RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

BRANCH OF SERVICE:  NAVY 
SEPARATION DATE:  20020510 

 
NAME:  XX 
CASE NUMBER:  PD1200816 
BOARD DATE:  20130206 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered individual (CI) was an active duty PH3/E-4 (Photographer Mate), medically separated 
for interstitial cystitis.  The CI had a history of chronic urinary urgency, frequency, nocturia, and 
pelvic pain with urination and she was diagnosed with interstitial cystitis in April 2001.  The CI 
did not improve adequately with treatment and was unable to meet the physical requirements 
of her rating or satisfy physical fitness standards.  The CI was placed on limited duty (LIMDU) 
and  referred  for  a  Medical  Evaluation  Board  (MEB).    The  MEB  forwarded  chronic  interstitial 
cystitis condition, benign essential hypertension, and exercise induced asthma to the Physical 
Evaluation Board (PEB).  The PEB adjudicated interstitial cystitis as the only unfitting condition.  
The  PEB  adjudicated  exercise  induced  asthma  and  essential  hypertension  as  Category  III 
conditions (“Conditions that are not separately unfitting and do not contribute to the unfitting 
condition”) with application of Veterans Affairs Schedule for Rating Disabilities (VASRD).  The CI 
made no appeals, and she was medically separated with a 10% disability rating.    
______________________________________________________________________________ 
 
CI  CONTENTION:    “I  have  chronic  interstitial  cystitis  which  worsens  each  year.    The  required 
medication needed to treat my condition causes me hair loss, gym bleeds, vaginal dryness, sore 
throat and constant heartburn.  I also encounter many sleepless nights.  My Elmiron medication 
is so strong that the side effect of vaginal dryness makes it hard for me to sit for long periods of 
time  along  with  making  it  difficult  for  me  to  have  sexual  intercourse  with  my  husband  and 
because of the vaginal soreness; the medication also makes my arms and legs sore and stiff.  
The Elmiron causes me constant mouth dryness and soreness.  During my menstrual cycle, it’s 
painful to wear sanitary napkins because the pad rubs against the vaginal area causing more 
pain and skin abrasions.  I’m warranted an increase because I have to live the rest of my life 
experiencing this pain due to the Elmiron medication.” 
 
 
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 rating for 
unfitting conditions will be reviewed in all cases.  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 IPEB – Dated 20020128 
Code 
Condition 
7512 
Interstitial Cystitis 
CAT III 
Exercise Induced Asthma 
Essential Hypertension 
CAT III 
↓No Additional MEB/PEB Entries↓ 
Combined:  10% 
*Increased to 30% effective 20100105  
 

VA 38 Months Post-Separation) – All Effective Date 20041025 
Condition 
Chronic Interstitial Cystitis 
Restrictive Lung Disease 
Hypertension  with  History  of 
Tachycardia 
0% X 1 / Not Service-Connected x 4 
Combined:  50% 

Exam 
20050617 
20050617 
20051114 
20051114 

Rating 
10% 

Code 
7512 
6699-6602 
7101 

Rating 
20%* 
30% 
10% 

ANALYSIS SUMMARY:  The Board acknowledges the sentiment expressed in the CI’s application 
regarding  the  significant  impairment  with  which  his  service-incurred  condition  continues  to 
burden her.  It is a fact, however, that the Disability Evaluation System (DES) has neither the 
role  nor  the  authority  to  compensate  members  for  anticipated  future  severity  or  potential 
complications of conditions resulting in medical separation.  This role and authority is granted 
by Congress to the Department of Veterans Affairs (DVA).  The Board’s authority as defined in 
DoDI  6040.44,  resides  in  evaluating  the  fairness  of  DES  fitness  determinations  and  rating 
decisions for disability at the time of separation.  The Board utilizes DVA evidence proximal to 
separation in arriving at its recommendations; and, DoDI 6040.44 defines a 12-month interval 
for  special  consideration  to  post-separation  evidence.    Post-separation  evidence  is  probative 
only to the extent that it reasonably reflects the disability and fitness implications at the time of 
separation. 
 
Interstitial  Cystitis  Condition.    The  CI  initially  presented  in  September  2000  with  a  2  week 
history of burning, urgency, frequent urination, suprapubic pain, pressure and back pain.  She 
failed  to  respond  to  treatment  and  a  urology  consult  was  requested.    In  April  2001,  the 
urologist  noted  a  history  of  urinary  frequency,  urgency,  pelvic  pain  that  was  relieved  by 
urination and nocturia 3 to 7 times a night.  The physical exam was relatively benign with only 
minimal  suprapubic  tenderness.    The  CI  was  continued  on  a  medication  (Elmiron)  specific  to 
control  the  bladder  pain  and  discomfort  associated  with  interstitial  cystitis,  along  with  a 
medication (Atarax) to stabilize mass cells in the bladder tissue and a medication (Elavil) which 
helps to stabilize pain fibers in the pelvis and reduce overall pain.  The immediate follow-up 
urology  appointment  performed  in  May  2001  showed  a  significant  improvement  in  the  CI’s 
symptoms with voiding every 3 to 4 hours during the day and nocturia once nightly; however, 
the pain while decreased still persisted.  The CI was reevaluated in September 2001 for LIMDU 
reevaluation.  At the time of the reevaluation, the CI had not improved and requested a PEB.  
The  CI  underwent  a  cystoscopy  in  October  2001,  however  due  to  the  lesions  and  severe 
discomfort,  the  urologist  wanted  to  repeat  this  procedure  under  anesthesia  with  possible 
biopsies and fulguration.  Later that month, the CI underwent a cystoscopy under anesthesia 
for  a  fulguration  to  remove  the  Hunner’s  ulcer  in  the  bladder.    The  urologist  subsequently 
noted the CI still had urinary urgency, frequency, and hematuria secondary to interstitial cystitis 
and  planned  to  modify  her  medication  regime.    The  MEB  narrative  summary  (NARSUM) 
examination  5  months  prior  to  separation  documented  a  year  history  of  interstitial  cystitis 
symptoms with minimal improvement.  No information regarding either daytime or nighttime 
voiding frequency was included.  The non-medical assessment (NMA) in January 2002 indicated 
the CI required frequent lavatory visits and that she was away from her duties on average 8 
hours per week for treatment, evaluation, or recuperation.  The VA Compensation & Pension 
(C&P)  examination  done  in  approximately  38  months  after  separation  noted  that  the  CI  
urinated 8  times  at  intervals  of  2  hours  during the day  and during  the night,  she  urinated  4 
times at intervals of 2 hours with associated problems of dysuria, weakness, and fatigue. 
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
PEB coded the interstitial cystitis condition 7512 cystitis, chronic rated as 10%.  The VA used the 
same coding as the PEB but assigned a 20% rating based on urinary frequency of every 2 hours 
during  the  day  and  4r  times  each  night.    There  was  ample  documentation  in  the  service 
treatment record that the CI has urinary frequency and urgency however most of the notes did 
not quantify the number of times that the urgency occurred.  An outpatient urology clinic visit 
note  14  months  prior  to  separation  indicated  urinary  frequency  and  nocturia  3  to  7  times  a 
night.  A note a month later indicated the CI was voiding every 3 to 4 hours during the day and 
had  nocturia  once  nightly.    No  further  information  regarding  actual  voiding  frequency  was 
available  in  the  record.    The  NMA  indicated  that  the  CI  required  frequent  lavatory  visits, 
however this frequency was not quantified, nor did the NMA address any nocturia.  The C&P 
exam, approximately 38 months after separation, noted that the CI urinated 8 times during the 
day at intervals of 2 hours and during the night; she urinated 4 times at intervals of 2 hours.  

   2                                                           PD1200816 
 

This  supports  a  20%  rating.    However,  this  exam  falls  well  outside  the  12-month  window 
specified  in  DoDI  6040.44  regarding  VA  evaluations  for  special  Board  consideration  and 
therefore has little direct significance to the determination of a rating at the time of separation.  
It appears the CI’s condition worsened over time.  A 10% disability rating is assigned for daytime 
voiding  interval  between  2  and  3  hours,  or;  awakening  to  void  2  times  per  night  and  the 
available  record  contains  no  evidence  to  support  a  frequency  greater  than  this  prior  to 
separation from service.  After due deliberation, considering all of the evidence and mindful of 
VASRD §4.3 (Resolution of reasonable doubt), the Board concluded that there was insufficient 
cause to recommend a change in the PEB adjudication for the interstitial cystitis 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 interstitial cystitis condition and IAW VASRD §4.71a, 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 
Interstitial Cystitis 

VASRD CODE  RATING 
7512 
COMBINED 

10% 
10% 

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120602, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 
 

 

           xx 
           Acting Director 
           Physical Disability Board of Review 

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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 21 Feb 13 
 

      In accordance with reference (a), I have reviewed the cases forwarded by reference (b), and, for 
the reasons provided in their forwarding memorandum, 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: 
 
 
 
 
 

 
 
 
 

 

 

     
 
 
 
 

-  former USN  
-  former USN  
-  former USMC 
-  former USN   
-  former USMC 
-  former USN  
-  former USN   
-  former USN 
-  former USMC 
-  former USMC 
-  former USMC 
-  former USMC 
 
  

 
      
 

 
 
 

 
 
 

 
 
 

 
 
 

  xxxx 
  Assistant General Counsel 
     (Manpower & Reserve Affairs) 

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