Citation Nr: 19166345 Decision Date: 08/27/19 Archive Date: 08/27/19 DOCKET NO. 18-35 482 DATE: August 27, 2019 ORDER Entitlement to an initial compensable rating for right ilio-inguinal nerve disability is denied. FINDING OF FACT For the entire period on appeal, the service connected nerve disability has been manifested by no more than mild to moderate incomplete paralysis. CONCLUSION OF LAW For the entire period on appeal, the criteria for an initial compensable disability rating for a right testicle nerve disability has not been met. 38 U.S.C. §§ 1155, 5103, 5103A, 5107; 38 C.F.R. §§ 4.3, 4.7, 4.124a, Diagnostic Code (DC) 8530. REASONS AND BASES FOR FINDING AND CONCLUSION This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a January 2016 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). Entitlement to an initial increased rating for right ilio-inguinal nerve disability Disability evaluations are determined by the application of the VA’s Schedule for Rating Disabilities (Rating Schedule), 38 C.F.R. Part 4. The percentage ratings contained in the Rating Schedule represent, as far as can be practicably determined, the average impairment in earning capacity resulting from diseases and injuries incurred or aggravated during military service and their residual disorders in civil occupations. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.321(a), 4.1. Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. A January 2016 rating decision awarded entitlement for the Veteran’s right testicle nerve disability, assigning a noncompensable rating under DC 8530 with an effective date of October 14, 2015. The right ilio-inguinal nerve disability is associated with the Veteran’s service-connected right epididymitis and cystoceles of the right testicle, status post right testicular torsion with orchiopexy, currently evaluated as 20 percent disabling since February 2016 for symptoms including the wearing of absorbent materials less than two times daily and voiding interval between one and two hours. Entitlement to a higher evaluation for this disability is not currently on appeal. Pursuant to DC 8530, a noncompensable (zero percent) disability rating is warranted for mild or moderate paralysis of the ilio-inguinal nerve. A 10 percent rating is warranted for severe to complete paralysis. 38 C.F.R. § 4.124a, DC 8530. In rating peripheral nerve disabilities, neuralgia, characterized usually by a dull and intermittent pain, of typical distribution so as to identify the nerve, is to be rated on the same scale, with a maximum equal to moderate incomplete paralysis. 38 C.F.R. § 4.124. When the involvement is wholly sensory, the rating should be for the mild, or at most, the moderate degree. 38 C.F.R. § 4.124a. As noted above, mild or moderate paralysis of the ilio-inguinal nerve is to be rated at zero percent disabling. 38 C.F.R. § 4.124a, DC 8530. (Continued on the next page)   After a review of all the evidence, lay and medical, the Board finds that the criteria for a compensable evaluation for the right testicle nerve disability have not been met or more nearly approximated under DC 8530. Throughout the rating period, the nerve disability has been manifested by no more than mild to moderate incomplete paralysis of the affected nerve. Specifically, findings from the November 2015 and July 2019 VA Peripheral Nerve examinations, and history and findings in the numerous VA treatment records, as well as the Veteran's lay statements, are consistent with a noncompensable rating under DC 8530 for the symptoms and level of impairment actually demonstrated by the right testicle nerve disability. DC 8530 warrants a 10 percent rating for severe to complete paralysis of the ilio-inguinal nerve. In this case, as noted at the July 2019 VA examination, the Veteran reported “increased pain with stair climbing and intermittent pain & tingling in right leg.” Physical evaluation revealed moderate paresthesias treated with oral pain medication. The July 2019 VA examiner specifically assessed mild incomplete paralysis of the ilio-inguinal nerve. In addition, no examiner has assessed severe to incomplete paralysis of the affected nerve, rather VA treatment records are consistent with the examination reports, reflecting complaints of chronic pain treated with medication and occasional nerve blocks. See i.e. March 2018 Primary Care note (“Chronic Right epididymitis. Chronic testicular pain... He was taking methadone but was tapered off due to inconsistent UDS. He is asking for opioid medications and I have declined. He was getting local injections and acupuncture in New York. He had nerve blocks that helped”) Based on the above, the Board finds that a compensable disability rating is not warranted under DC 8530 for the right testicle nerve disability. 38 C.F.R. §§ 4.3, 4.7. MICHAEL E. KILCOYNE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Marcus J. Colicelli, Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.