Rectum and anus, impairment of sphincter control — VA Rating Criteria (38 CFR DC 7332)

The VA rates Rectum and anus, impairment of sphincter control under Diagnostic Code 7332 at the following tiers: 0%, 10%, 30%, 60%, 100%. The minimum 0% rating requires: History of loss of sphincter control, currently asymptomatic. The maximum 100% rating requires: Complete loss of sphincter control characterized by incontinence or retention that is not responsive to a physician-prescribed bowel program and requires either surgery or digital stimulation, medication (beyond laxative use), and special diet; or incontinence to solids and/or liquids two or more times per day, which requires changing a pad two or more times per day.

Diagnostic Code 7332 is the VA rating identifier for Rectum and anus, impairment of sphincter control within 38 CFR 38 CFR § 4.114. It defines the specific symptom criteria and percentage thresholds a VA adjudicator uses to assign a disability rating. The diagnostic code is listed on a veteran's rating decision letter.

The highest schedular rating for Rectum and anus, impairment of sphincter control under DC 7332 is 100%. This tier requires: Complete loss of sphincter control characterized by incontinence or retention that is not responsive to a physician-prescribed bowel program and requires either surgery or digital stimulation, medication (beyond laxative use), and special diet; or incontinence to solids and/or liquids two or more times per day, which requires changing a pad two or more times per day. Veterans who cannot secure substantially gainful employment due to Rectum and anus, impairment of sphincter control alone or in combination with other service-connected conditions may also qualify for TDIU at the 100% compensation rate under 38 CFR § 4.16.

Rectum and anus, impairment of sphincter control is rated under 38 CFR 38 CFR § 4.114, Diagnostic Code 7332. This section is part of the Schedule for Rating Disabilities (38 CFR Part 4) and can be read in full at the eCFR website.

Secondary conditions caused or aggravated by Rectum and anus, impairment of sphincter control may be ratable under 38 CFR § 3.310. Veterans should work with a VSO or accredited claims agent to document the medical relationship.

Service connection for Rectum and anus, impairment of sphincter control requires three elements: (1) a current diagnosis of the condition, (2) an in-service event, injury, or disease that may have caused or aggravated it, and (3) a medical nexus connecting the current diagnosis to that in-service event. A nexus letter from a treating physician or independent medical examiner is the most reliable nexus evidence. C&P exam findings can also establish nexus if adequately documented.