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Internal and external hemorrhoids — rated by prolapse, thrombosis episodes, persistent bleeding and anemia under the 2024 digestive schedule. This guide quotes the actual rating criteria from 38 CFR Part 4 for diagnostic code 7336, explains what the C&P examiner measures, covers the presumptive and secondary routes to service connection, and lists the reasons these claims come back denied — and how each gets fixed.
How the VA rates hemorrhoids in 2026 — the exact criteria
These are the criteria a VA rater applies, quoted from the rating schedule (§ 4.114). Your rating is the highest level whose wording your evidence meets — and evidence that never uses these words tends to be rated at the bottom.
DC 7336 — Hemorrhoids, external or internal
| Rating | Criteria (38 CFR Part 4 wording) |
|---|---|
| 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 |
The 2024 rewrite removed the old 0 percent "mild or moderate" level; hemorrhoids that do not meet the 10 percent criteria are not compensable, but the diagnosis still anchors related claims.
Honest ceiling: up to 20% under the revised digestive schedule.
What the C&P examiner measures
The examiner documents internal/external hemorrhoids, prolapse, thrombosis episodes per year, bleeding and anemia (with lab values). A colonoscopy or GI note listing the findings carries the claim.
The questions that get at the rating criteria — answer them for yourself before the exam:
- Any hemorrhoid trouble since the service? One question, I had to ask.
Service connection: presumptive, direct, or secondary
No presumption. Direct service connection from in-service treatment, or secondary to a service-connected IBS or other digestive condition with chronic constipation or straining.
Every service-connection claim has three legs: a current diagnosis (the C&P exam can supply it), an in-service event, injury, exposure or an already-connected condition, and a link between the two — which the VA's own examiner addresses at the exam for direct and secondary claims, and which the law supplies for presumptive ones. You do not need a private opinion to file; you need one only if the VA denies for lack of nexus, and a supplemental claim within one year keeps your effective date.
Secondary conditions veterans miss
This condition is more often the secondary in a chain than the anchor — see the secondary-claims guides for the recognized pathways.
What the medical literature says
38 CFR 3.303 — direct service connection via onset and continuity
In-service onset plus continuity carries the claim; field conditions, MRE constipation and lifting straining are the mechanism a physician can state. Why it matters: Direct or secondary-to-IBS/medication constipation.
Why hemorrhoids claims get denied — and the fix
- Rated 0 percent under the old criteria; under the 2024 schedule thrombosis episodes and prolapse must be documented by a GI note.
A denial is a grade on the evidence packet, not a verdict on you. Filed as a supplemental claim within one year, the fix keeps your original effective date.
Filing it right the first time
- Intent to File first. It locks your effective date for a year — back pay runs from that day, not from the day the package is ready.
- File everything at once. Every condition with a real symptom and a plausible route — direct, presumptive, secondary, increase — goes in one claim. The VA's duty to assist schedules the exam and pulls your records; a condition held back "for more evidence" only starts its clock later.
- Your statement in the criteria's words. A Statement in Support of Claim (VA Form 21-4138) that describes your worst days and your typical days using the language in the table above is the evidence the rater reads first.
- Your records. VA records through Blue Button, decision letters and code sheet from VA.gov, and private records from each doctor's office or patient portal — or a signed 21-4142 so the VA pulls them.
- Prepare for the exam. Know what the examiner measures (above) and answer honestly, including the bad days.
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See If You Qualify →Frequently asked questions
What is the VA rating for hemorrhoids?
Hemorrhoids is rated under diagnostic code 7336 (§ 4.114) at 10%, 20%. The percentage depends on which criteria in the rating schedule your evidence meets — the full table is on this page.
What is the highest VA rating for hemorrhoids?
The highest schedular rating available is 20%. Every case is decided on its own evidence.
Is hemorrhoids a presumptive condition?
No presumption. Direct service connection from in-service treatment, or secondary to a service-connected IBS or other digestive condition with chronic constipation or straining.
Do I need a nexus letter for hemorrhoids?
Not to file. The VA's duty to assist schedules a C&P exam where its own examiner addresses the connection, and presumptive conditions need no opinion at all. A private opinion becomes worth buying only if the VA denies for lack of nexus — a supplemental claim within one year keeps your original effective date.
Rating criteria verified against eCFR (38 CFR Part 4) — last reviewed 2026-09-19. Regulations change; confirm anything decision-critical at ecfr.gov.