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AF | PDBR | CY2012 | PD2012 01658
Original file (PD2012 01658.rtf) Auto-classification: Denied
RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:    CASE: PD1201658
BRANCH OF SERVICE: MARINE CORPS  BOARD DATE: 20130410
SEPARATION DATE: 20021130


SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty SSGT/E-6(1833/Assault Amphibious Vehicle Crewman) medically separated for a left testalgia (left testicular pain) condition. The CI had a relatively abrupt onset of left testicular pain in October 2001, not associated with physical activity. Evaluation demonstrated findings consistent with epididymo-orchitis. Despite medication and surgical treatment, the condition could not be adequately rehabilitated to meet the physical requirements of his Military Occupational Specialty (MOS) or satisfy physical fitness standards. He was placed on limited duty (LIMDU) and referred for a Medical Evaluation Board (MEB). Left testalgia associated and varicocele, status post (s/p) varicocele ligation was forwarded to the Physical Evaluation Board (PEB) IAW SECNAVINST 1850.4E. No other conditions were submitted by the MEB. The Informal PEB (IPEB) adjudicated left testalgia associated as unfitting rated 10% with application of the Veteran’s Affairs Schedule for Rating Disabilities (VASRD). The remaining condition, varicocele, s/p varicocele ligation was adjudicated to by a Category II condition, a condition that contributes to the unfitting condition. The CI made no appeals, and was medically separated with a 10% disability rating.


CI CONTENTION: The CI writes: “Pain has continued to constantly effect my day to day life and continually degrades my quality of life. I am forced to take the maximum amount of pain medication that the VA since separation from the Marine Corps while the pain constantly increases and restricts my daily activities. This negatively effects my personal and professional life in multiple ways.”


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 left testalgia associated condition along with the varicocele, s/p varicocele ligation is addressed below; and, no additional conditions are 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 Board for Correction of Naval Records. The Board acknowledges the CI’s information regarding the significant impairment with which his service-connected condition continues to burden him; but must emphasize that the Disability Evaluation System has neither the role nor the authority to compensate members for anticipated future severity or potential complications of conditions resulting in medical separation. That role and authority is granted by Congress to the Department of Veterans Affairs, operating under a different set of laws.


 RATING COMPARISON :

Service IPEB – Dated 20020904
 VA - (3 Mos. Pre-Separation)
Condition
 Code Rating Condition Code Rating Exam
Left Testalgia Associated 8730 10% s/p Left Varicocelectomy And Spermatic Cord Block, With Residual Scar 7599-8730 10% 20020808
Varicocele, S/P Varicocele Ligation Category II
No Additional MEB/PEB Entries
 Other x 4 20020808
Combined: 10%
 Combined: 50%


ANALYSIS SUMMARY: N/A

Left Testicular Pain Condition. The CI had an abrupt onset of left testicular pain and swelling without a history of trauma in October 2001. Multiple diagnoses to include epididymo-orchitis, bilateral hydroceles, and left varicocele confirmed by ultrasound were entertained as the source of pain in the presence of normal infectious laboratory studies. The swelling responded to treatment yet the pain was unresponsive to multiple treatment modalities to include surgery for the varicocele, spermatic cord nerve blocks, and medications. He declined surgery to remove the painful left testes as he was advised this may or may not resolve the pain. He described the pain as constant and 7 of 10 in intensity despite taking nonsteroidal anti-inflammatory, narcotic based and pain modifying medications. The pain worsened after working throughout the day, with running, after intercourse with associated erectile dysfunction and awoke him at night. The LIMDU limitations included no lifting over five pounds, physical training, field duty, running, standing greater than 10 minutes or deployments. The non-medical assessment (NMA) corroborated the medical condition and further documented the CI was not working in his MOS, missed 35 hours of work per week and was incapable of performing assigned duties to include inspection of workplaces and clerical duties due to pain.

The MEB physical exam demonstrated a soft, nontender abdomen without masses, descended bilateral testes, ballottable fluid around the left testicle with a Grade 2-3 left varicocele and a very tender left testicle but without palpable mass which was slightly smaller than the right. No new additional historical or physical exam findings were documented at the VA Compensation and Pension (C&P) exam performed 3 months prior to separation.

The Board directs attention to its rating recommendation based on the above evidence. The PEB and VA chose to code with 8730 (neuralgia ilioinguinal nerve) for the condition and both awarded the maximum allowable IAW §4.124a—Schedule of ratings–neurological conditions and convulsive disorders and IAW §4.115b—Ratings of the genitourinary system. There was no viable approach to a higher rating for the left testicular pain condition which was countenanced by the VASRD in the absence of complete testicular atrophy, recurrent infections, or hospitalizations. 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 left testicular 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 left testicular condition and IAW VASRD §4.124a, the Board unanimously recommends no change in the PEB adjudication. There were no other conditions within the Board’s scope of review for consideration.

RECOMMENDATION: The Board, therefore, recommends that there be no recharacterization of the CI’s disability and separation determination, as follows:

UNFITTING CONDITION
 VASRD CODE RATING
Left Testalgia Associated 8730 10%
Varicocele, S/P Varicocele Ligation Category II
COMBINED
 10%


The following documentary evidence was considered:

Exhibit A. DD Form 294, dated 20120730, w/atchs
Exhibit B. Service Treatment Record
Exhibit C. Department of Veterans’ Affairs Treatment Record




         Physical Disability Board of Review


 SFMR-RB                                                                         


MEMORANDUM FOR Commander, US Army Physical Disability Agency
(TAPD-ZB)

 SUBJECT: Department of Defense Physical Disability Board of Review Recommendation for AR20130011060 (PD201201658)

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                                                 
                                                      (Army Review Boards)

CF:
( ) DoD PDBR
( ) DVA

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