Anal Fistula (Fistula in Ano)

DC 7335Digestive38 CFR 4.114, DC 7335

An abnormal tunnel between the inside of the anal canal and the skin near the anus, often caused by an abscess. It can lead to pain, discharge, and leakage. The VA rates anal fistula based on the amount of leakage and whether you have lost bowel control.

Rating Levels

You have complete loss of sphincter control. This is the maximum rating for anal fistula.

What the VA looks for

Complete loss of sphincter control documented on examination
Total fecal incontinence
Anorectal manometry showing absent sphincter function
Continuous use of protective garments or colostomy
Inability to maintain employment due to incontinence

Common Pitfalls

⚠Not describing the amount and frequency of leakage honestly at the C&P exam — embarrassment leads many veterans to downplay symptoms that directly determine the rating percentage.
⚠Not documenting how many absorbent pads or protective garments you use per day — this is concrete evidence of leakage severity.
⚠Not getting anorectal manometry or other sphincter function testing to objectively measure any loss of bowel control.
⚠Not connecting the fistula to a service-connected condition like Crohn's disease, which commonly causes perianal fistulas and supports a secondary service connection claim.
⚠Not filing for separate ratings for related conditions such as recurrent perianal abscesses, scarring, or the mental health impact of living with fecal incontinence.

Related DBQ Forms

DBQ Rectum and Anus Conditions

View evidence checklist →See secondary conditions →

Condition Rating Guides

Understand what the VA looks for at each rating level — loading conditions…

Rating Levels

You have complete loss of sphincter control. This is the maximum rating for anal fistula.

What the VA looks for

Complete loss of sphincter control documented on examination
Total fecal incontinence
Anorectal manometry showing absent sphincter function
Continuous use of protective garments or colostomy
Inability to maintain employment due to incontinence

Common Pitfalls

⚠Not describing the amount and frequency of leakage honestly at the C&P exam — embarrassment leads many veterans to downplay symptoms that directly determine the rating percentage.

⚠Not documenting how many absorbent pads or protective garments you use per day — this is concrete evidence of leakage severity.

⚠Not getting anorectal manometry or other sphincter function testing to objectively measure any loss of bowel control.

⚠Not connecting the fistula to a service-connected condition like Crohn's disease, which commonly causes perianal fistulas and supports a secondary service connection claim.

⚠Not filing for separate ratings for related conditions such as recurrent perianal abscesses, scarring, or the mental health impact of living with fecal incontinence.