Body system: Digestive SystemRegulation: 38 CFR § 4.114DBQ: DBQ GI Rectum & Anus
An anal fistula is an abnormal tunnel that forms between the inside of your anus or rectum and the skin around your bottom, often causing drainage, pain, and sometimes abscesses (infected pockets of pus). The VA rates this condition from 10% to 60% based on how many fistulas you have, whether they cause abscesses, and how well they respond to treatment. Higher ratings go to veterans with multiple fistulas that keep coming back despite medical care and surgery, while lower ratings are for single fistulas without abscesses.
Rating levels
- 60% — You have more than two anal fistulas (abnormal tunnels between the anal canal and skin) that are constantly or almost constantly present, along with abscesses (infected pockets of pus), ongoing drainage, and pain. These fistulas haven't responded to medical treatments or surgical procedures, meaning they persist despite doctors' best efforts to heal them.
- 40% — You have one or two anal fistulas (abnormal tunnels or openings near your anus) that are present at the same time, and these fistulas are causing an abscess (infected pocket of pus), ongoing drainage of fluid or pus, and pain. The fistulas create openings that allow waste or fluid to leak out, requiring frequent cleaning and causing discomfort during daily activities.
- 20% — You must have two or more fistulas (abnormal tunnels or openings) around your anus at the same time that are actively draining fluid and causing you pain. However, you cannot have any abscesses (infected pockets of pus) present to qualify for this rating level.
- 10% — You have one abnormal tunnel-like connection (fistula) around your anus that constantly drains fluid or pus and causes you pain. However, you don't currently have a collection of infected fluid (abscess) in that area.