Rectovaginal Fistula — VA Disability Rating (DC 7624)
Diagnostic Code 7624 · 38 CFR §4.116
What Is It?
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
| 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. |
Evidence Needed
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.
C&P Exam Tips
The rating depends entirely on leakage frequency, so keep a detailed daily log before your exam. Describe exactly how often you experience vaginal fecal leakage — daily, several times a week, or less than weekly. Report your pad usage and how often you change them. Describe any odor control challenges and their impact on your confidence and social interactions. Describe all infections that have resulted from the fistula. If you have had repair surgery, explain whether it was successful or if the fistula recurred.
How to File
File VA Form 21-526EZ listing rectovaginal fistula under DC 7624. Include examination findings, imaging results, and surgical reports. Provide a leakage frequency log as this directly determines your rating level. Document daily impact with descriptions of symptoms and pad usage. Provide evidence connecting the fistula to a service event, surgery, or condition. Consider also filing for secondary conditions.
Common Mistakes
Underreporting leakage frequency because of embarrassment — the rating is directly based on how often leakage occurs Not keeping a leakage frequency log to support the claimed rating level Not documenting pad usage, which corroborates the frequency of leakage episodes
Frequently Asked Questions
How important is tracking leakage frequency?
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.
What if my fistula was repaired but I still have problems?
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.