VA Ratings for Hemorrhoids Secondary to IBS in Veterans Disability

Last Updated on 17 September, 2025

Hemorrhoids are a common gastrointestinal condition that affects about 10 million U.S. adults annually, which is roughly 4.4% of the population. Veterans, in particular, may be unaware that they can be service-connected for hemorrhoids, making it crucial to address this issue and provide information on how it relates to Irritable Bowel Syndrome (IBS) and constipation in the context of VA disability. Leah explains what hemorrhoids are, the causes and the connection between IBS and hemorrhoids in veterans’ disability claims.

What Are Hemorrhoids and How Do They Relate to IBS?

The Cleveland Clinic defines hemorrhoids as swollen veins that form inside and outside the anus and rectum, causing discomfort, pain, and rectal bleeding. They are generally classified into:

• Internal hemorrhoids: Found inside the rectum, often painless but can cause bleeding.
• External hemorrhoids: Found under the skin around the anus, often painful, especially when thrombosed (clotted).

It is estimated that more than one in 20 Americans suffer from symptomatic hemorrhoids, making it a prevalent issue. Risk factors include obesity, pregnancy, a low-fiber diet, chronic constipation or diarrhea, heavy lifting, prolonged sitting on the toilet, and straining during bowel movements.

Hemorrhoids and Irritable Bowel Syndrome

Irritable Bowel Syndrome (IBS) is a chronic gastrointestinal disorder characterized by:

• Abdominal pain or cramping
• Bloating
• Irregular bowel movements (diarrhea, constipation, or both)

Veterans with IBS are at significantly increased risk of developing hemorrhoids due to repeated episodes of constipation, diarrhea, and abdominal discomfort. The VA disability for hemorrhoids secondary to IBS is based on a secondary service connection, meaning the hemorrhoids are caused or aggravated by a primary service-connected condition (IBS).

IBS contributes to hemorrhoids in several ways:

• Chronic straining during constipation increases pressure in the rectal veins.
• Frequent diarrhea irritates the rectal lining, causing inflammation.
• Bloating and gas raise intra-abdominal pressure, worsening hemorrhoid symptoms.
• Unpredictable bowel habits make symptom management difficult

This physiological link establishes the foundation for VA disability for hemorrhoids secondary to IBS.

Literature Supporting the Connection

Several studies highlight the association between hemorrhoids and gastrointestinal disorders, including IBS. A study published in May 2007 discussed how symptomatic hemorrhoids can improve with dietary and bowel changes. Dietary changes, which are characteristic of military service, can contribute to chronic constipation, creating a link between the two conditions. Another study found a significant association between hemorrhoids and various diarrheal disorders, including IBS.

A peer-reviewed cross-sectional study of 121 consecutive outpatients with upper-abdominal discomfort reported that hemorrhoids were present in 33.3% of individuals with irritable bowel syndrome (IBS) compared with 15.7% of individuals without IBS (p < 0.05). 

A 2023 American College of Gastroenterology retrospective cohort study found that patients with IBS had significantly higher rates of hemorrhoids and other anal/rectal events such as fissures, prolapse, and fecal impaction than matched control groups.

These findings suggest a statistically significant association between IBS and a higher prevalence of hemorrhoidal disease, highlighting the importance of comprehensive evaluation and management in affected patients.

VA Disability Ratings for Hemorrhoids Secondary to IBS

The VA rating for hemorrhoids secondary to IBS is determined under Diagnostic Code 7336, found in 38 C.F.R. § 4.114 (Schedule of Ratings—Digestive System). Ratings depend on severity of symptoms, frequency of complications, and whether internal hemorrhoids remain continuously prolapsed. 

Diagnostic Code (DC) 7336 — Hemorrhoids, external or internal (effective May 19, 2024):

• 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.

Important: Although the noncompensable (0%) level was removed from DC 7336 with the VA rating changes effective May 19, 2024, a 0% rating can still be assigned under 38 C.F.R. § 4.31 when the requirements for a compensable evaluation aren’t met.

See 89 Fed. Reg. 19735 (Mar. 20, 2024)

These VA rating criteria apply whether hemorrhoids are “secondary to” irritable bowel syndrome or another precipitating digestive condition, as long as the symptoms are service-connected.

VA Disability Ratings for Irritable Bowel Syndrome (IBS)

IBS is one of the most common gastrointestinal conditions among veterans, rated by the VA under Diagnostic Code (DC) 7319 in 38 C.F.R. § 4.114 to determine disability ratings. Veterans who receive a rating for IBS can also claim secondary conditions like hemorrhoids, since chronic bowel changes increase rectal pressure and irritation.

Below are the current VA rating levels for IBS:

Because IBS can be rated up to 30% and hemorrhoids up to 20%, veterans may receive a significantly higher combined rating when both are service-connected.

Service Connection for Hemorrhoids

Hemorrhoids can be service-connected from both a primary and secondary standpoint. If a veteran is diagnosed with hemorrhoids during active duty and continues to experience symptoms post-service, it may be straightforward to establish a direct service connection. 

Three Key Requirements for VA Service Connection for Hemorrhoids

1. Current Medical Diagnosis – A diagnosis of hemorrhoids from a qualified healthcare provider confirming the condition exists.
2. Evidence of In-Service Event, Injury, or Illness – Proof that factors related to military service (e.g., prolonged sitting, heavy lifting, chronic digestive issues) caused or aggravated the hemorrhoids.
3. Medical Nexus Opinion – A written medical opinion linking the veteran’s current hemorrhoids either directly to military service or as a secondary condition caused or worsened by another service-connected disability, such as IBS, GERD, or chronic constipation

It’s essential to note that individual cases may vary, and seeking guidance from legal professionals like Veterans Service Officers, attorneys, or accredited claims agents is often advisable.

Secondary Service Connection: IBS and Other Related Conditions

From a secondary standpoint, if a veteran has another service-connected condition that exacerbates or leads to hemorrhoids, it may also be eligible for service connection. Examples include gastrointestinal and mental health conditions that cause chronic bowel issues. In particular:

• Irritable Bowel Syndrome (IBS): Frequently service-connected for Gulf War veterans or those with in-service diagnoses; IBS often produces chronic diarrhea or constipation.
• Chronic Constipation: A common IBS symptom, chronic constipation can increase rectal pressure, directly leading to hemorrhoids.
• PTSD or Depression-Related GI Issues: Mental health conditions like PTSD or depression can exacerbate IBS or constipation, indirectly worsening hemorrhoids.
• Ulcerative Colitis or Crohn’s Disease: Inflammatory bowel conditions causing frequent bowel movements, bleeding, and irritation that may trigger hemorrhoids. 
• Gastroesophageal Reflux Disease (GERD): Although it primarily affects the upper digestive tract, GERD-related straining, altered bowel habits, or medication side effects can increase intra-abdominal pressure, contributing to hemorrhoids. 

When these conditions are properly documented, they can qualify for secondary service connection to hemorrhoids, potentially increasing a veteran’s overall combined rating. 

Increasing VA Rating and Compensation with TDIU 

While the maximum schedular VA rating for hemorrhoids is 20%, veterans may qualify for Total Disability Individual Unemployability (TDIU) if multiple conditions, including IBS and hemorrhoids, collectively render them unemployable.

TDIU Eligibility (Schedular):

• One condition rated 60% or higher
• OR multiple conditions with a combined rating of 70%, one of which is at least 40%

While a hemorrhoid VA rating alone is unlikely to qualify a veteran for TDIU, it can contribute to a higher combined rating when linked with IBS, GERD, anxiety, or PTSD.

How to File a VA Disability Claim for Hemorrhoids Secondary to IBS

To pursue a VA disability rating for hemorrhoids secondary to IBS, follow these steps:

Step 1: Gather Evidence

• Medical records for IBS and hemorrhoids
• Diagnosis and symptom severity documentation
• Nexus letter from a licensed healthcare provider

Step 2: File the Claim

Submit VA Form 21-526EZ via the VA’s Online Application Portal to file new claims for secondary hemorrhoids. Attach all supporting evidence, including VA Form 21-4138, to provide lay statements. 

Step 3: Attend Your C&P Exam

Prepare for the VA Compensation & Pension exam and accurately describe your symptoms. This step directly affects your VA disability rating for hemorrhoids.

Step 4: Monitor & Appeal if Needed 

Track your claim status at VA.gov. If denied or received a low VA hemorrhoids rating, submit a Supplemental Claim with new evidence, request a Higher-Level Review, or file a Board Appeal.

Linking IBS, GERD, and Hemorrhoids for Higher Disability Ratings 

Veterans with multiple gastrointestinal (GI) conditions often face a domino effect where one disorder triggers or worsens another. This is especially true with Irritable Bowel Syndrome (IBS) and hemorrhoids. Gastroesophageal Reflux Disease (GERD) can also play an indirect but significant role, potentially intensifying hemorrhoid symptoms or complicating treatment.

Can GERD Cause Hemorrhoids?

While GERD (Gastroesophageal Reflux Disease) primarily affects the esophagus, it can indirectly impact the lower GI tract:

• Chronic reflux or its treatment can lead to constipation or diarrhea, both of which strain rectal veins.
• Medications for GERD may cause side effects such as slowed bowel motility, increasing pressure and irritation in the rectal area.
• Straining, irregular bowel movements, or dietary restrictions related to GERD may further aggravate hemorrhoids.

These links mean a veteran may qualify for VA disability for hemorrhoids as secondary to IBS, GERD, or both, potentially increasing their combined rating.

Combined Disability Rating Example:

• 50% for PTSD
• 30% for IBS
• 10% for hemorrhoids secondary to IBS
• 10% for GERD

Combined, these conditions could bring the total rating closer to the 70% threshold, qualifying some veterans for schedular TDIU (38 C.F.R. § 4.16) or higher compensation.

For the official numbers, see the VA’s Combined Ratings Table (38 C.F.R. § 4.25).

Veterans experiencing compounded gastrointestinal distress are strongly encouraged to:

• Obtain an independent medical opinion connecting all overlapping GI conditions. 
• Request completed Disability Benefits Questionnaires (DBQs) from their treating providers.
• Include lay statements that describe how these conditions interact and impact daily life.

This approach strengthens claims for VA hemorrhoids disability compensation even if IBS is not the primary condition.

Proving VA Disability for Hemorrhoids Secondary to IBS

Establishing a secondary service connection for hemorrhoids and IBS requires clear evidence showing both the diagnosis and the medical nexus. Below are practical steps to build a favorable VA claim:

1. Obtain a Current Hemorrhoid Diagnosis

Start with a formal diagnosis by a licensed medical provider confirming hemorrhoids. Include exam findings such as bleeding, thrombosis, prolapse, or pain.

2. Prove Service-Connected IBS

Submit VA rating decisions or military medical records that already recognize IBS as service-connected. This anchors your secondary claim.

3. Secure a Strong Nexus Letter

Ask a qualified medical professional to write a nexus letter stating that your hemorrhoids are “proximately due to or aggravated by IBS.” A well-written nexus opinion should:

• Reference medical literature or past Board of Veterans’ Appeals (BVA) cases
• Use VA terminology such as “at least as likely as not”
• Establish the medical rationale linking IBS to hemorrhoid development 

Veterans should work with experienced independent medical opinion providers familiar with the VA’s rating schedule for hemorrhoids to ensure the letter carries high probative value. 

4. Maintain Detailed Symptom Documentation

Keep a daily log noting flare-ups, bleeding, bowel movement frequency, pain levels, and work or social impact. This objective record supports the severity of your condition at the C&P exam.

5. Gather Lay Statements

Family, friends, or coworkers can submit statements describing how hemorrhoids and IBS affect your daily activities, hygiene, and comfort. This humanizes your VA disability claim and shows real-world impact.

For example, a wife may give a statement, “Whenever my husband’s IBS flares up, his hemorrhoids get so bad that he can’t sit comfortably, he’s in constant pain, and we have to plan our days around his bathroom trips.”

6. Prepare Thoroughly for the C&P Exam

After you submit a VA claim for hemorrhoids, the Compensation and Pension (C&P) exam verifies the severity of your condition to determine its connection to service and assign a disability rating. 

• A VA medical professional reviews your medical records, past diagnoses, and treatments, then asks how hemorrhoids affect your daily activities.  
• Be honest when discussing symptoms like pain, bleeding, and prolapse during flare-ups.
• Later, they will also perform a physical examination to gather accurate information. 

When preparing for the hemorrhoids C&P exam, bring your medical documentation and symptom log. The C&P examiner report may be favorable if your condition is “at least as likely as not” linked to military service. 

By combining this evidence, veterans can increase the likelihood of an accurate claim evaluation and fair VA rating for hemorrhoids secondary to IBS. 

Case Study – IBS and Hemorrhoids in a VA Appeal

A veteran who served from 2002 to 2009 appealed for higher ratings for IBS and hemorrhoids. Evidence showed alternating diarrhea and constipation with near-constant abdominal pain after meals. Applying Diagnostic Code 7319, the Board supported a “severe” characterization of IBS and raised ratings from 10% to 30% for the veteran’s symptoms. 

However, hemorrhoids remained rated at 0% under Diagnostic Code 7336 because medical exams documented only small internal hemorrhoids with occasional rectal bleeding but no thrombosis, persistent bleeding, anemia, or fissures.

This decision illustrates that to secure higher VA ratings for hemorrhoids, the veteran could have demonstrated:

• Objective findings of large or thrombosed hemorrhoids
• Evidence of persistent bleeding, anemia, or fissures
• Consistent treatment records and lay statements

Even with thorough symptom documentation elevating the IBS rating, the veteran’s hemorrhoids remained noncompensable due to the lack of objective evidence of severity. 

Conclusion

In conclusion, veterans experiencing hemorrhoids, especially in connection with IBS or chronic constipation, should be aware of the possibility of obtaining service connection and disability compensation. Seeking guidance from accredited legal professionals can be crucial in navigating the complexities of the VA disability claims process. By shedding light on this topic, veterans can better understand their rights and take proactive steps to address health concerns related to their military service. If you believe that your hemorrhoids are connected to your service, it’s essential to advocate for yourself and explore the available avenues for compensation.

FAQs

What is the VA disability rating for hemorrhoids related to IBS?

Under Diagnostic Code 7336, hemorrhoids secondary to IBS can be rated from 10% to 20% depending on severity, bleeding, and prolapse.

Can veterans claim VA disability for hemorrhoids caused by IBS?

Veterans can receive VA disability for hemorrhoids if medical evidence shows they are caused or aggravated by service-connected IBS.

How are hemorrhoids and IBS connected in veterans?

IBS can lead to chronic constipation, diarrhea, or straining, which can significantly increase the risk of developing hemorrhoids.

Which conditions can be rated as secondary to IBS by the VA?

The VA may consider hemorrhoids, anal fissures, depression, anxiety, or pelvic floor disorders as secondary to IBS if supported by evidence.

How can a veteran qualify for a 30% VA disability rating for IBS?

A veteran must show severe diarrhea or alternating diarrhea and constipation with constant abdominal distress to meet the 30% criteria under Diagnostic Code 7319.

What are the updated VA rating changes for hemorrhoids in 2024?

As of May 19, 2024, even mild or moderate hemorrhoids now receive a minimum 10% compensable VA rating.

Can hemorrhoids be service-connected as secondary to GERD?

Hemorrhoids can be service-connected as secondary to GERD only if a medical nexus shows GERD symptoms like straining or altered bowel movements caused or aggravated by them.

What happens during a VA C&P exam for hemorrhoids?

During the VA Compensation & Pension exam, the examiner inspects the anal/rectal area, reviews medical history, documents the severity of hemorrhoid symptoms, and their link to service-connected conditions to determine your rating.

Can PTSD lead to a VA claim for hemorrhoids as a secondary condition?

PTSD can worsen IBS or constipation, indirectly increasing hemorrhoids and allowing a claim for secondary VA disability.

Also read: Veterans Disability Rating for IBS at the 30% Level

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Leveraging an extensive network of licensed independent medical professionals, all well-versed in the medical professional aspects of the VA claims process, we review the necessary medical evidence to incorporate in our reports related to your VA Disability Claim.

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