VA Disability Rating for Urethra Fistula (DC 7519)
Diagnostic Code 7519 · 38 CFR §§4.115a
What Is It?
A urethral fistula is an abnormal opening from the urethra to the skin surface or to another body structure, creating a passage through which urine escapes the normal urinary pathway. In veterans these develop from pelvic combat injuries, catheterization complications, surgical procedures, and chronic infection, and they produce persistent leakage, difficulty voiding, and recurrent infections. 38 CFR §4.115b gives DC 7519 an empty rating cell with one instruction — "Rate as voiding dysfunction" — plus a single row of its own: multiple urethroperineal fistulae at 100 percent. Voiding dysfunction, set out in §4.115a, is not one ladder but three separate branches, and the rater applies whichever fits the particular condition: continual urine leakage, post surgical urinary diversion, urinary incontinence or stress incontinence at 60 / 40 / 20 by how often absorbent materials must be changed; urinary frequency at 40 / 20 / 10 by daytime voiding interval and nightly voids; and obstructed voiding at 30 / 10 / 0 by retention, post void residuals, peak flow, recurrent infection, and how often a stricture needs dilating. Which branch the evidence supports is what decides the percentage, and the same structure governs the neighbouring codes DC 7517 (bladder injury) and DC 7518 (urethral stricture).
Rating Criteria
| Rating | Criteria |
|---|---|
| 100% | Multiple urethroperineal fistulae. This is the one percentage 38 CFR §4.115b attaches to DC 7519 itself; every other row below comes from the voiding dysfunction framework in §4.115a, which the code's entry directs evaluation under. |
| 60% | Continual urine leakage, post surgical urinary diversion, urinary incontinence, or stress incontinence requiring the use of an appliance or the wearing of absorbent materials which must be changed more than 4 times per day. |
| 40% | Urine leakage requiring the wearing of absorbent materials which must be changed 2 to 4 times per day; or urinary frequency with a daytime voiding interval of less than one hour, or awakening to void five or more times per night. |
| 30% | Obstructed voiding with urinary retention requiring intermittent or continuous catheterization. This is the highest figure the obstructed voiding branch reaches. |
| 20% | Urine leakage requiring the wearing of absorbent materials which must be changed less than 2 times per day; or urinary frequency with a daytime voiding interval between one and two hours, or awakening to void three to four times per night. |
| 10% | Urinary frequency with a daytime voiding interval between two and three hours, or awakening to void two times per night; or marked obstructive symptomatology (hesitancy, slow or weak stream, decreased force of stream) with any one or combination of post void residuals greater than 150 cc, markedly diminished peak flow rate below 10 cc/sec, recurrent urinary tract infections secondary to obstruction, or stricture disease requiring periodic dilatation every 2 to 3 months. |
| 0% | Obstructive symptomatology with or without stricture disease requiring dilatation 1 to 2 times per year. |
Evidence Needed
- Urethrogram or cystoscopy reports showing the fistula location and size
- Documentation of urinary leakage patterns and absorbent material usage
- Surgical records if repair has been attempted
- Records of infections related to the fistula
- Service medical records linking the fistula to an in-service cause
C&P Exam Tips
- Document leakage frequency and volume as specifically as possible
- Track your daily absorbent material usage in a log
- Describe any difficulty with urination beyond the leakage itself
- Mention all infections that have resulted from or been worsened by the fistula
- If the fistula is from a combat or training injury, have documentation ready
How to File
File under DC 7519 with diagnostic imaging confirming the fistula, documentation of leakage severity, and treatment records. Connect the condition to service with records of the causative injury or procedure. A detailed personal statement about daily impact is important for this condition.
Common Mistakes
Not providing objective imaging evidence of the fistula Underreporting leakage severity during the compensation exam Failing to document infections attributable to the fistula Not claiming secondary skin conditions or mental health effects separately
Frequently Asked Questions
What causes urethral fistulas in veterans?
Common causes include traumatic injuries to the pelvic area during combat or training, complications from catheterization during military hospitalization, failed surgical repairs, and chronic infections that erode through the urethral wall. Some fistulas develop gradually from radiation exposure.
Can a urethral fistula be permanently repaired?
Many urethral fistulas can be surgically repaired, though complex or recurrent fistulas may require multiple procedures. Even after successful repair, some veterans experience residual voiding dysfunction that can still be rated by the VA.
How do I document leakage for my VA claim?
Keep a daily log noting each leakage episode, the approximate amount, and each pad or absorbent material change. Save receipts for absorbent supplies as evidence of ongoing need. Buddy statements from household members can corroborate your reported symptoms.