was restricted to a small area in the mid surgical incision
and further reduced after local wound cryoablation. By report, a laparoscopy, performed on
20 April 2001, revealed no internal evidence of hernia recurrence or mesh migration. At the
MEB/narrative summary (NARSUM) evaluation performed on 23 August 2001, 3 months before
separation, the CI reported constant severe pain and pressure in the surgical incision
exacerbated by straining, and ambulation. The abdominal examination was negative except for
tenderness in the right inguinal area over a well‐healed scar. No VA Compensation and Pension
(C&P) evaluation was performed. The Board directs attention to its rating recommendation
based on the above evidence. The PEB rated the condition 0%, 8730, neuralgia, illio‐inguinal
nerve, the highest rating achievable under this code IAW §4.124. The VA, basing its decision on
the service treatment record (STR) and MEB evaluation, rated the condition 10%, 7804, single
painful scar. A higher rating, 20% requires three to four painful scars, a condition not
supported by the record in evidence. The Board noted the disparity between the findings of
improving, episodic pain with reduction of the site of pain to a small area in the central surgical
scar on multiple pain clinic visits and the report of the NARSUM of severe, constant pain with
activity. The Board noted that the CI, prior to separation, was assigned a garrison position (S‐
1/75B) for 7 months where his performance was reported as outstanding and invaluable with
no apparent inhibition of activity by severe pain. The Board unanimously agreed the groin
condition was mild. 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 adjudication for the groin pain 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. In the matter of the chronic right groin condition and IAW VASRD §4.124, the
Board unanimously recommends no change in the PEB adjudication. There were no other
conditions within the Board’s scope of review for consideration.
2 PD1200844
RECOMMENDATION: The Board, therefore, recommends that there be no recharacterization of
the CI’s disability and separation determination, as follows:
Chronic Right Groin Pain
UNFITTING CONDITION
VASRD CODE RATING
7388‐8730
COMBINED
0%
0%
The following documentary evidence was considered:
Exhibit A. DD Form 294, dated 20120606, w/atchs
Exhibit B. Service Treatment Record
Exhibit C. Department of Veterans’ Affairs Treatment Record
SFMR‐RB
XXXXXXXXXXXXX, DAF
President
Physical Disability Board of Review
MEMORANDUM FOR Commander, US Army Physical Disability Agency
(TAPD‐ZB / XXXXXX), 2900 Crystal Drive, Suite 300, Arlington, VA 22202‐3557
SUBJECT: Department of Defense Physical Disability Board of Review Recommendation for
XXXXXXXXXXXXXXXXX, AR20120022736 (PD201200844)
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
XXXXXXXXXXXXXX
Deputy Assistant Secretary
(Army Review Boards)
CF:
( ) DoD PDBR
( ) DVA
3 PD1200844
4 PD1200844
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AF | PDBR | CY2014 | PD-2014-00989
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AF | PDBR | CY2010 | PD2010-00064
PHYSICAL DISABILITY BOARD OF REVIEW In the matter of the right inguinal condition (neuropathy complicating hernia repair), the Board unanimously recommends a disability rating of 10%, coded 8699-8630 IAW VASRD §4.124a. I direct that all the Department of the Army records of the individual concerned be corrected accordingly no later than 120 days from the date of this memorandum.
AF | PDBR | CY2014 | PD-2014-01682
The Board’s assessment of the PEB rating determinations is confined to review of medical records and all available evidence for application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards to the unfitting medical condition at the time of separation. The abdominal examination was normal except right inguinal scar tenderness. In the matter of the chronic inguinal pain condition, the Board unanimously determined that the painful surgical scar was separately...
AF | PDBR | CY2010 | PD2010-00006
In the matter of the right inguinal neuralgia condition with chronic right groin pain condition, the Board unanimously recommends a rating of 10% coded 8630 IAW VASRD §4.124a. In the matter of the right inguinal scar condition, the Board unanimously agrees that it cannot recommend a finding of unfit for additional rating at separation. Exhibit C. Department of Veterans' Affairs Treatment Record.
AF | PDBR | CY2010 | PD2010-00132
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