Hemorrhoids — VA Disability Rating Criteria (DC 7336)
Diagnostic Code 7336 · 38 CFR §4.114
What Is It?
Hemorrhoids are swollen veins in and around the rectum and anus, and they are one of the most commonly claimed digestive conditions among veterans — prolonged sitting in vehicles, heavy lifting, dietary change on deployment and limited field sanitation all contribute. The criteria were rewritten effective 19 May 2024 (89 FR 19743) and the new table is short and specific. It has exactly two rows, 20 and 10 percent, and it counts two things: prolapse and episodes of thrombosis per year. Three features of the current entry catch people out. There is no 0 percent row at all — the old "mild or moderate" 0 percent entry was removed, so the schedule now starts at 10. The 20 percent row requires persistent bleeding *and* anemia together, not either one alone. And anal fissures, which used to be an independent route to 20 percent, are no longer named in this code; a fissure is rated where it belongs, and pruritus ani has its own entry at DC 7337 (10 percent with bleeding or excoriation, 0 without).
Rating Criteria
| 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 less episodes per year of thrombosis; or external hemorrhoids with three or more episodes per year of thrombosis. |
Evidence Needed
A current examination that states whether the hemorrhoids are internal or external and whether internal hemorrhoids are prolapsed — and, for the 20 percent row, whether prolapse is continuous. Then a dated count of thrombosed episodes over the past year, because both rows turn on that count. If you are claiming 20 percent on the bleeding route, you need both halves: documentation of persistent bleeding and laboratory evidence of anemia, so recent hemoglobin and hematocrit results belong in the file. Add treatment and procedure records — rubber-band ligation, sclerotherapy, hemorrhoidectomy — and any colonoscopy report, which both supports the diagnosis and rules out other bleeding sources.
C&P Exam Tips
Ask the examiner to record two things precisely: whether internal hemorrhoids are prolapsed and whether that prolapse is continuous, and how many thrombosed episodes you have had in the past year. Those two facts decide the entire rating. If your route to 20 percent is bleeding, make sure a recent hemoglobin is in the file — persistent bleeding without documented anemia does not meet that row as written. Distinguish internal from external, since the 10 percent row treats them differently: prolapsed internal hemorrhoids qualify at two or fewer thromboses per year, while external hemorrhoids need three or more. Do not soften the picture out of embarrassment; the examiner is grading anatomy and counts, not stoicism.
How to File
File under DC 7336 with the examination describing internal versus external and prolapsed versus not, a dated thrombosis count for the past year, and hemoglobin results if you are claiming the bleeding route to 20 percent. Useful to know: DC 7336 is not in the digestive non-combination group at 38 CFR 4.114 — that group is 7301 through 7329, 7331, 7342, 7345 through 7350, 7352 and 7355 through 7357 — so a hemorrhoid rating can be combined with a rating for a condition inside that group, such as irritable bowel syndrome under DC 7319, under 38 CFR 4.25. If hemorrhoids developed or worsened because of a service-connected condition, file as secondary and include a nexus opinion.
Common Mistakes
Expecting a 0 percent option and appealing "up" from it — the current code has no 0 row, so the question is whether you meet 10. Claiming 20 percent on persistent bleeding without a hemoglobin result: that row requires bleeding and anemia together. Relying on anal fissures for 20 percent, which the pre-2024 table allowed and the current one does not name. Leaving thrombosis episodes uncounted and undated, when both rows are written as counts per year. And not filing at all out of embarrassment — chronic hemorrhoids are an ordinary service-connected disability, and even a low rating establishes the connection and the effective date.
Frequently Asked Questions
Is there a 0 percent rating for hemorrhoids?
Not any more. The pre-2024 table had a 0 percent row for mild or moderate hemorrhoids. The current DC 7336 lists only 20 and 10 percent. Where the 10 percent criteria are not met, 38 CFR 4.31 still supplies a 0 percent evaluation, which preserves service connection and the effective date.
What is the maximum rating for hemorrhoids?
Twenty percent. It requires either persistent bleeding with anemia, or continuously prolapsed internal hemorrhoids with three or more episodes of thrombosis per year.
Do anal fissures still get me to 20 percent?
No. Fissures were named in the old 20 percent row and are not in the current one. A fissure is evaluated under the code that fits it, and pruritus ani has its own entry at DC 7337 — 10 percent with bleeding or excoriation, 0 percent without.
Does bleeding alone reach 20 percent?
No. The wording is "persistent bleeding and anemia." Both are required on that route. Without documented anemia the bleeding route is not met, though the prolapse-and-thrombosis route may still apply.
What is the difference between the two 10 percent options?
Internal versus external. Prolapsed internal hemorrhoids qualify with two or fewer episodes of thrombosis per year; external hemorrhoids need three or more episodes per year.
Can I be rated for hemorrhoids and IBS at the same time?
Yes. DC 7336 is outside the non-combination group in 38 CFR 4.114, so it does not have to yield to a predominant-disability evaluation the way codes inside that group do. The two ratings are combined under 38 CFR 4.25.