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Evidence checklist

Anal Fistula (Fistula in Ano)

DC 733538 CFR § 4.114Digestive

Evidence strength

Mark what you already have below and your evidence strength appears here.

Target
Saved locally
01

Specialist opinion

Highest value0 of 3 collected
Proctologic examination documenting fistula tract, external opening, and drainageCritical

Clinical examination documenting the external opening location (Parks classification), internal opening, tract complexity (simple vs. complex/intersphincteric/trans-sphincteric), and drainage characteristics.

Private provider · independent opinion
MRI pelvis (MRI fistulography) mapping fistula tract anatomyCritical

High-resolution MRI of the pelvis documenting the fistula tract anatomy relative to the sphincter muscles — essential for surgical planning and documenting complexity.

Private provider · independent opinion
Nexus opinion linking anal fistula to service ("at least as likely as not")Critical

A medical opinion connecting fistula formation to service-connected Crohn's disease, perianal abscess during service, perineal trauma, or other service-related anorectal disease.

Private provider · independent opinion
02

Treating physician

0 of 2 collected
Documentation of chronic drainage and wound care requirements

Medical records or personal statement documenting persistent drainage from the fistula, wound care requirements (dressings, padding), fecal soiling, and hygiene impact.

Your treating provider · written request
Fecal incontinence documentation (if sphincter damage present)

Clinical documentation of fecal incontinence resulting from sphincter damage from the fistula tract or surgical repair — supports additional rating consideration.

Your treating provider · written request
03

Treatment records

0 of 1 collected
Surgical records for fistulotomy, seton placement, or flap repair

Operative reports documenting surgical procedures performed (fistulotomy, seton placement, LIFT procedure, advancement flap, fibrin glue), recurrence, and post-operative course.

VA or private records · written request
04

Lay statements

0 of 2 collected
Buddy statement from spouse, family, or fellow service member

A written statement from someone who can describe observable symptoms and how your condition affects daily life.

You or a witness · VA Form 21-4138 or 21-10210How to get this →
Personal statement describing symptoms and functional impact

Your own written account of how this condition affects your daily activities, work, and relationships. Describe your worst days.

You or a witness · VA Form 21-4138 or 21-10210How to get this →
05

Benefits questionnaire

0 of 1 collected
Completed DBQ Rectum and Anus ConditionsCritical

Standardized form capturing fistula anatomy, drainage, sphincter integrity, incontinence, and treatment history.

Provider-completed · VA DBQ formHow to get this →
06

Service records

0 of 1 collected
Service treatment records (STRs)Critical

Military medical records showing in-service treatment, complaints, or injuries related to this condition.

NPRC / milConnect · SF-180
Condition guideRating criteria and what VA looks forBuddy statement builderGuided VA Form 21-10210

What you mark here is saved in this browser, on this device only — not to an account. Changing the target rating shows different items, but never loses what you have already marked.