Citation Nr: 0000699 Decision Date: 01/10/00 Archive Date: 01/19/00 DOCKET NO. 98-19 613 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Atlanta, Georgia THE ISSUE Entitlement to an initial compensable disability evaluation for bilateral orchialgia, left greater than right. ATTORNEY FOR THE BOARD C. Hancock, Counsel INTRODUCTION The veteran served on active duty from July 1986 to March 1997. This case comes before the Board of Veterans' Appeals (Board) on appeal from an August 1997 rating decision of the Department of Veterans Affairs (VA) Regional Office in Atlanta, Georgia (RO). FINDING OF FACT The veteran's right and left orchialgia cause severe pain. CONCLUSIONS OF LAW 1. The criteria for a separate, initial disability evaluation of 10 percent for right orchialgia have been met. 38 U.S.C.A. §§ 1155, 5107 (West 1991); 38 C.F.R. § 4.124a, Diagnostic Code 8730 (1999). 2. The criteria for a separate, initial disability evaluation of 10 percent for left orchialgia have been met. 38 U.S.C.A. §§ 1155, 5107 (West 1991); 38 C.F.R. § 4.124a, Diagnostic Code 8730 (1999). REASONS AND BASES FOR FINDING AND CONCLUSIONS Initially, the Board finds that the veteran's claim is well grounded within the meaning of 38 U.S.C.A. § 5107(a) (West 1991); that is, he has presented a claim that is plausible. Proscelle v. Derwinski, 2 Vet. App. 629, 632 (1992). He has not asserted that any records of probative value that may be obtained and which have not already been associated with his claims folder are available. It is accordingly found that all relevant facts have been properly developed, and that the duty to assist him, mandated by 38 U.S.C.A. § 5107(a), has been satisfied. Disability evaluations are determined by evaluating the extent to which a veteran's service-connected disability adversely affects his ability to function under the ordinary conditions of daily life, including employment, by comparing his symptomatology with the criteria set forth in the Schedule for Rating Disabilities. 38 U.S.C.A. § 1155 (West 1991); 38 C.F.R. Part 4 (1999). Each disability must be reviewed in relation to its history and emphasis must be placed upon the limitation of activity imposed by the disabling condition. 38 C.F.R. § 4.1 (1999). Medical reports must be interpreted in light of the whole recorded history, and each disability must be considered from the point of view of the veteran working or seeking work. 38 C.F.R. 4.2 (1999). Service connection for bilateral orchialgia disability was granted by a rating decision dated in August 1997, and a noncompensable evaluation was assigned, by analogy, under the provisions of 38 C.F.R. § 4.124a, Diagnostic Code 8730. This rating contemplates mild to moderate paralysis of the ilioinguinal nerve. A 10 percent evaluation requires severe to complete paralysis. Inasmuch as the veteran's right orchialgia symptomatology is separate from his left orchialgia symptomatology, each resulting in differing degrees of neuralgia, the Board finds that separate evaluations are warranted. A VA general medical examination, dated in June 1997, reports a history of vasectomy in 1988. The veteran noted that since that time he had experienced chronic pain in the scrotal area, particularly on the left side. The report noted that the veteran was evaluated but that the exact cause of the pain could not be ascertained. It was further noted that a later evaluation revealed a benign tumor in the area, with subsequent examinations revealing regression of the tumor. The genitourinary examination revealed that the scrotum was quite tender to palpation. No evidence of hernia was appreciated, and no inflammation of the cord was noted. The examiner gave a diagnosis of status post vasectomy with chronic scrotal pain. A urology examination found no particular etiology for the chronic pain. The examiner opined that the veteran's pain was related to one of the chronic inflammatory or nerve-related problems associated with a vasectomy. The veteran contends that his bilateral orchialgia disability caused him to experience reoccurring pain which had prompted to him to quit two jobs which required fieldwork and lifting. He added that this condition caused him to be discharged from active duty with the military. The clinical and other probative evidence of record indicate that the veteran experiences chronic discomfort in the testicular region which equates to neuralgia of the ilioinguinal nerve. The veteran's complaints regarding the symptoms, particularly pain, related to his bilateral orchialgia are considered to be competent and credible. Additionally, the veteran's chronic pain is shown to be representative of manifestations of the ilioinguinal nerve. Based on these findings, the Board concludes that a question exists as to whether the veteran's bilateral orchialgia disability is manifested by mild, moderate, or severe impairment. See 38 C.F.R. § 4.124a, Diagnostic Code 8730. Therefore, with the resolution of reasonable doubt in the veteran's favor, the Board concludes that the evidence more nearly approximates a disability picture which demonstrates severe impairment of the veteran's bilateral orchialgia disability. See 38 C.F.R. § 4.7 (1999). As such, separate 10 percent evaluations are warranted for both right and left orchialgia disabilities pursuant to 38 C.F.R. 4.124a, Diagnostic Code 8730. It is noted that a 10 percent rating is the maximum assignable rating pursuant to Diagnostic Code 8730. The Board finds that an evaluation higher than 10 percent is not in order for the service-connected disabilities at this time. The current findings do not show the presence of presence of pathology of a sufficient severity as to warrant the assignment of a higher rating under 38 C.F.R. § 4.115a, Diagnostic Code 7525 (1999), which is utilized to rate chronic epididymo-orchitis. Chronic epididymo-orchitis is rated as urinary tract infection. In this instance, the veteran is not shown to have suffered from recurrent symptomatic infection requiring drainage/frequent hospitalization (greater than two times/year), and/or requiring continuous intensive management. Id. In reaching its decision, the Board considered the potential application of the various other provisions of 38 C.F.R., Parts 3 and 4, whether or not they were raised by the veteran, as well as the entire history of the veteran's disorder. See Schafrath v. Derwinski, 1 Vet. App. 589, 592 (1991). The Board acknowledges the veteran's assertions that his bilateral orchialgia has interfered in the past with his employment. However, the veteran has also stated that he has taken an office job. There simply is no evidence that the veteran's right and left orchialgia disabilities have caused marked interference with employment beyond that contemplated by the assigned evaluation or necessitated frequent periods of hospitalization. In the absence of such factors, the criteria for submission for assignment of an extraschedular evaluation pursuant to 38 C.F.R. § 3.321(b)(1) (1999) have not been met. See Bagwell v. Brown, 9 Vet. App. 337, 338-9 (1996). The United States Court of Appeals for Veterans Claims (Court) has held that in claims for initial ratings, staged ratings may be warranted if the claim involves an original grant of service connection. See Fenderson v. West, 12 Vet. App. 119 (1999). As noted above, the RO granted service connection and originally assigned a noncompensable evaluation for bilateral orchialgia as of the day following separation from active service, i.e., March 29, 1997. See 38 C.F.R. § 3.400(b)(2)(i) (1999). After review of the evidence, there is no medical evidence of record that would support a rating in excess of 10 percent for the disabilities at issue at any time subsequent to the day following separation from active service. Id.; Fenderson v. West, 12 Vet. App. 119 (1999). ORDER Entitlement to a separate, initial disability evaluation of 10 percent for left orchialgia is granted, subject to the laws and regulations governing the payment of monetary benefits. Entitlement to a separate, initial disability evaluation of 10 percent for right orchialgia is granted, subject to the laws and regulations governing the payment of monetary benefits. JOY A. MCDONALD Acting Member, Board of Veterans' Appeals