Evidence Checklist: Rectal Prolapse
DC 7334
Significant gaps — claim likely to be denied or underrated
Specialist Opinion (Highest Value)
Proctologic examination documenting prolapse type, degree, and reducibilityCritical
Clinical examination documenting the type of rectal prolapse (partial/mucosal vs. complete/full-thickness), degree of protrusion during straining, reducibility, and associated symptoms (bleeding, mucus discharge, incontinence).
Defecography or MRI defecography documenting prolapse during strainingCritical
Dynamic defecography (fluoroscopic or MRI) demonstrating rectal prolapse, intussusception, or pelvic floor dysfunction during simulated defecation — provides objective confirmation and grading.
Nexus opinion linking rectal prolapse to service ("at least as likely as not")Critical
A medical opinion connecting rectal prolapse to service-related factors including chronic straining, pelvic floor trauma, difficult deliveries during service-connected conditions, or prior anorectal surgery during service.
Anorectal manometry documenting sphincter dysfunction
Manometry results showing resting anal pressure, squeeze pressure, rectal sensation thresholds, and rectoanal inhibitory reflex — documents sphincter weakness contributing to prolapse and incontinence.
Treating Physician
Fecal incontinence documentation and severity scoring
Clinical documentation of fecal incontinence severity (Wexner/Cleveland Clinic Incontinence Score or Fecal Incontinence Severity Index), including frequency of episodes and social impact.
Treatment Records
Surgical records (rectopexy, Delorme procedure, Altemeier perineal rectosigmoidectomy)
Operative reports documenting surgical repair procedure type, approach (perineal vs. abdominal), recurrence after repair, and post-operative continence outcomes.
Lay Statements & Personal Documentation
Buddy statement from spouse, family, or fellow service member
A written statement from someone who can describe observable symptoms and how your condition affects daily life.
Personal statement describing symptoms and functional impact
Your own written account of how this condition affects your daily activities, work, and relationships. Describe your worst days.
Disability Benefits Questionnaire (DBQ)
Completed DBQ Rectum and Anus ConditionsCritical
Standardized form capturing prolapse type and grade, incontinence severity, surgical history, and functional limitations.
Service Records
Service treatment records (STRs)Critical
Military medical records showing in-service treatment, complaints, or injuries related to this condition.