RECTUM AND ANUS IMPAIRMENT OF SPHINCTER CONTROL

Summary

The Veteran, who served from September 1977 to September 1981 and again from December 1981 to September 1995, appeals the November 2023 decision regarding her service-connected sphincter repair residuals. The Veteran sought an increased disability rating for these residuals, disagreeing with the 30 percent rating previously assigned. The Board reviewed the evidence under both the pre-amended and the revised rating criteria for Diagnostic Code 7332, effective May 19, 2024, applying the criteria more favorable to the Veteran and resolving all doubt in her favor. The Board considered treatment notes from June 2023, a VA examination from November 2023, and assertions from the Veteran's representative. The Veteran reported worsening symptoms including bowel leakage and urgency, with multiple episodes of incontinence requiring pad use. The VA examiner noted the diagnosis but failed to record the severity of the impairment. Based on the evidence, the Board found the Veteran experienced incontinence of the bowels two or more times per week, requiring pad use two or more times per week. These symptoms align with the criteria for a 60 percent rating under the revised DC 7332. A 100 percent rating was not warranted as the evidence did not support complete loss of sphincter control. Therefore, the Board granted an increased rating of 60 percent for sphincter repair residuals.

Rationale

Resolving doubt in Veteran's favor; Symptoms fit criteria for 60% rating under revised DC 7332; Incontinence two or more times per week requiring pad use

Full Decision Text

Citation Nr: A26034712
Decision Date: 04/15/26	Archive Date: 04/15/26

DOCKET NO. 251211-614054
DATE: April 15, 2026

ORDER

Entitlement to an increased rating of 60 percent, but no higher, for sphincter repair residuals is granted.

FINDING OF FACT

Resolving doubt in the Veteran's favor, her sphincter repair residuals resulted in partial loss of sphincter control that is characterized by symptoms of bowel urgency and decreased sensation that results in bowel incontinence to two or more times per week, which requires wearing a pad two or more times per week.

CONCLUSION OF LAW

The criteria for an initial 60 percent rating for sphincter repair residuals are met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.3, 4.7, 4.114, Diagnostic Code (DC) 7332.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty from September 1977 through September 1981 and from December 1981 through September 1995.

In August 2024, the Veteran submitted a VA Form 20-0996, Decision Review Request: Higher-Level Review (HLR), and requested review of a November 2023 decision. 

In December 2024, the agency of original jurisdiction (AOJ) issued the HLR decision on appeal, which considered the evidence of record at the time of the prior November 2023 rating decision. 

In a December 2025 VA Form 10182, Decision Review Request: Board Appeal, the Veteran elected the Direct Review docket. Therefore, the Board may only consider the evidence of record at the time of the November 2023 AOJ rating decision, which was subsequently subject to higher-level review. 38 C.F.R. § 20.301. If evidence was submitted during the period after the AOJ issued the decision, which was subsequently subject to higher-level review the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.301, 20.801. 

1. Entitlement to an increased rating of 60 percent, but no higher, for sphincter repair residuals is granted.

During the period on appeal, the Veteran was assigned a 30 percent rating for her service-connected sphincter repair residuals. She disagrees with the rating assigned.

Disability ratings are determined by the application of VA's Schedule for Rating Disabilities, which is based on average impairment of earning capacity. 38 U.S.C. § 1155; 38 C.F.R. Part 4. VA must evaluate all the evidence so that its decisions are equitable and just. 38 C.F.R. § 4.6. Where there is a question as to which of two evaluations shall be applied, a higher rating will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. Any reasonable doubt remaining is resolved in favor of the Veteran. 38 C.F.R. § 4.3.

VA recently amended the rating criteria for the digestive system, including the DC 7332 under which the Veteran's disability is rated, effective May 19, 2024. See Schedule for Rating Disabilities: The Digestive System, 89 Fed. Reg. 19,735 (March 20, 2024) (codified at 38 C.F.R. § 4.114). That means the Board must consider the Veteran's claim under both the old and new rating criteria for the period from May 19, 2024, and apply the criteria more favorable to the Veteran. 38 U.S.C. § 5110(g); Kuzma v. Principi, 341 F.3d 1327 (Fed. Cir. 2003). Resolving all doubt in favor of the Veteran, both the pre-amended version and the revised version of DC 7332 are favorable to the Veteran and will be applied here. Thus, the Board will discuss the revised criteria.

The amended criteria (effective from May 19, 2024) for DC 7332 provide a noncompensable rating for history of loss of sphincter control, currently asymptomatic; a 10 percent rating for complete or partial loss of sphincter control characterized by incontinence or retention that is fully responsive to a physician-prescribed bowel program and requires medication or special diet; or incontinence to solids and/or liquids at least once every six months, which requires wearing a pad at least once every six months; a 30 percent rating for
 both the pre-amended version and the revised version of DC 7332 are favorable to the Veteran and will be applied here. Thus, the Board will discuss the revised criteria.

The amended criteria (effective from May 19, 2024) for DC 7332 provide a noncompensable rating for history of loss of sphincter control, currently asymptomatic; a 10 percent rating for complete or partial loss of sphincter control characterized by incontinence or retention that is fully responsive to a physician-prescribed bowel program and requires medication or special diet; or incontinence to solids and/or liquids at least once every six months, which requires wearing a pad at least once every six months; a 30 percent rating for complete or partial loss of sphincter control characterized by incontinence or retention that is fully responsive to a physician-prescribed bowel program and requires digital stimulation, medication (beyond laxative use), and special diet; or incontinence to solids and/or liquids two or more times per month, which requires wearing a pad two or more times per month; a 60 percent rating for complete or partial loss of sphincter control characterized by incontinence or retention that is partially 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 week, which requires wearing a pad two or more times per week; and a 100 percent rating for 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. 38 C.F.R. § 4.114 (2024).

"Incontinence" is defined as an inability of the body to control the evacuative functions of urination or defecation: partial or complete loss of bladder or bowel control. See MERRIAM WEBSTER'S COLLEGIATE DICTIONARY (11th ed.).

Turning now to the evidence, in June 2023, treatment notes document the Veteran's report that she had experienced a couple of fecal incontinence episodes in the last six months. In November 2023, the Veteran underwent a VA examination for sphincter repair residuals. She reported that her symptoms had worsened and had current symptoms of bowel leakage and decreased sensation in that area with urgency of bowels. She explained that she had more episodes of incontinence of the bowels and wore incontinence pads for leakage. She also endorsed multiple accidents throughout the period on appeal due to bowel urgency. The examiner noted a diagnosis of status-post sphincter repair. However, the November 2023 VA examiner failed to record severity of the Veteran's sphinicter impairement residuals within the examination report. With the December 2025 10182, the Veteran's representative asserted that the Veteran had extensive leakage and fairly frequent involuntary bowel movements during the period on appeal.

Based on this evidence, the Board will resolve doubt in the Veteran's favor and find that her sphincter impairment residuals caused incontinence of the bowels two or more times per week, which requires wearing a pad two or more times per week. 

These symptoms fit squarely within the criteria for a 60 percent rating under the revised DC 7332.  See 38 CFR § 4.114, DC 7332. A 100 percent rating is not warranted because the evidence does not show, and the Veteran does not report, that she has or has had complete loss of sphincter control.

Thus, a 60 percent disability rating, but no higher, is warranted for the Veteran's sphincter repair residuals for the period on appeal.

 

 

J. NICHOLS

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	N.B. Mmeje, Counsel

The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.