EDUCATIONAL TOOL ONLY. Not legal or medical advice. Not affiliated with the VA.
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Fistula-in-Ano
✓ VERIFIED AGAINST 38 C.F.R.§ 4.114 (Digestive system) · reviewed 2026-05-17 · ClaimRecon Editorial Team
Fistula-in-Ano is rated by the U.S. Department of Veterans Affairs under DC 7335 of 38 CFR § 4.114, DC 7335 across 4 severity tiers (10% / 20% / 40% / 60%). Service connection requires (1) a current diagnosis, (2) an in-service event, injury, or exposure, and (3) a medical nexus opinion linking the two under 38 C.F.R. § 3.303.
OVERVIEW
Abnormal tunnel between the anal canal and the skin near the anus, often following an abscess
RATING CRITERIA (4 LEVELS)
10%
One fistula with drainage and pain, but without abscess.
20%
Two or more simultaneous fistulas with drainage and pain, but without abscesses.
40%
One or two simultaneous fistulas, with abscess, drainage, and pain.
60%
More than two constant or near-constant fistulas with abscesses, drainage, and pain, which are refractory to medical and surgical treatment.
KEY EVIDENCE TO GATHER
-Service treatment records showing injury or complaints
-Imaging (X-ray, MRI, CT)
-Range of motion measurements
-Flare-up documentation per Sharp v. Shulkin
-Buddy statements describing limitations
-Prescription history
-Physical therapy records
-Employment impact documentation
C&P EXAM TIPS (6)
1.Do NOT stretch, warm up, or take pain medication before your exam. The VA needs your baseline limitation.
2.Report your WORST day. DeLuca v. Brown requires documentation of functional loss during flare-ups.
3.Tell the examiner about flare-ups: frequency, duration, estimated ROM loss. Sharp v. Shulkin (2017) requires estimates.
4.Request active, passive, weight-bearing, and non-weight-bearing ROM testing per Correia v. McDonald (2016).
5.If you use assistive devices (brace, cane), bring them.
6.Describe daily activity impact: work, sleep, household tasks.
SOURCES & EDITORIAL
Rating criteria text quoted verbatim from 38 C.F.R. § 4.114 (Digestive system). Source verified 2026-05-17 by ClaimRecon Editorial Team during a regulation-text comparison against the Cornell Law CFR mirror; eCFR.gov is the authoritative government source.
EDUCATIONAL TOOL ONLY. NOT LEGAL OR MEDICAL ADVICE.
NOT AFFILIATED WITH THE U.S. DEPARTMENT OF VETERANS AFFAIRS.
CLAIM RECON 2026