Hemorrhoids, external or internal — VA Diagnostic Code 7336

Persistent bleeding and anemia

One 20 percent path is “Internal or external hemorrhoids with persistent bleeding and anemia.” The schedule does not define “persistent” or name a lab value for anemia under this code. The Rectum and Anus DBQ asks the examiner to check persistent bleeding and anemia, and, if anemia is checked, to provide a hemoglobin or hematocrit value in the diagnostic-testing section.

Continuously prolapsed internal hemorrhoids, with three or more episodes

The other 20 percent path is “continuously prolapsed internal hemorrhoids with three or more episodes per year of thrombosis.” “Continuously prolapsed” and “three or more” are both in that phrase. The schedule does not define “episode” or “per year.” 38 CFR § 4.6 (Evaluation of evidence) and 38 CFR § 4.7 (Higher of two evaluations) are the general rules for weighing the record and choosing between two evaluations.

Prolapsed internal hemorrhoids, with two or less episodes

One 10 percent path is “Prolapsed internal hemorrhoids with two or less episodes per year of thrombosis.” The words are prolapsed, not “continuously prolapsed,” and the count is two or fewer episodes in a year.

External hemorrhoids, with three or more episodes

The other 10 percent path is “external hemorrhoids with three or more episodes per year of thrombosis.” External hemorrhoids are not given the 20 percent thrombosis path. The 20 percent thrombosis path is the continuously prolapsed internal line. External hemorrhoids reach 20 percent on this table only through “persistent bleeding and anemia.”

Other rectum and anus codes

What is the VA rating for hemorrhoids under DC 7336?

Under 38 CFR § 4.114, Diagnostic Code 7336, hemorrhoids are rated 20 percent for persistent bleeding with anemia, or for continuously prolapsed internal hemorrhoids with three or more thrombosis episodes a year. They are rated 10 percent for prolapsed internal hemorrhoids with two or fewer thrombosis episodes a year, or for external hemorrhoids with three or more thrombosis episodes a year. The code has no 0 percent line, so § 4.31 assigns 0 percent when a compensable line is not met. These lines have been effective since May 19, 2024. Education only.

What should I document for a hemorrhoid rating?

The criteria count thrombosis episodes per year, whether internal hemorrhoids are prolapsed or continuously prolapsed, and persistent bleeding together with anemia. Dated treatment records for each episode, exam findings on prolapse, and lab results for anemia are the records that use those words. The Rectum and Anus DBQ asks the examiner to check those same findings. A symptom log can support timing. Education only.

What are the current VA rating criteria for hemorrhoids?

Under 38 CFR § 4.114, Diagnostic Code 7336, the 20 percent line is internal or external hemorrhoids with persistent bleeding and anemia, or continuously prolapsed internal hemorrhoids with three or more episodes per year of thrombosis. The 10 percent line is prolapsed internal hemorrhoids with two or less episodes per year of thrombosis, or external hemorrhoids with three or more episodes per year of thrombosis. Those lines are the text effective May 19, 2024.

What is the maximum rating under DC 7336?

The highest line printed under DC 7336 is 20 percent. The other compensable line is 10 percent. The code does not print 30, 50, or 100 percent. If the compensable lines are not met, § 4.31 assigns 0 percent because the schedule does not provide a zero percent evaluation for this code. VA decides from the record.

What if my hemorrhoids do not meet the 10 percent line?

DC 7336 has no 0 percent row. Section 4.31 says that where the schedule does not provide a zero percent evaluation, a zero percent evaluation shall be assigned when the requirements for a compensable evaluation are not met. In the March 20, 2024 preamble, VA said it removed the old mild-or-moderate 0 percent criteria and that § 4.31 still allows a noncompensable evaluation.

What counts as an episode of thrombosis?

The schedule uses “episodes per year of thrombosis” and does not define “episode” or “per year.” Sections 4.6 and 4.7 are the general rules for weighing the record and choosing between two evaluations. Our reading: a dated treatment note is where an episode is usually documented. The Rectum and Anus DBQ asks the examiner to check the episode counts that the criteria name. A personal log can place events in time. It is not the schedule’s definition of an episode.

Did the hemorrhoid criteria change in 2024?

Yes. The digestive-system final rule, 89 FR 19735, was published March 20, 2024, and is effective May 19, 2024. The regulatory text in that rule is the 20 percent and 10 percent lines now in § 4.114. The eCFR copy of § 4.114, up to date as of 2026-09-24, matches those lines. VA’s preamble says it removed the former mild-or-moderate 0 percent criteria.