Hemorrhoids are one of the most overlooked ratable conditions in the VA system. Veterans spend years dealing with chronic discomfort, bleeding, and prolapse without ever connecting the condition to service or filing a claim. This page treats it like the legitimate medical and financial issue it is.
1. What This Condition Is
Hemorrhoids are swollen veins in the rectum or around the anus. Internal hemorrhoids form inside the rectum. External hemorrhoids form under the skin around the anus. Both types can cause pain, bleeding, itching, and prolapse (tissue pushing outside the anal opening).
Military service creates direct risk factors: prolonged sitting in vehicles or aircraft, heavy lifting under load, constipation from field rations or dehydration, chronic stress, and limited access to timely medical care. Veterans who developed hemorrhoids during service or whose service-connected conditions aggravated an existing case have a valid claim. This is a rateable condition with real compensation attached -- do not ignore it.
2. VA Rating Criteria
Diagnostic Code: 7336 under 38 CFR 4.114 (Schedule of Ratings -- Digestive System)
| Rating | Criteria |
|---|---|
| 20% | Internal or external hemorrhoids with persistent bleeding and anemia; OR continuously prolapsed internal hemorrhoids with three or more episodes per year of thrombosis |
| 10% | Prolapsed internal hemorrhoids with two or fewer episodes per year of thrombosis; OR external hemorrhoids with three or more episodes per year of thrombosis |
| 0% (non-compensable) | Hemorrhoids not meeting criteria above |
A 0% rating still establishes service connection, which matters for future aggravation claims and for building secondary condition claims.
The VA evaluates hemorrhoids based on objective, documented findings: frequency of thrombosis episodes, whether the hemorrhoids prolapse and whether they reduce on their own, documented bleeding, and whether anemia has developed as a result.
3. What to Expect at Your C&P Exam
The C&P exam for hemorrhoids is typically brief and conducted by a general practitioner or gastroenterologist. The examiner will review your medical records for documented episodes of thrombosis, bleeding, and prolapse.
The examiner will ask: When did you first develop hemorrhoids? How often do they flare? Do they prolapse -- and if so, do they return on their own or require manual reduction? Have you had bleeding? Has any provider documented anemia attributed to the hemorrhoids? What treatments have you used?
Be specific about frequency. The difference between 10% and 20% comes down to documented episode counts per year. Bring any records from urgent care visits, colonoscopy results, or VA or private treatment records.
4. Evidence You Need to Win
Diagnosis: A current diagnosis from a physician or VA provider documenting the type (internal, external, or both), severity, and treatment history. Colonoscopy or proctoscopy reports are strong objective evidence.
Nexus: A statement or treatment record connecting the hemorrhoids to service or to a service-connected condition. The nexus can be direct (onset during service, documented in service treatment records) or secondary (aggravation by service-connected constipation, IBS, or heavy lifting related to a rated musculoskeletal condition).
DBQ Form: Request completion of the VA Disability Benefits Questionnaire for Intestinal Conditions (other than small or large intestine).
Personal Statement: Describe when symptoms started, how often flares occur, whether you have had bleeding episodes, and how the condition affects daily life including work, physical activity, and hygiene.
Buddy Statement (VA Form 21-10210): A family member or fellow service member can document your symptoms and functional impact without medical training.
Frequency Log: Keep a written log of thrombosis episodes, bleeding events, and prolapse occurrences with dates. This documentation directly supports the rating criteria and is harder for a rater to dismiss.
5. Secondary Conditions to Consider
Anemia: Persistent rectal bleeding from hemorrhoids can cause iron-deficiency anemia. If your hemorrhoids are service-connected, document any resulting anemia and file it as a secondary condition.
Irritable Bowel Syndrome (IBS): IBS causes the chronic straining and irregular bowel habits that worsen hemorrhoid severity. Service-connected IBS and hemorrhoids often co-exist and each supports the other in a secondary claim.
Chronic Constipation: Constipation is a recognized risk factor for hemorrhoid development and aggravation. If constipation is caused or worsened by service-connected medications (opioids, iron supplements) or conditions, connect it to the hemorrhoid claim.
Anxiety and Mental Health Conditions: Chronic pain and bleeding create documented psychosocial impact. Service-connected PTSD or anxiety can be documented as an aggravating factor, and the hemorrhoid condition can be cited in a mental health secondary claim.
Colorectal Complications: Chronic hemorrhoids, especially those with persistent bleeding, warrant documented colorectal follow-up. If any resulting colorectal condition develops (fissures, fistulas, rectal prolapse), those conditions can be separately rated.
6. Common Mistakes That Kill Claims
Not filing because it seems embarrassing or minor. A 10% or 20% rating translates to real monthly compensation. Hemorrhoids are a documented medical condition, and there is nothing minor about chronic thrombosis, bleeding, or prolapse. File it.
Failing to document episode frequency. The rating criteria require specific counts of thrombosis or prolapse episodes per year. If you only say "they flare up a lot," a rater has nothing to anchor a rating to. Document every episode in your medical record or a personal log.
Missing the anemia connection. Veterans with hemorrhoids causing persistent bleeding and anemia qualify for 20% but fail to bring in hemoglobin or hematocrit lab results showing anemia. Get those labs and link them to the hemorrhoids.
Not establishing service connection for a secondary nexus. If your hemorrhoids started in service or were caused by a service-connected condition (heavy lifting, chronic constipation from a gut condition, or medications), that nexus must be clearly stated. A diagnosis alone is not enough.
Skipping this condition when filing for other digestive or musculoskeletal conditions. Veterans filing for back, hip, or abdominal conditions should review their records for any documented hemorrhoid history. These conditions frequently co-exist, and hemorrhoids are easy to add to an existing claim.
7. FWD Assist Resources
These FWD Assist titles are most relevant if you are building a hemorrhoid claim alongside other conditions:
- Secondary Conditions: How to Build a Cascading Claim -- Explains how to connect hemorrhoids to IBS, constipation, or musculoskeletal conditions for a layered claim.
- C&P Exam Prep Guide -- Covers how to present digestive and gastrointestinal conditions during an exam without underselling the severity.
- Nexus Letters: How to Get the Medical Evidence You Need -- Guides you through getting a private nexus letter for conditions that raters commonly underrate.
- Appeals Guide -- If a prior hemorrhoid claim was denied or rated at 0%, this guide explains how to reopen it with stronger evidence.
All titles are available at fwdassisthq.com.
8. Get Help Without a Claim Shark
Free, accredited help is available through VSOs such as the DAV, American Legion, VFW, and AMVETS. County Veterans Service Officers can assist at no cost. VA-accredited claims agents and attorneys may represent you after an initial decision.
Charging upfront fees to help with a VA claim is illegal under 38 USC 5905. After an initial decision, accredited representatives may charge a fee capped at 20% of past-due benefits only. Do not pay anyone who asks for money before a decision is issued.
Verify accreditation at: va.gov/ogc/accreditation.asp