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AF | PDBR | CY2013 | PD-2013-02470
Original file (PD-2013-02470.rtf) Auto-classification: Denied
RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXX      CASE: PD -20 1 3 - 0 2470
BRANCH OF SERVICE: MARINE CORPS   BOARD DATE: 2014 1024
Separation Date: 20040430


SUMMARY OF CASE : Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty Marine Corps SSgt/E-6 (1341/Engineer Equipment Specialist) medically separated for left side testicular pain. The condition could not be adequately rehabilitated to meet the physical requirements of his Military Occupational Specialty or satisfy physical fitness standards. He was placed on light duty and referred for a Medical Evaluation Board (MEB). The testicular condition, characterized as “left side testicle pain” was forwarded to the Physical Evaluation Board (PEB) IAW SECNAVINST 1850.4E. No other conditions were submitted by the MEB. The Informal PEB adjudicated “left side testicular pain, status post (s/p) epididymectomy and s/p left orchiectomy with placement of prosthesis” as unfitting, rated 10% IAW VA Schedule for Rating Disabilities (VASRD). The CI appealed to the Formal PEB which affirmed the PEB finding and rating.


CI CONTENTION : The CI elaborated no specific contention in his application.


 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 side testicular pain, s/p epididmectomy and s/p left orchiectomy with placement of prosthesis condition is addressed below; 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.


 RATING COMPARISON :

Service FPEB – Dated 20040122
 VA - ( 3 Mos. Post-Separation)
Condition
 Code Rating Condition Code Rating Exam
Left Side Testicular Pain, s/p Epididymectomy and s/p Left Orchiectomy with Placement of Prosthesis 7599-7525 10% S/P Left Orchiectomy 7524 0% 20040707
Other x 0
 Other x 6
Combined: 10%
 Combined: 10%
Derived from VA Rating Decision (VARD) dated 20041019 (most proximate to date of separation [DOS])


ANALYSIS SUMMARY :

Left Side Testicular Pain, s/p Epidid y mectomy and s/p Left Orchiectomy with Placement of Prosthesis Condition . The CI developed left testicular pain after heavy lifting which was intermittent for 3 months. He sought care on 19 April 2001 and was diagnosed with epididymitis. Although he underwent treatment for the epididymitis (inflammation of the epididymis) , he continued with bouts of discomfort. The p rimary c are examiner documented physical exam findings of a possible left varicocele (enlargement of the veins in the scrotum) and pain of 4/10 with palpation of the left epididymis (part of the spermatic duct system) . The u rologist noted physical exam findings of tenderness and decreased circulation with a small spermatocele (abnormal cyst that develops in the epididymis) and advised non-steroidal anti-inflammatory drugs (NSAIDS), a possible spermatic cord block and surgical options. The u rologist in follow-up noted physical exam findings of a small spermatocele on the left side, tender to palpation which reproduced the symptoms. A testicular ultrasound performed in March 2002 was normal . A limited duty Board was initiated on 2 April 2002 for left testicular pain, rule out spermatocele with specific limitations of non–impact PT, PT at own pace and distance. The CI had chronic epididymitis and was started on antibiotics in June 2002. He underwent a left spermatic cord nerve block on 1 July 2002 with a good response . He developed a recurrence of testicular pain and underwent a right epididymectomy (surgical removal of the epididymis) in October 2002. In November 2002, he had a recurrence of left testicular pain. He underwent a second cord block in January 2003. The CI underwent a left orchiectomy ( surgical procedure in which one or both testicles are removed with placement of prosthesis ) on 8 May 2003. Post - operatively, the CI continued with increased lower abdominal pain made worse with standing and sitting along with testicular soreness with mild soft tissue edema on exam. The examiner noted that the CI still had pain on the left testicle area and complained of recent right testicular pain. The examiner documented that u rology at Tripler felt that there was no further treatment for the left testicular condition that could be offered. The c ommander’s s tatement indicated that the CI was limited to administrative duties only and was unable to perform physical fitness training without further injury. The CI was noted to have chronic bouts of epididymitis which required treatment with NSAIDS and antibiotics from January 2002 through July 2003. The MEB n arrative summary exam approximately 9 months prior to separation documented that the CI had ongoing testicular pain without resolution. The examiner opined that the CI carried a poor prognosis for continued military service and a fair prognosis for return to civilian life. T he VA Compensation and Pension exam accomplished approximately 2 months after separation documented that the CI had chronic pain in the bilateral testicle area when he perform ed any heavy lifting. The physical exam findings were benign without any evidence of epididymitis.

The Board directs attenti on to its rating recommendation based on the above evidence . The PEB coded the l eft s ide t esticular p ain, s/p epididymectomy and s/p l eft o rchiectomy with p lacement of p rosthesis condition as 7599 analogous to 7525 ( e pididymo-orchitis, chronic only ), rated at 10%. The VA coded the s / p l eft o rchiectomy condition as 7524 ( t estis, removal ), rated at 0%. VASRD §4.115b states , “ In cases of the removal of one testis as the result of a service-incurred injury or disease, other than an undescended or congenitally undeveloped testis, with the absence or nonfunctioning of the other testis unrelated to service, an evaluation of 30 percent will be assigned for the service-connected testicular loss. ” In this case, the CI had only one testicle removed and in accordance with coding of 7524, the rating is 0%. 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 l eft side t esticular p ain, s/p e pidid y mectomy and s/p l eft o rchiectomy with p lacement of p rosthesis 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 l eft s ide t esticular p ain, s/p epididymectomy and s/p l eft o rchiectomy with p lacement of p rosthesis condition and IAW VASRD §4. 115 , 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 re-characterization of the CI's disability and separation determination.


The following documentary evidence was considered:
Exhibit A. DD Form 294, dated 20 131119 , w/atchs
Exhib it B. Service Treatment Record
Exhibit C. Department of Veterans ’ Affairs Treatment Record







                          
XXXXXXXXXXXXXX
President
Physical Disability Board of Review


MEMORANDUM FOR DIRECTOR, SECRETARY OF THE NAVY COUNCIL OF REVIEW
BOARDS

Subj: PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS

Ref: (a) DoDI 6040.44
(b) CORB ltr dtd 22 Apr 15

In accordance with reference (a), I have reviewed the cases forwarded by reference (b), and, for the reasons provided in their forwarding memorandums, approve the recommendations of the PDBR that the following individual’s records not be corrected to reflect a change in either characterization of separation or in the disability rating previously assigned by the Department of the Navy’s Physical Evaluation Board:

- XXXXXXXXXXXXXXX, former USMC
- XXXXXXXXXXXXXXX, former USN
- XXXXXXXXXXXXXXX, former USMC
- XXXXXXXXXXXXXXX, former USN
- XXXXXXXXXXXXXXX, former USMC
- XXXXXXXXXXXXXXX, former USN
- XXXXXXXXXXXXXXX, former USN
- XXXXXXXXXXXXXXX, former USMC
- XXXXXXXXXXXXXXX, former USN
- XXXXXXXXXXXXXXX, former USMC
- XXXXXXXXXXXXXXX, former USN



                                                      XXXXXXXXXXXXXXX
                                            Assistant General Counsel
                                                      (Manpower & Reserve Affairs)

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