An abnormal tunnel between the anal canal and skin, or a pus-filled infection near the anus or rectum.
Medical records that document the number of fistulas active at the same time are central to this rating. Operative reports, colonoscopy or imaging findings, and clinic notes that record whether an abscess was identified alongside the fistula directly speak to the difference between the 10% and 20% levels and the 40% level. Records showing drainage and pain at each visit help establish those criteria are consistently met.
For the 60% level, records showing that the fistulas are constant or near-constant are important, as are treatment notes from multiple providers or facilities reflecting that both medical management and surgical procedures have been attempted without lasting success. Surgical reports, records of repeated procedures, and notes from specialists documenting treatment failure all speak to refractoriness.
Statements from you or people who know you describing ongoing drainage, pain, and how those symptoms affect your daily activities and work can help fill gaps between medical appointments. These statements are most useful when they tie directly to the specific symptoms — number of active fistulas, presence of drainage and pain, and how often flares occur.
Conditions that are often caused or made worse by this one. If you have any of these, they may be claimable as secondary service connection.
