Hemorrhoids VA Rating

Hemorrhoids are common, they come and go, and they are routinely claimed. Reported risk factors include constipation and sedentary behavior (Lohsiriwat and colleagues, Advances in Therapy, 2023, PMID 36331754), and both can come with military life. They are also capped at a 20 percent schedular maximum, and since May 19, 2024, the rating turns on criteria that differ from the ones many Board decisions on hemorrhoids applied.

Across 2,905 decided Board rulings on hemorrhoids from 2021 to 2026, 18.8% were granted, 40.0% denied and 41.2% remanded. A ruling is one issue the Board decided in one decision; one decision often rules on several issues. The grant rate sits 5.9 points below the Board-wide 24.7%, and the denial rate sits 10.0 points above the Board-wide 30.0%. Remand is still the most common outcome, but only just. The denials come from two directions: service connection claims that lacked a link to service, an in-service event or a current diagnosis, and rating appeals where the record did not meet the schedular criteria. Rating appeals fared worse than service connection appeals; the Board section below shows both.

Under the old criteria, 10 percent required hemorrhoids that were large or thrombotic, irreducible, with excessive redundant tissue, evidencing frequent recurrences. Many Board decisions accepted the diagnosis and then held the rating at 0 percent because one of those elements was missing.

This page covers the current DC 7336 criteria, what changed in May 2024, which criteria apply to a pending claim, how to prove service connection, and why VA denies hemorrhoid claims.

TL;DR

• Across 2,905 decided Board rulings on hemorrhoids from 2021 to 2026, 18.8% were granted, 40.0% denied and 41.2% remanded. The denial rate is 10.0 points above the Board-wide 30.0%.
• Hemorrhoids are rated under 38 CFR § 4.114 DC 7336 with two tiers: 10% and 20%. There is no higher schedular tier, and when neither tier is met, VA assigns 0% under § 4.31.
• The criteria changed on 2024-05-19 (89 FR 19735). The current 10 percent tier is prolapsed internal hemorrhoids with two or fewer thrombosis episodes per year, or external hemorrhoids with three or more. The current 20 percent tier is persistent bleeding with anemia, or continuously prolapsed internal hemorrhoids with three or more thrombosis episodes per year.
• The old "mild or moderate, 0" row and the fissure route to 20 percent are gone. A 0 percent rating still exists through § 4.31, which VA confirmed in the final rule.
• For a claim pending across the change, VA applies the old criteria before May 19, 2024, and from that date uses whichever set is more favorable to you.
• Rating appeals fared worse than service connection appeals, and many of them applied the old criteria, where the 10 percent tier required four qualitative elements at once. The current episode-count standard is easier to document with dated records.
• No presumptive list names hemorrhoids. Secondary claims (hemorrhoids secondary to constipation from service-connected IBS, chronic pain medications, or other GI conditions) did about as well as direct claims, and claims that raised a presumption did worst. The Board section below shows all three, and how claims went by medical opinion.
• Claim Raven's read does not record which tier the Board assigned, so this page does not report a rating distribution. Rulings decided under the old ladder are not a forecast under the current rule.

Hemorrhoids VA rating criteria under DC 7336

Hemorrhoids are rated under DC 7336 in the digestive system chapter at 38 CFR § 4.114. VA rewrote that chapter in a final rule published March 20, 2024 (89 FR 19735), effective May 19, 2024, and DC 7336 was one of the codes that changed substantially. Here is the current ladder in full.

Internal or external hemorrhoids with persistent bleeding and anemia; or continuously prolapsed internal hemorrhoids with three or more episodes per year of thrombosis, 20%

Prolapsed internal hemorrhoids with two or less episodes per year of thrombosis; or external hemorrhoids with three or more episodes per year of thrombosis, 10%

That is the entire ladder: two tiers, with 20 percent as the schedular maximum. Below them, 38 CFR § 4.31 says "a zero percent evaluation shall be assigned when the requirements for a compensable evaluation are not met," and VA's response to comments in the final rule says it can still assign 0 percent for hemorrhoids (89 FR 19739). A diagnosis of hemorrhoids alone does not reach 10 percent.

The current structure splits on two axes: whether the hemorrhoids are internal and prolapsed or external, and how many thrombosis episodes occurred in the year.

Two practical consequences follow. First, the episode count is now the number to document. Each thrombosed hemorrhoid should appear in the record with a date. Three dated episodes in twelve months is the difference between 10 and 20 percent for a veteran with continuously prolapsed internal hemorrhoids. Second, anemia is still a route to 20 percent, but a rare one. A Mayo Clinic review counted anemia caused by hemorrhoid bleeding in about 0.5 people per 100,000 a year and advised ruling out other causes of anemia first (Kluiber and Wolff, Diseases of the Colon and Rectum, 1994, PMID 7924705). The C&P questionnaire asks for at least a hemoglobin or hematocrit value whenever anemia is checked, so a blood count taken during a period of persistent bleeding is the lab that matters for this route.

What changed in May 2024

Three things changed.

The 0 percent row left the code, not the practice. The old schedule had a "mild or moderate, 0" rung. VA removed that wording as "unquantifiable and nonspecific," but § 4.31 still produces 0 percent when the 10 percent criteria are not met. The change is not a guaranteed 10 percent.

Fissures left the 20 percent tier. The old 20 percent read "with persistent bleeding and with secondary anemia, or with fissures." Anal fissures no longer appear anywhere in DC 7336. If you were counting on a documented fissure to reach 20 percent, that route is closed for any period from May 19, 2024. In its place is a second route: continuously prolapsed internal hemorrhoids with three or more thrombosis episodes in a year.

The adjectives were replaced with counts. The old 10 percent tier required hemorrhoids that were "large or thrombotic, irreducible, with excessive redundant tissue, evidencing frequent recurrences," four qualitative elements a record had to show at once. The current tiers turn on prolapse status and a countable number of thrombosis episodes per year, which ordinary treatment records can document if each episode is dated.

How much VA pays for hemorrhoids

At the 2026 rates (effective December 1, 2025) for a veteran with no dependents, 10 percent pays $180.42 a month and 20 percent pays $356.66 a month. VA pays by your combined rating, so the hemorrhoid rating adds money only when it changes the combined percentage.

Which hemorrhoids criteria apply to a pending claim

The effective date decides which version of DC 7336 applies to which part of your claim.

• If VA decided your claim before May 19, 2024, the old criteria applied to that decision.
• If your claim or appeal was pending when the rule changed, VA applies the old criteria to the period before May 19, 2024. From May 19, 2024 on, it considers both the old and the new criteria and uses whichever is more favorable to you. The new criteria cannot be applied to any period before their effective date. Board decisions on hemorrhoids cite 38 U.S.C. § 5110(g) for this rule.

The two versions reward different facts. A documented fissure fit the old 20 percent wording on its own, and large, irreducible hemorrhoids with redundant tissue fit the old 10 percent. Prolapsed internal hemorrhoids and dated thrombosis episodes fit the new. For a claim open across the change, make the record support the better of the two, and check that the decision addressed both sets.

The Board outcomes on this page largely reflect the old ladder. Claim Raven's read covers decisions from 2021 to 2026. Every decision from 2021 through mid-2024 predates the change, a later decision can still rate an earlier period under the old criteria, and the read does not record which version of DC 7336 each ruling applied or which tier the Board assigned. How far rating results shift under the current criteria, nobody can say yet.

How to prove hemorrhoids are service connected

No presumptive list names hemorrhoids, so the claim runs on direct or secondary service connection. Reported risk factors for hemorrhoidal disease include constipation, sedentary behavior, age and male sex, and the disease often recurs after treatment (PMID 36331754). Hemorrhoids are also common in pregnancy and after childbirth, where constipation and long straining are associated with them (Bužinskienė and colleagues, Frontiers in Surgery, 2022, PMID 35252326).

Direct service connection

• A current diagnosis during the claim. Hemorrhoids come and go, and the claim needs them shown at some point while it is pending (McClain v. Nicholson, 21 Vet. App. 319 (2007)). A recent treatment note or exam finding matters.

• In-service medical treatment. Service treatment records showing hemorrhoid complaints, treatment, or surgical procedures during active duty. Sick call visits, dispensary records, or hospital records establish the in-service onset.

• A nexus opinion connecting service to the hemorrhoids. The opinion needs to name the service factors in your record, such as chronic constipation or long periods of sitting documented in service, and explain how they led to the hemorrhoids or made them worse. If the hemorrhoids began during a pregnancy in service and continued, the opinion has to address that timing and continuity.

• Continuity of treatment after service. Treatment records spanning the years since service, showing chronic or recurrent hemorrhoid problems, support that the in-service condition did not resolve.

Hemorrhoids secondary to IBS, constipation or pain medication

Secondary service connection under 38 CFR § 3.310 covers hemorrhoids caused by a service-connected condition, or aggravated by it, meaning they would be less severe but for that condition. Secondary claims did about as well as direct claims at the Board, so the secondary lane is a nexus strategy, not a shortcut. It fits when your hemorrhoids developed in the context of another service-connected condition.

Chronic constipation from service-connected IBS or another GI condition. Constipation is a reported risk factor for hemorrhoidal disease, and the Board has granted hemorrhoids secondary to service-connected IBS and to a service-connected functional gastrointestinal disorder.

Opioid-induced constipation from service-connected pain conditions. Constipation is a common side effect of long-term opioid therapy for chronic pain (Rauck and colleagues, Pain Practice, 2017, PMID 26990277). The opinion can trace the medication prescribed for a service-connected condition to the constipation, and the constipation to the hemorrhoids.

For either chain, the opinion has to explain the path in your records, and for aggravation, how much worse the hemorrhoids are than they would be without the service-connected condition.

Why VA denies hemorrhoids claims

Hemorrhoid claims fail at two different points. When the Board denied service connection, the missing piece was split among a link to service, an in-service event, and a current diagnosis; the Board section below shows how often each part failed and why claims were sent back. Rating appeals fail on severity. Under the old criteria the pattern repeated: the Board accepted the diagnosis, may even have granted service connection, and then held the rating at 0 percent because the symptoms did not clear the 10 percent criteria.

The gaps that show up in these decisions are specific.

No current diagnosis. Hemorrhoids that resolved before the claim, or that no examiner or treating provider recorded during it, leave nothing to service connect.

No in-service record. Without service treatment records showing hemorrhoid complaints or treatment, the direct theory rests on the opinion alone.

A generic nexus opinion. An opinion that does not engage with the in-service factors or the secondary path in your records does not move the case.

Old-criteria elements not documented (periods before May 19, 2024). The exam noted hemorrhoids but did not say they were large or thrombotic, irreducible, with excessive redundant tissue, or frequently recurring. Under the old criteria, any one missing element kept the rating at 0 percent.

No anemia lab and no thrombosis count (current 20 percent tier). Lab results showing hemoglobin in the normal range, or no recent labs at all, preclude the anemia element. The second route to 20 percent needs continuously prolapsed internal hemorrhoids plus three or more dated thrombosis episodes in a year, and an undated record of "recurrent thrombosed hemorrhoids" does not establish the count.

No prolapse finding (current criteria). Apart from the bleeding-with-anemia route, internal hemorrhoids rate only if they prolapse, so an exam that does not say whether they prolapse, and whether continuously, leaves the tier open.

What wins is specific documentation. Records from a treating gastroenterologist or colorectal surgeon can describe the tier facts directly: internal or external, prolapsed or not, each thrombosis with a date, and a blood count during persistent bleeding. Pair that with in-service treatment records, continuity of treatment, and a medical opinion that engages with your history. The Board section below shows how claims went when the Board relied on a favorable medical opinion, an opinion against the claim, or none.

Questions veterans ask about hemorrhoids

What is the VA rating for hemorrhoids?

Under DC 7336, hemorrhoids rate 10 or 20 percent, and 0 percent when neither tier is met. 10 percent is prolapsed internal hemorrhoids with two or fewer thrombosis episodes a year, or external hemorrhoids with three or more; 20 percent is persistent bleeding with anemia, or continuously prolapsed internal hemorrhoids with three or more thrombosis episodes a year.

Can hemorrhoids still be rated 0 percent after the 2024 change?

Yes. The 0 percent row was removed from DC 7336, but 38 CFR § 4.31 assigns 0 percent whenever the compensable criteria are not met, and Board decisions since the change still assign noncompensable hemorrhoid ratings. A 0 percent rating still keeps service connection in place.

Are hemorrhoids a presumptive condition for veterans?

No. Hemorrhoids are not on any presumptive list in 38 CFR part 3. The Gulf War rule at § 3.317 covers functional gastrointestinal disorders, which by definition are unexplained by structural or other objective findings, and hemorrhoids are found on examination, so you prove them on a direct or secondary theory.

Can hemorrhoids be secondary to IBS or constipation?

Yes. Under 38 CFR § 3.310, hemorrhoids caused or made worse by a service-connected condition can be service connected, and the Board has granted hemorrhoids secondary to service-connected IBS. The opinion has to explain the path in your records, such as chronic constipation.

Did the 2024 change reduce my hemorrhoids rating?

A schedule change alone cannot reduce a rating already in effect. Under 38 CFR § 3.951(a), VA can reduce it only if medical evidence shows the condition actually improved.

What happens at a hemorrhoids C&P exam?

The examiner completes the Rectum and Anus Conditions questionnaire, which asks whether the hemorrhoids are internal or external, whether there is persistent bleeding or anemia, whether internal hemorrhoids are prolapsed, and how many thrombosis episodes occur a year. If anemia is checked, the form asks for a hemoglobin or hematocrit value, so bring recent blood work and dated records of each episode.

Bottom Line

Hemorrhoids are rated under 38 CFR § 4.114 DC 7336, which since 2024-05-19 lists two tiers. The 10 percent tier is prolapsed internal hemorrhoids with two or fewer thrombosis episodes per year, or external hemorrhoids with three or more. The 20 percent tier, still the schedular maximum, is persistent bleeding with anemia, or continuously prolapsed internal hemorrhoids with three or more thrombosis episodes per year. When neither is met, the rating is 0 percent under § 4.31. Across 2,905 decided Board rulings on hemorrhoids from 2021 to 2026, 18.8% were granted, 40.0% denied and 41.2% remanded, and many of those rulings applied the superseded ladder, whose 10 percent tier required four qualitative elements at once. The current criteria replace those adjectives with a dated count of thrombosis episodes, and a claim pending across the change gets the more favorable set from May 19, 2024. The secondary lane (constipation from service-connected IBS or other GI conditions, or from opioids prescribed for a service-connected condition) did about as well as direct claims at the Board, so it is a nexus strategy, not a shortcut. A higher tier needs records that document the specific tier facts, not just a diagnosis of hemorrhoids.

Methodology and Limitations

• Data source: 38 CFR § 4.114 DC 7336 as amended by the final rule "Schedule for Rating Disabilities: The Digestive System," 89 FR 19735, published 2024-03-20, effective 2024-05-19, checked against the current eCFR text in October 2026, including VA's response to comments on DC 7336 at 89 FR 19739. The pre-2024 criteria are taken from Board decisions that quote them. 38 CFR §§ 3.310, 3.317, 3.951 and 4.31, the Rectum and Anus Conditions DBQ (updated June 2024), the 2026 VA rate table (effective December 1, 2025), and Claim Raven's read of 511,036 Board decisions from 2021 to 2026, which contain 1,378,030 rulings, including 3,235 rulings on hemorrhoids.
• Sample size: 2,905 decided Board rulings on hemorrhoids, with outcomes split 18.8% granted (546), 40.0% denied (1,161) and 41.2% remanded (1,198). Another 330 rulings were dismissed or withdrawn and are left out of the grant rate. The Board section on this page breaks these down by denial reason, remand reason, appeal type, medical opinion, claim theory and era since 1992; those figures are computed from the data, not typed here. The denial breakdown covers service connection rulings, and this page does not report the rating tier the Board assigned.
• Limitations: Many of these rulings applied the superseded pre-2024 ladder, whose "mild or moderate" row, four-element 10 percent tier, and fissure route to 20 percent no longer exist. Every decision from 2021 through mid-2024 predates the change, and the read does not record which version each later ruling applied. The outcome rates on this page are not a forecast under the current criteria. The data also captures only Board-level decisions; hemorrhoid claims granted at the regional office without appeal are not in the sample. The current criteria are more concrete but still leave open how VA counts a thrombosis "episode" and what makes prolapse "continuous." Board figures on medical opinions are associations, not causes. These observations describe BVA patterns and are not predictions of individual outcomes, and Claim Raven is data analysis, not legal, medical, or VA-accredited advice.