Palatal Fistula

DC 9916Dental/Oral38 CFR 4.150, DC 9916

An abnormal opening (fistula) in the palate creating a communication between the oral and nasal cavities. This causes nasal regurgitation of food and liquid, speech changes, and difficulty eating. Rated based on the size of the fistula and its functional impact.

How the VA rates this condition

The VA rates this condition based on objective clinical measurements and test results. The examiner will use standardized tests or lab values to determine the severity of your condition rather than relying primarily on subjective symptom reports.

Diagnostic code

DC 9916

Rating range

0% – 30%

Rating levels

Rating criteria are defined in 38 CFR 4.150, DC 9916. This guide presents a plain-language summary and is not a substitute for the full regulatory text. Always consult a VSO or VA-accredited attorney for case-specific advice.

Rating Levels

You have a large palatal fistula causing constant nasal regurgitation, severely impaired speech, and significant difficulty eating. The fistula is not surgically repairable or repair has failed.

What the VA looks for

Large palatal fistula documented on examination
Constant nasal regurgitation documented
Severely impaired speech on evaluation
Significant difficulty eating documented
Surgical repair not feasible or has failed

Common Pitfalls

⚠Not having the fistula size and location precisely documented — the examiner should measure the opening and describe its exact location on the palate.
⚠Not getting a speech-language pathology evaluation to objectively document the degree of hypernasal speech — subjective reports alone may not support the claimed rating.
⚠Not documenting nasal regurgitation frequency and the types of foods and liquids that trigger it — keep a detailed log of episodes.
⚠Not connecting the fistula to in-service dental procedures, trauma, or cancer treatment — the cause must be linked to military service.

Related DBQ Forms

DBQ Dental and Oral Conditions

View evidence checklist →See secondary conditions →

Condition Rating Guides

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

Palatal Fistula

How the VA rates this condition

Diagnostic code

DC 9916

Rating range

0% – 30%

Rating levels

Rating Levels

You have a large palatal fistula causing constant nasal regurgitation, severely impaired speech, and significant difficulty eating. The fistula is not surgically repairable or repair has failed.

What the VA looks for

Large palatal fistula documented on examination
Constant nasal regurgitation documented
Severely impaired speech on evaluation
Significant difficulty eating documented
Surgical repair not feasible or has failed

Common Pitfalls

⚠Not having the fistula size and location precisely documented — the examiner should measure the opening and describe its exact location on the palate.

⚠Not getting a speech-language pathology evaluation to objectively document the degree of hypernasal speech — subjective reports alone may not support the claimed rating.

⚠Not documenting nasal regurgitation frequency and the types of foods and liquids that trigger it — keep a detailed log of episodes.

⚠Not connecting the fistula to in-service dental procedures, trauma, or cancer treatment — the cause must be linked to military service.