Diagnostic Code 7624 · 38 CFR §4.116
A rectovaginal fistula is an abnormal connection between the rectum and the vagina, allowing bowel contents to pass through the vaginal opening. This condition causes significant hygiene challenges, discomfort, and social embarrassment. It can result from traumatic injury, surgical complications, severe infections, or radiation damage. For veterans, it may develop from injuries during service, complications from military medical procedures, or as a result of treatment for other service-connected conditions. The VA rates rectovaginal fistulas based on the frequency of vaginal fecal leakage.
| Rating | Criteria |
|---|---|
| 100% | Vaginal fecal leakage at least once a day requiring wearing of a pad. |
| 60% | Vaginal fecal leakage four or more times per week, but less than daily, requiring wearing of a pad. |
| 30% | Vaginal fecal leakage one to three times per week requiring wearing of a pad. |
| 10% | Vaginal fecal leakage less than once a week. |
Physical examination findings documenting the fistula are essential. Imaging studies (MRI, contrast studies) showing the size and location of the fistula provide objective evidence. Surgical reports if repair was attempted document the severity. A detailed log of fecal leakage frequency is critical because ratings are directly tied to how often leakage occurs. Records of pad usage support your reported frequency. Records of infections and impact on daily activities demonstrate functional limitation.
Extremely important. Your rating is directly determined by how often vaginal fecal leakage occurs: daily leakage is 100 percent, four or more times per week is 60 percent, one to three times per week is 30 percent, and less than weekly is 10 percent. Keep a daily log and bring it to your exam.
Residual effects from a repaired fistula are still ratable. If you have scarring, pain, recurrent infections, or bowel or vaginal dysfunction after repair, those symptoms support a disability rating even though the fistula itself was surgically closed.