Hemorrhoids VA Rating and Diagnostic Code 7336 Criteria

Detailed breakdown of each hemorrhoids rating tier

Because Diagnostic Code 7336 sets different criteria for internal versus external hemorrhoids at both the 10% and 20% levels, medical records must specify whether the hemorrhoids are internal, external, or mixed, alongside documenting bleeding, hemoglobin/hematocrit values, prolapse, and annual thrombosis episodes.

0 percent noncompensable rating (38 CFR 4.31)

In the May 19, 2024 final rule, the VA removed the explicit 0% row that previously covered “mild or moderate” hemorrhoids. As explained in the Federal Register preamble (89 FR 19739), “mild or moderate” was nonspecific, and 38 CFR 4.31 directs adjudicators to assign a 0% evaluation whenever a diagnostic code omits a zero percent row and compensable requirements are not met.

A service-connected veteran receives a 0% rating when internal hemorrhoids remain inside the anal canal without prolapsing (Grade I) and without persistent bleeding and anemia, or when external hemorrhoids cause fewer than three episodes of thrombosis per year without persistent bleeding and anemia. While a 0% rating pays no monthly cash benefit, it establishes service connection, qualifies the veteran for no-cost VA health care for the condition, and allows a claim for an increased rating if prolapse, frequent thrombosis, or anemia later develops. At 89 FR 19739, the VA also confirmed that a 0% hemorrhoids rating remains eligible for the special 10% rating under 38 CFR 3.324 for two or more permanent noncompensable disabilities that clearly interfere with normal employability.

10 percent disability rating

Diagnostic Code 7336 provides two pathways to a 10% evaluation:

1. Prolapsed internal hemorrhoids with two or less episodes per year of thrombosis: Internal hemorrhoids are graded clinically by prolapse: Grade II prolapse during defecation and reduce spontaneously; Grade III prolapse and require manual reduction; Grade IV remain continuously prolapsed. Because the rule specifies “two or less episodes per year of thrombosis,” prolapsed internal hemorrhoids warrant 10% even with zero, one, or two thrombotic episodes per year, provided prolapse is documented.
2. External hemorrhoids with three or more episodes per year of thrombosis: External hemorrhoids originate below the dentate line and qualify for 10% when medical records document at least three acute episodes per year in which a blood clot forms inside an external hemorrhoidal vessel.

Effective 2025-12-01, a standalone 10% rating pays $180.42 per month for a veteran with no dependents.

20 percent disability rating (schedular maximum)

The maximum schedular evaluation under Diagnostic Code 7336 is 20%, awarded under either of two criteria:

1. Internal or external hemorrhoids with persistent bleeding and anemia: Applies to either internal or external hemorrhoids when chronic rectal bleeding is accompanied by laboratory-confirmed anemia (reduced hemoglobin or hematocrit levels on a complete blood count). Intermittent bleeding without anemia does not meet this threshold.
2. Continuously prolapsed internal hemorrhoids with three or more episodes per year of thrombosis: Applies to internal hemorrhoids that remain persistently prolapsed outside the anal canal (Grade IV irreducible or continuously unreduced prolapse) and cause at least three thrombotic episodes per year.

Effective 2025-12-01, a standalone 20% rating pays $356.66 per month for a veteran without dependents.

How the May 19, 2024 revision changed Diagnostic Code 7336

Before May 19, 2024, Diagnostic Code 7336 used criteria adopted in November 1962 (87 FR 1534):

The May 19, 2024 revision removed “or with fissures” from the 20% tier and replaced subjective 10% terms (“large,” “irreducible,” “excessive redundant tissue”) with prolapse and annual thrombosis counts. Under 38 U.S.C. 1155 and 38 CFR 3.951(a), a rating schedule revision cannot reduce an evaluation in effect on the date of the revision unless medical evidence proves actual improvement under ordinary conditions of life. Veterans rated at 10% or 20% before May 19, 2024 retain their protected rating.

Related anorectal codes and Diagnostic Code 7332 (sphincter control)

While hemorrhoids are evaluated under Diagnostic Code 7336, severe anorectal disease or surgical complications (such as after a hemorrhoidectomy) may involve neighboring codes in 38 CFR 4.114:

• Diagnostic Code 7332 (Rectum and anus, impairment of sphincter control): Evaluates inability to retain or expel stool at an appropriate time and place at 0% (asymptomatic history), 10% (fully responsive to a prescribed bowel program requiring medication or special diet; or incontinence to solids/liquids at least once every six months requiring wearing a pad at least once every six months), 30% (fully responsive to a bowel program requiring digital stimulation, medication beyond laxatives, and special diet; or incontinence two or more times per month requiring wearing a pad two or more times per month), 60% (partially responsive to a bowel program requiring surgery or digital stimulation, medication beyond laxatives, and special diet; or incontinence two or more times per week requiring wearing a pad two or more times per week), and 100% (complete loss not responsive to a bowel program requiring surgery or digital stimulation, medication beyond laxatives, and special diet; or incontinence two or more times per day requiring changing a pad two or more times per day).
• Diagnostic Code 7333 (Rectum and anus, stricture of): Rated at 10% (luminal narrowing managed by dietary intervention), 30% (lumen reduced less than 50% with straining), 60% (lumen reduced 50% or more with pain and straining), or 100% (inability to open the anus and expel solid feces). Includes dyssynergic defecation and anismus (Note 1).
• Diagnostic Code 7334 (Rectum, prolapse of): Evaluates full-thickness rectal wall prolapse at 10% (spontaneously reducible, unrepairable), 30% (manually reducible, unrepairable, after bowel movements/exertion/Valsalva), 50% (manually reducible, unrepairable, at other times), or 100% (persistent irreducible prolapse). Note 2 directs rating under DC 7332 where sphincter impairment is predominant.
• Diagnostic Code 7335 (Ano, fistula in, including anorectal fistula and anorectal abscess): Rated at 10%, 20%, 40%, or 60% based on the number of fistulas, drainage, pain, and abscesses.
• Diagnostic Code 7337 (Pruritus ani [anal itching]): Revised effective May 19, 2024 to provide 0% (without bleeding or excoriation) and 10% (with bleeding or excoriation).

Anti-pyramiding rules under 38 CFR 4.114 and 38 CFR 4.14

The introductory paragraph of 38 CFR 4.114 prohibits combining ratings across Diagnostic Codes 7301 through 7329, 7331, 7342, 7345 through 7350, 7352, and 7355 through 7357. Because Diagnostic Codes 7332 through 7337 are excluded from that bar, a veteran may receive separate ratings for hemorrhoids (DC 7336) and intestinal conditions like IBS (DC 7319) or esophageal conditions like GERD (DC 7206), as well as separate ratings for DC 7336 and sphincter impairment (DC 7332) when supported by distinct, non-overlapping symptoms under 38 CFR 4.14.

Direct and secondary service connection for hemorrhoids

Hemorrhoids are a structural vascular condition and are not a presumptive Gulf War functional gastrointestinal disorder under 38 CFR 3.317. Service connection is established directly or secondarily:

• Direct service connection (38 CFR 3.303): Requires a current diagnosis of internal or external hemorrhoids, in-service documentation of rectal bleeding, perianal symptoms, or diagnosis in service treatment records, and a medical nexus (38 CFR 3.303).
• Secondary service connection (38 CFR 3.310): Under 38 CFR 3.310(a), hemorrhoids may be service connected as proximately due to or aggravated by an existing service-connected disability when supported by a medical nexus opinion. Common primary causes include chronic straining or diarrhea from service-connected IBS (DC 7319) or inflammatory bowel disease (DC 7323/7326), chronic constipation caused by prescription opioid analgesics or psychiatric medications taken for service-connected back pain or PTSD, pelvic floor dysfunction, or portal hypertension from chronic liver disease.

How the C&P exam and Rectum and Anus Conditions DBQ measure hemorrhoids

At a Compensation and Pension (C&P) exam, the clinician completes the Rectum and Anus Conditions Disability Benefits Questionnaire (DBQ) (VA Form 21-0960H-2, listed as “Rectum & Anus” on the VA Public DBQs page). The examiner records:

1. Whether hemorrhoids are internal, external, or both, and whether prolapse is intermittent/reducible or continuously prolapsed.
2. The number of thrombosis episodes over the past 12 months (two or fewer vs. three or more per year).
3. Whether persistent bleeding and anemia are present, verified by hemoglobin and hematocrit laboratory testing.
4. Prior anoscopy, colonoscopy, or clinic notes documenting flare-ups or thrombotic episodes that occurred between exams.

Combining hemorrhoids ratings and getting accredited help

A 10% or 20% evaluation under Diagnostic Code 7336 combines with other service-connected ratings using the Combined Ratings Table in 38 CFR 4.25. Model how a 10% or 20% hemorrhoids grant affects your overall compensation using our VA combined rating calculator.

If you need assistance preparing a claim or appeal, consider a VA-accredited representative. Accredited Veterans Service Organizations (VSOs) such as the DAV, VFW, and American Legion provide free claims assistance, while accredited claims agents and attorneys handle contested appeals. No representative can guarantee an outcome; verify accreditation through the VA Office of General Counsel Accreditation Search.