VA Disability Rating for Bladder Fistula (DC 7516)
Diagnostic Code 7516 · 38 CFR §§4.115a
What Is It?
DC 7516 covers bladder fistula — an abnormal connection between the urinary bladder and another organ or the skin surface. The CFR assigns a 100% rating for postoperative suprapubic cystotomy. Otherwise, bladder fistula is an abnormal connection between the urinary bladder and another organ or the skin surface. These openings allow urine to leak into areas where it does not belong, such as the intestines, vagina, or through the abdominal wall. In veterans, fistulas may develop from combat injuries, surgical complications, radiation treatment, or chronic infections. The condition often causes persistent urinary leakage, infections, and significant quality of life impacts. Treatment may involve surgical repair, though some fistulas recur or cannot be fully corrected.
Rating Criteria
| Rating | Criteria |
|---|---|
| 100% | Postoperative suprapubic cystotomy — a surgically created bladder-to-skin fistula for urinary drainage. |
| 60% | When rated as voiding dysfunction: continuous or near-continuous urinary leakage requiring an external collection device or absorbent materials changed more than four times daily. |
| 40% | Significant intermittent leakage requiring absorbent materials changed two to four times daily. |
| 20% | Occasional leakage manageable with minimal absorbent protection. |
| 10% | When rated as urinary tract infection: recurrent symptomatic infection requiring one to two hospitalizations per year or suppressive drug therapy six months or longer. |
| 0% | Fistula surgically repaired with no residual leakage or complications. |
Evidence Needed
- Imaging or cystoscopy reports confirming the presence and location of the fistula
- Surgical records if repair has been attempted
- Documentation of urinary leakage frequency and absorbent material usage
- Records of recurrent infections attributable to the fistula
- Medical records connecting the fistula to an in-service event or condition
C&P Exam Tips
- Be specific about the amount and frequency of urinary leakage
- Document how many absorbent pads or materials you use and how often they are changed
- Describe any odor, skin irritation, or social limitations caused by the leakage
- Bring records of any surgical repair attempts and their outcomes
- Mention all infections that have resulted from the fistula
How to File
File under DC 7516 with imaging confirming the fistula, treatment records, and documentation of daily leakage patterns. If the fistula resulted from combat injury or military medical treatment, include those service records. A personal statement describing the daily impact is particularly important for this condition.
Common Mistakes
Not documenting the daily volume and frequency of urinary leakage Failing to track absorbent material usage with specificity Not claiming skin conditions caused by chronic urine exposure separately Overlooking the mental health impact of living with a bladder fistula
Frequently Asked Questions
What types of bladder fistulas does the VA recognize?
The VA recognizes all types of bladder fistulas regardless of where the abnormal connection leads. Common types include vesicovaginal (bladder to vagina), vesicointestinal (bladder to bowel), and vesicocutaneous (bladder to skin surface). The rating is based on functional impact rather than fistula type.
Can a fistula be fully repaired?
Some fistulas can be surgically repaired successfully, while others may recur or resist closure. If your fistula was repaired but you still have residual symptoms like incontinence or scarring, you may still qualify for a compensable rating based on those residual effects.
How do I prove the daily impact of a bladder fistula?
Keep a daily log of leakage episodes, pad changes, and infections. Take photos of the supplies you use. Buddy statements from family members who can attest to the impact on your daily life are also valuable evidence for your claim.