Fistula in Ano (Rectal Fistula)

DC 7332Digestive38 CFR 4.114, DC 7332

An abnormal tunnel-like passage (fistula) that forms between the anal canal or rectum and the skin near the anus. Fistulae cause persistent drainage, pain, and recurring infections. The VA rates fistula in ano based on the degree of drainage, whether the fistula is constant or intermittent, and the presence of complications.

How the VA rates this condition

The VA rates this condition based on the type, severity, and frequency of your symptoms. The examiner will evaluate your specific symptoms and how they affect your daily life and ability to work.

Diagnostic code

DC 7332

Rating range

0% – 100%

Rating levels

Rating criteria are defined in 38 CFR 4.114, DC 7332. 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 extensive fistulae with complete loss of sphincter control, requiring a colostomy or diverting ostomy. Your condition involves chronic severe infection, massive tissue destruction, or uncontrolled fecal incontinence.

What the VA looks for

Complete loss of sphincter control
Colostomy or diverting ostomy required
Extensive tissue destruction documented
Chronic severe infection unresponsive to treatment
Total fecal incontinence

Common Pitfalls

⚠Not documenting drainage frequency and volume — keep a daily log of how many pad or dressing changes you need and the character of the drainage (serous, purulent, fecal). This directly maps to the rating criteria.
⚠Not getting imaging to map the fistula tract — MRI of the pelvis or endoanal ultrasound showing the fistula tract anatomy (superficial vs. deep, simple vs. complex) helps the VA understand the severity.
⚠Not claiming secondary conditions — chronic perianal fistulae commonly cause depression, anxiety, and social isolation. Skin conditions around the drainage site may warrant separate evaluation.
⚠Not documenting failed surgical repairs — each failed attempt at closure demonstrates the complexity and chronicity of the condition. Keep operative reports from every procedure.

Related DBQ Forms

DBQ Intestinal Conditions (Other Than Surgical or Infectious)

View evidence checklist →See secondary conditions →

Condition Rating Guides

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

Fistula in Ano (Rectal Fistula)

How the VA rates this condition

The VA rates this condition based on the type, severity, and frequency of your symptoms. The examiner will evaluate your specific symptoms and how they affect your daily life and ability to work.

Diagnostic code

DC 7332

Rating range

0% – 100%

Rating levels

Rating Levels

What the VA looks for

Complete loss of sphincter control
Colostomy or diverting ostomy required
Extensive tissue destruction documented
Chronic severe infection unresponsive to treatment
Total fecal incontinence

Common Pitfalls

⚠Not documenting drainage frequency and volume — keep a daily log of how many pad or dressing changes you need and the character of the drainage (serous, purulent, fecal). This directly maps to the rating criteria.

⚠Not getting imaging to map the fistula tract — MRI of the pelvis or endoanal ultrasound showing the fistula tract anatomy (superficial vs. deep, simple vs. complex) helps the VA understand the severity.

⚠Not claiming secondary conditions — chronic perianal fistulae commonly cause depression, anxiety, and social isolation. Skin conditions around the drainage site may warrant separate evaluation.

⚠Not documenting failed surgical repairs — each failed attempt at closure demonstrates the complexity and chronicity of the condition. Keep operative reports from every procedure.