Because of the functions controlled by the pelvic floor muscles, veterans with pelvic floor dysfunction experience its effects on a continuous or nearly continuous basis. For veterans with this condition, obtaining pelvic floor dysfunction VA disability benefits can be critical to compensate them for their lost earning potential.
Pelvic floor dysfunction is a dysfunction of pelvic floor muscles necessary for proper bowel movements, urination, and sex. This condition can be caused by damage to muscles or nerves. Although women are more likely than men to suffer pelvic floor dysfunction, this condition can affect both men and women.
In this article about VA ratings for pelvic floor dysfunction:
- How Does the VA Assign the Disability Rating for Pelvic Floor Dysfunction?
- Ratable Symptoms Common in Pelvic Floor Dysfunction
- Residuals Ratings Used for Pelvic Floor Dysfunction VA Disability Ratings
- Pelvic Floor Dysfunction VA Disability Rating Calculation Example
- How Can Pelvic Floor Dysfunction Be Service Connected?
- How to Receive the Highest Possible Pelvic Floor Dysfunction VA Disability Rating
- Additional Benefits for Pelvic Floor Dysfunction VA Disability Rating
How Does the VA Assign the Disability Rating for Pelvic Floor Dysfunction?
The VA uses ratings schedules to determine the ratings for VA disability benefits. For most conditions and disabilities, the rating schedule lists groups of symptoms and rates them according to their severity. For example, a condition with moderate severity is assigned a rating of 10%, while the same condition with considerable severity is assigned a rating of 30%, and substantial severity is assigned a rating of 50%.
There is no pelvic floor dysfunction VA disability rating schedule. In other words, there is no schedule that the VA can look at when reviewing your symptoms to determine what your VA disability rating should be.
Instead, when arriving at a pelvic floor dysfunction VA disability rating, the VA rates the individual symptoms (called residuals) and aggregates them using VA math.
Ratable Symptoms Common in Pelvic Floor Dysfunction
The pelvic floor muscles help the body control many functions in the pelvic region. As a result, pelvic floor dysfunction can manifest differently depending on the individual veteran. Physicians will frequently use health questionnaires to identify the occurrence and severity of pelvic floor outcome measures the patient experiences.
The two most common forms are referred to as the pelvic floor disability index or pelvic floor distress inventory (PFDI-20) and the pelvic floor impact questionnaire (PFIQ-7). These general questionnaires are occasionally supplemented with condition-specific questionnaires like the pelvic girdle questionnaire (to quantify pelvic girdle pain experienced by pregnant and postpartum women) and the vulvar pain questionnaire (to measure the functional limitations imposed by pelvic or vulvar pain). Some of the effects of pelvic floor dysfunction that are included in the questionnaires include:
- Bowel difficulties: Since the muscles of the abdomen and pelvis move waste through the bowels, dysfunction of the pelvic floor muscles can cause constipation. In fact, pelvic floor dysfunction is responsible for as many as 50% of cases of chronic constipation.
- Bladder problems: Trouble controlling the pelvic floor muscles can lead to both a feeling of urgency to urinate, frequent urination, and leakage of urine.
- Rectal dysfunction: The pelvic floor muscles also control the rectum. This causes many patients who strain during bowel movements and suffer chronic constipation to also leak stool.
- Sexual disorders: Because the pelvic region is home to the reproductive organs, pelvic floor dysfunction can result in sexual disorders like erectile dysfunction and impotence in men and pain during sex in women.
Residuals Ratings Used for Pelvic Floor Dysfunction VA Disability Ratings
To arrive at a pelvic floor dysfunction VA disability rating, each symptom is rated based on its severity and the individual ratings are aggregated using VA math. For example:
- Constipation: The VA regulations do not contain a rating schedule specifically for constipation. However, constipation is included as a symptom in the VA rating schedules for both amebiasis and irritable colon syndrome. Both provide a 10% disability rating for chronic constipation with frequent gastric distress. If constipation alternates with diarrhea and the gastric distress is nearly constant, a 30% disability rating may be assigned.
- Bladder voiding: A rating can be assigned based on only one of leakage, urgency, or incomplete voiding. However, under the VA’s rules, a veteran who experiences more than one of these symptoms will receive the highest rating. For example, if the veteran does not experience leakage but qualifies for a 40% rating due to urgency and a 10% rating due to incomplete voiding, the voiding dysfunction disability rating is bumped to 40%.
- Rectum control: The VA assigns a rating for rectum control based on the frequency of stool leakage. Ratings of 10%, 30%, and 60% are assigned for moderate, occasional, or frequent involuntary bowel movements, respectively. A 100% disability rating is assigned for complete loss of sphincter control.
- Pelvic pain: Veterans who experience pelvic pain would likely receive a rating using the VA rating schedule for endometriosis. Pelvic pain that requires continuous treatment is rated at 10% while pelvic pain that cannot be controlled despite continuous treatment is rated at 30%.
Pelvic Floor Dysfunction VA Disability Rating Calculation Example
Suppose a veteran’s pelvic floor dysfunction causes chronic constipation with frequent pain, urgency to urinate five times per night, moderate stool leakage, and pelvic pain that can be controlled with continuous treatment with drugs or radiofrequency ablation (RFA). The VA would rate the constipation at 10%, the urgency at 40%, the rectum control at 10%, and the pelvic pain at 10%.
Rather than adding the ratings using arithmetic, the VA uses a whole-body disability formula. We discuss VA Math in other articles, so we will not go into details here. Instead, we will use this free VA disability calculator to aggregate these residuals ratings and calculate an overall pelvic floor dysfunction VA rating of 60% for these four conditions.
Here is a video explaining how the VA combined ratings table works from one of our Veterans Disability Lawyers.
How Can Pelvic Floor Dysfunction Be Service Connected?
VA disability claims must include facts to establish a service connection. That is, your disability must have manifested during, or been caused or worsened by, your military service.
Manifested During Service
If pelvic floor dysfunction manifested during your service, it is service connected. This service connection exists even if military doctors only diagnosed (or misdiagnosed) the symptoms without attributing it to pelvic floor dysfunction.
For example, in one case, a veteran was examined during basic training for pelvic pain. The pelvic pain was attributed to a urinary tract infection and a strained bladder. After discharge, the veteran’s family doctor reviewed years of medical records both during and after service.
The doctor rendered an opinion that the original diagnosis was incomplete and that the veteran’s pelvic pain, bloody urine, and bladder problems were due to permanent damage to the pelvic floor muscles incurred during basic training. Based on this medical opinion, the VA awarded a service connection to the veteran’s case of pelvic floor dysfunction.
If Your Disability Manifested After Discharge
If a veteran cannot show that pelvic floor dysfunction manifested during service, it is still possible to establish a service connection by showing that the condition was caused by the veteran’s service.
Pelvic floor dysfunction can be caused by physical injury to the pelvic floor muscles or the nerves that control them. Veterans who suffered a pelvic injury or had pelvic surgery during their service might be able to connect that event to their later case of pelvic floor dysfunction.
Similarly, if a minor case of pelvic floor dysfunction manifested prior to joining the service, but worsened during service, veterans might be able to establish a service connection by showing that their service worsened the condition. This would likely require the veteran to identify a specific cause, such as a training accident or combat injury that damaged pelvic muscles or nerves, since the VA will not pay disability benefits that represent a natural progression of a condition.
Secondary Service-Connection for Pelvic Floor Dysfunction
When a primary service-connected disability causes pelvic floor dysfunction, the pelvic floor dysfunction is entitled to a service connection. This secondary service connection is assigned if the cause is the primary disability or treatment of the primary disability.
For example, if you have a primary service-connected bowel condition and required surgery to treat it, a case of pelvic floor dysfunction caused by the surgery would be entitled to a secondary service connection. Similarly, if a primary service-connected hip disability strained your pelvic floor muscles getting into and out of a wheelchair, the pelvic floor dysfunction caused by the muscle strain would be entitled to a secondary service connection.
How to Receive the Highest Possible Pelvic Floor Dysfunction VA Disability Rating
To maximize your pelvic floor dysfunction VA disability benefits, you should make sure your medical records document every symptom that can reasonably be tied to your condition.
For example, if you have a hernia or other prolapse, make sure your doctor documents that prolapse so you can include it in your VA disability claim. Similarly, if you suffer from pelvic pain, have your physician document the severity and frequency of the pain.
Under the revisions to the VA’s Compensation and Pension Manual, particularly the Deciding Claims for Disability Compensation section triggered by a court case in 2018, the VA can award disability benefits for chronic pain, even if the cause is unknown. Thus, pelvic pain by itself, even in the absence of other symptoms that might indicate pelvic floor dysfunction, is sufficient to support a VA disability claim.
In fact, this is exactly what occurred in one case. The veteran complained of chronic pelvic pain, but medical examinations could not pinpoint the cause of the pain. The veteran was prescribed leuprorelin, a hormone therapy drug, and ibuprofen, an anti-inflammatory drug, which controlled the pain. The VA found that the chronic pelvic pain was ratable by analogy to endometriosis even though the cause was unknown. Since the pain was controlled with drug therapy, the VA assigned a disability rating of 10%.
Moreover, make sure you include any conditions reasonably caused by your pelvic floor dysfunction. For example, if treatment of your pelvic floor dysfunction with anti-inflammatories causes gastroesophageal reflux disease (GERD), make sure you include that in your VA disability claim. Likewise, if the bladder problems caused by pelvic floor dysfunction leads to a sleep disorder due to the urgency to urinate felt at night, you can include a sleep disorder as secondary to the pelvic floor dysfunction.
It may be difficult to get 100% TDIU from one disability, but here one of our VA disability lawyers talks about common disabilities that add up to a 100% combined rating.
Additional Benefits for Pelvic Floor Dysfunction VA Disability Rating
Special monthly compensation (SMC) is paid to disabled veterans for the physical or functional loss of body parts or organs. If pelvic floor dysfunction has caused sexual disorders that have effectively deprived you of the use of your reproductive organs, you can claim SMC along with your disability benefits.
For example, pelvic floor dysfunction is known to cause erectile dysfunction in men and severe pain during sex in women. If these conditions are not treatable that you have effectively lost the function of your reproductive organs, you can claim entitlement to SMC.
Even if your symptoms aren’t enough to warrant more than a 0% rating, you can still get SMC. Since SMC is based on loss of use rather than the symptoms, you can still have a 0% rating but get a monthly check for the SMC purposes. That 0% rating is helpful too, because then in 5 years you can apply for an increased rating rather than start proving your nexus and application all over again.
Hiring a VA Lawyer to Help Obtain Pelvic Floor Dysfunction VA Disability Benefits
For a condition like pelvic floor dysfunction, hiring a lawyer might reduce the risk that your VA disability claim will be rejected. VA lawyers are familiar with the types of evidence that the VA accepts to establish a service connection and can help you identify all the symptoms that can be claimed to increase your rating.
Schedule a free consultation with a VA attorney online or call (866)232-5777 to discuss your pelvic floor dysfunction VA disability claim. We can assist you regardless of where you are currently located and whether you were deployed.
Yes. The VA understands that it could have been limiting or embarrassing to fully report these symptoms during active duty. If you have records of symptoms while you served, the diagnosis can be made by a doctor years after you are discharged.
Yes. We have a staff of over 90 people that can help you with your case. We also have women and doctors on staff that are doctors and one of our owners is a woman. Our staff will keep your case private as we care for your claim from start to finish!