Veterans usually assume hemorrhoids are too minor for VA to care about, and older guides describe criteria that no longer exist. The 2024 rewrite built DC 7336 around countable facts: episodes of thrombosis per year, prolapse, and the pairing that decides the 20 percent level, persistent bleeding with documented anemia. Bleeding alone does not reach it; the lab work completes it.
Veterans often assume hemorrhoids are too minor for VA to rate, and older guides describe criteria that no longer exist. The 2024 rewrite built DC 7336 around countable facts: episodes of thrombosis per year, prolapse, and the pairing that decides the 20 percent level, persistent bleeding with documented anemia. Bleeding alone does not reach it. The lab work completes it.
How VA rates hemorrhoids
External or internal hemorrhoids are rated under diagnostic code 7336 in the digestive schedule (38 CFR 4.114). The condition is common and often dismissed as minor, but the higher level recognizes that hemorrhoids can cause persistent bleeding and real complications. VA rewrote this code in 2024, so the current criteria differ from what older guides describe.
The percentage levels
The current 7336 is built around episodes of thrombosis (a clot in the hemorrhoid) and bleeding with anemia:
- 10 percent: prolapsed internal hemorrhoids with two or fewer episodes of thrombosis per year, or external hemorrhoids with three or more episodes of thrombosis per year.
- 20 percent: internal or external hemorrhoids with persistent bleeding and anemia, or continuously prolapsed internal hemorrhoids with three or more episodes of thrombosis per year.
The 20 percent level turns on bleeding plus anemia
The detail that decides the top rating is the pairing of persistent bleeding with anemia. Bleeding alone is not enough. The criteria look for documented anemia from that blood loss. That is why lab work tying anemia to rectal bleeding in the record is often what makes the difference between 10 and 20 percent. That can include a complete blood count, hemoglobin or hematocrit results, or other blood work a provider orders to evaluate blood loss. The other route to 20 percent is continuously prolapsed internal hemorrhoids that thrombose three or more times a year, so the frequency of thrombosis is worth documenting too.
Complications and surgery are rated on their own
Hemorrhoids can lead to other rated conditions. Impairment of sphincter control or leakage (DC 7332), an anal fistula (DC 7335), or a stricture of the rectum (DC 7333) each have their own diagnostic codes and can be evaluated separately when present, rather than folded into the hemorrhoid rating. Residuals of hemorrhoid surgery are considered as well.
Document the recurrences and the labs
Because the levels turn on thrombosis episodes, prolapse, and anemia, the record should show how often the hemorrhoids thrombose, whether internal hemorrhoids are continuously prolapsed, and the lab work behind any anemia. A note that simply says "hemorrhoids" without that detail tends to land at the lower level.
Common rating details veterans overlook
- The 20 percent level requires persistent bleeding with anemia, or continuously prolapsed internal hemorrhoids that thrombose three or more times a year.
- Bleeding by itself does not reach 20 percent; the lab evidence of anemia is what completes that criterion.
- The 2024 revision rebuilt this code around thrombosis episodes, so older references to "mild or moderate" or "irreducible with redundant tissue" are out of date.
- Count the thrombosis episodes, because both the 10 and 20 percent levels turn on how many you have in a year.
- Bring any lab work that documents anemia, such as a complete blood count, hemoglobin level, or hematocrit, because that documented evidence of anemia is what satisfies the higher rating criterion.