What is the Pelvic Floor Dysfunction VA Rating?

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Pelvic Floor Dysfunction (PFD) can have a profound impact on a veteran’s quality of life, affecting their ability to perform essential daily activities, maintain employment, and preserve overall health.

Veterans who have experienced military-related trauma, sustained injuries, or endured prolonged physical strain may develop PFD as a direct result of their service.

While the VA does not assign a specific diagnostic code (DC) solely for pelvic floor dysfunction, it does recognize and rate the underlying conditions that cause or result from PFD under several diagnostic codes.

These conditions often include urinary incontinence, chronic pelvic pain, and digestive issues, among others.

To receive VA compensation for PFD, it’s critical to establish service-connection—this means proving that your pelvic floor dysfunction is directly linked to a service-related injury, illness, or condition, or that it developed as a secondary condition to an existing service-connected disability.

Once this connection is established, the VA evaluates your condition based on the severity of your symptoms and how they negatively impact your daily life, work, and social interactions.

In this article, we’ll provide an in-depth overview of pelvic floor dysfunction, explore the symptoms and risk factors veterans face, and outline how the VA rates this condition.

Additionally, we’ll cover common secondary conditions associated with PFD to help ensure you are fully informed when navigating the VA claims process.

Let’s begin!

Summary of Key Points

• Pelvic Floor Dysfunction (PFD) Impact: PFD can significantly affect a veteran’s quality of life, limiting daily activities, ability to work, and overall well-being.

• Service-Related Causes: Veterans who have experienced military trauma, sustained injuries, or prolonged physical exertion during service may develop PFD as a result of their military experience.

• VA Ratings for PFD: Although the VA does not have a specific diagnostic code for PFD, it recognizes and rates related conditions like urinary incontinence, chronic pelvic pain, and digestive issues under several diagnostic codes.

• Establishing Service Connection: To receive VA compensation, veterans must establish that their PFD is linked to a service-related injury or developed as a secondary condition to an already service-connected disability.

What is Pelvic Floor Dysfunction?

Pelvic Floor Dysfunction (PFD) occurs when the muscles in the pelvic region cannot coordinate correctly, causing issues like urinary incontinence, constipation, and chronic pelvic pain.

This dysfunction can be due to weakened or overactive muscles, injury, or trauma to the pelvic region.

Veterans may develop PFD from service-related factors like prolonged physical strain, combat injuries, or surgeries.

Symptoms of Pelvic Floor Dysfunction in Veterans

Veterans with Pelvic Floor Dysfunction (PFD) may face a variety of symptoms that can significantly affect their physical and emotional well-being.

These symptoms often stem from the dysfunction of muscles in the pelvic region, impacting multiple bodily systems.

Here’s a detailed breakdown of the common symptoms:

Urinary Issues

Veterans may experience bladder control problems, including:

• Urinary incontinence: This can involve stress incontinence (leakage when coughing, sneezing, or lifting) or urge incontinence (a sudden and uncontrollable need to urinate).

• Frequent urination: The urge to urinate more often than normal, including during the night.

• Difficulty with urination: Struggling to start or stop urination, or feeling as though the bladder is not fully emptying.

Chronic Pelvic Pain

Persistent pain or discomfort in the lower abdomen, pelvic region, hips, or genitals is common in veterans with PFD.

This pain can range from dull aches to sharp, intense discomfort and may worsen with movement, sitting for long periods, or physical exertion.

Bowel Issues

Pelvic floor dysfunction can also affect bowel function, leading to:

• Constipation: Difficulty passing stool, often needing to strain, or having infrequent bowel movements.

• Painful bowel movements: Experiencing discomfort or pain during bowel movements due to muscle tension.

• Incomplete emptying: A feeling that the bowels are not fully emptied, leading to frequent attempts to pass stool.

Sexual Dysfunction

Veterans may encounter sexual health problems, including:

• Pain during intercourse: In women, this may manifest as pain or discomfort during penetration, while in men, pelvic pain or muscle tension can interfere with sexual activity.

• Erectile dysfunction: Men with PFD may have difficulty achieving or maintaining an erection due to muscle or nerve-related issues in the pelvic region.

Musculoskeletal Pain

Pelvic floor dysfunction can cause pain that radiates to other parts of the body, including:

• Lower back pain: Tight or weakened pelvic muscles can lead to chronic lower back pain.

• Hip and thigh pain: Muscle tension in the pelvic area can cause pain in the hips or thighs, especially during movement or exercise.

These symptoms can severely impact a veteran’s daily life, including their physical activities, emotional health, and quality of life.

Veterans experiencing these symptoms should seek medical evaluation to properly diagnose and manage PFD, particularly if related to service-related injuries or trauma.

Early intervention can help manage symptoms and improve overall functioning.

Risk Factors for Pelvic Floor Dysfunction in Military Veterans

Risk factors specific to veterans include:

• Combat Injuries: Trauma to the pelvic region can lead to muscle dysfunction.

• Prolonged Physical Exertion: Repeated heavy lifting, long marches, or physically strenuous activities during service.

• Military Sexual Trauma (MST): Survivors of MST are at an increased risk of developing pelvic floor issues.

• Surgeries: Veterans who underwent surgeries, such as for hernias, may develop pelvic floor dysfunction as a post-surgical complication.

• Post-Traumatic Stress Disorder (PTSD): Emotional trauma can exacerbate muscle tension, leading to PFD symptoms.

Pelvic Floor Dysfunction (PFD) vs Pelvic Pain

Although Pelvic Floor Dysfunction (PFD) and pelvic pain are related conditions, they differ in terms of cause, symptoms, and treatments.

• Causes: PFD is caused by issues with the pelvic floor muscles, leading to functional problems with urination, bowel movements, and sexual function. Pelvic pain, however, can stem from a broader range of causes, such as organ-related issues, infections, or nerve irritation.

• Symptoms: PFD’s hallmark symptoms are related to muscle coordination issues—leading to urinary or bowel dysfunction and pelvic discomfort. Pelvic pain, on the other hand, is more of a broad symptom that can manifest due to various underlying conditions, with pain being the central issue.

• Diagnosis and Treatment: PFD often requires specialized physical therapy focused on retraining pelvic muscles, whereas pelvic pain may require diagnostic tests to identify the cause before developing a treatment plan, which could include surgery, medication, or lifestyle changes.

Is There a Pelvic Floor Dysfunction VA Rating?

The VA does not have a specific diagnostic code (DC) for Pelvic Floor Dysfunction itself.

However, the symptoms of PFD—such as urinary incontinence, chronic pelvic pain, or constipation—can be rated under various 38 CFR, Part 4, the Schedule for Rating Disabilities diagnostic codes related to the genitourinary system or musculoskeletal system.

It’s common for Pelvic Floor Dysfunction and Pelvic Pain to be rated under either voiding dysfunction, with ratings ranging from 20% to 60% with a break at 40%, or urinary frequency, with ratings ranging from 10% to 40% with a break at 20%.

Here are some relevant diagnostic codes, their ratings, and criteria:

DC 7527: Prostate Gland Conditions (Chronic Prostatitis or Chronic Pelvic Pain Syndrome – CPPS)

For conditions such as chronic prostatitis or chronic pelvic pain syndrome, rated under voiding dysfunction as follows:

• 60% Rating: Requiring the use of an appliance or the wearing of absorbent materials which must be changed more than 4 times per day

• 40% Rating: Requiring the wearing of absorbent materials which must be changed 2 to 4 times per day         

• 20% Rating: Requiring the wearing of absorbent materials which must be changed less than 2 times per day            

DC 7512: Chronic cystitis (interstitial cystitis) may cause urinary dysfunction, and ratings can be based on voiding dysfunction or urinary frequency

Voiding dysfunction is rated from 20% to 60% with a break at 40% while urinary frequency is rated from 10% to 40% with a break at 20%.

Urinary frequency VA ratings:           

• 40% Rating: Daytime voiding interval less than one hour, or; awakening to void five or more times per night

• 20% Rating: Daytime voiding interval between one and two hours, or; awakening to void three to four times per night             

• 10% Rating: Daytime voiding interval between two and three hours, or; awakening to void two times per night

DC 7629: For endometriosis (in women), which can cause chronic pelvic pain, urinary symptoms, and bowel dysfunction

• 50% Rating: Lesions involving bowel or bladder confirmed by laparoscopy, pelvic pain or heavy or irregular bleeding not controlled by treatment, and bowel or bladder symptoms

• 30% Rating: Pelvic pain or heavy or irregular bleeding not controlled by treatment

• 10% Rating: Pelvic pain or heavy or irregular bleeding requiring continuous treatment for control

Note: Diagnosis of endometriosis must be substantiated by laparoscopy.

List of VA Secondary Conditions Linked to Pelvic Floor Dysfunction

Pelvic floor dysfunction (PFD) often contributes to several secondary conditions, particularly due to its impact on physical and emotional well-being.

Here’s a list of VA-recognized secondary conditions that may arise from or be aggravated by pelvic floor dysfunction:

• Depression and Anxiety: Chronic pain, disruption of daily life, and physical limitations caused by PFD can lead to mental health disorders such as depression and anxiety. The emotional toll of living with chronic pain and discomfort can exacerbate or trigger these conditions.

• Urinary Incontinence: PFD often leads to bladder control problems, resulting in stress incontinence (leakage with pressure on the bladder) or urge incontinence (sudden, strong urges to urinate). This is common in both men and women with pelvic floor dysfunction​.

• Chronic Fatigue: Persistent discomfort, sleep disturbances, and the physical strain of managing PFD symptoms can lead to chronic fatigue, impacting a veteran’s ability to perform daily activities​.

• Sexual Dysfunction: PFD can lead to pain during intercourse (dyspareunia) for women and erectile dysfunction (ED) for men. The condition may cause a lack of sexual function or reduced sexual satisfaction due to pain, weakness, or muscle tension​.

• Bowel Disorders: PFD is closely linked to bowel dysfunction, including irritable bowel syndrome (IBS), constipation, and painful bowel movements. The inability to relax pelvic floor muscles can make it difficult to pass stool, leading to chronic digestive issues.

• Lower Back Pain: Pelvic floor dysfunction can result in or worsen chronic lower back pain. Muscle tension in the pelvic floor often affects the surrounding muscles and nerves, leading to pain that radiates to the lower back​.

• Sciatica or Hip Pain: PFD can contribute to nerve impingement, leading to sciatic nerve pain or hip pain. The dysfunction of pelvic muscles may lead to nerve irritation, causing shooting pains down the leg or pain in the hip area.

• Sleep Disorders: Veterans with pelvic floor dysfunction may experience interrupted sleep due to pain or frequent need to urinate. Sleep disturbances, such as insomnia, can result from discomfort, bladder control issues, or psychological distress caused by PFD.

• Mobility Issues: Chronic pelvic pain and muscle dysfunction can limit a veteran’s ability to walk, sit for long periods, or perform physical tasks, leading to mobility impairments. Physical limitations often increase over time if the condition is left untreated.

• Prostatitis in Men: Chronic pelvic pain syndrome (CPPS) in men often includes symptoms of prostatitis (inflammation of the prostate), which can cause pelvic pain, urinary issues, and sexual dysfunction.

• Fibromyalgia: PFD can trigger or exacerbate widespread musculoskeletal pain seen in fibromyalgia. The chronic pain and discomfort in the pelvic region may spread to other parts of the body, worsening overall pain levels.

• Post-Traumatic Stress Disorder (PTSD): Veterans with PTSD may be more prone to developing chronic pain conditions, including pelvic floor dysfunction. Emotional trauma and high stress levels can manifest physically as muscle tension, including in the pelvic region, worsening symptoms of PFD.

• Chronic Pain Syndrome: Over time, untreated PFD can evolve into a generalized chronic pain syndrome where the nervous system becomes hypersensitive, amplifying the pain experienced in the pelvic floor area and potentially throughout the body.

• Recurrent Urinary Tract Infections (UTIs): Due to bladder dysfunction and improper voiding caused by PFD, veterans may experience recurrent UTIs. This can result from incomplete bladder emptying and frequent urinary retention.

Conclusion & Wrap-Up

Pelvic Floor Dysfunction (PFD) is no small matter—it can drastically affect a veteran’s quality of life, from managing daily tasks to holding down a job and maintaining overall well-being.

If you’ve experienced trauma, injury, or prolonged physical stress during your military service, you could be at higher risk for developing PFD.

The good news is that even though the VA doesn’t have a specific diagnostic code for PFD, they do recognize and rate the underlying conditions that stem from it—like urinary incontinence, chronic pelvic pain, or digestive issues.

To get the VA benefits you deserve for PFD, it’s crucial to establish service-connection.

That means proving your PFD is directly linked to your military service, whether from a primary injury, illness, or as a secondary condition to an already service-connected disability.

Once service-connection is established, the VA will evaluate how your condition impacts your work, life, and social functioning.

Remember, securing VA disability compensation is about knowing your rights and presenting a solid case.

Thorough documentation of your symptoms, medical treatment, and how PFD affects your life will ensure the VA rates your condition properly.

Don’t settle for less—if you’re suffering, make sure you’re getting the VA rating and compensation you deserve for serving our country!

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