HEMORRHOIDS

G. A. WASIK · 2026 · Case ID: A26035677

MIXED

Summary

The Veteran, who served from September 2019 to December 2024, appeals the denial of higher initial disability ratings for hemorrhoids, pruritus ani, and irritable bowel syndrome (IBS), and seeks a higher rating for his service-connected adjustment disorder with anxiety. The Board denied the claims for hemorrhoids and IBS, finding that the medical evidence, including service treatment records and VA examinations, did not meet the criteria for a compensable rating or a higher rating, respectively. The Board noted that while the Veteran provided lay statements regarding his symptoms, the medical evidence was more credible on the nature and severity of these conditions. For hemorrhoids, the evidence was negative for prolapse and thrombosis. For IBS, the evidence did not meet the frequency criteria for abdominal pain related to defecation. The Board granted a 50 percent rating for adjustment disorder with anxiety, finding an approximate balance of evidence regarding the criteria for this rating, and applied the benefit of the doubt to the Veteran's favor. However, the Board denied a higher 70 percent rating, concluding that the evidence did not support the severe impairment required for that level, despite the Veteran's reported difficulties with concentration, mood, and daily activities. The medical evidence indicated the Veteran remained alert, cooperative, and socially engaged, with intact judgment and insight, precluding the higher rating.

Rationale

Medical evidence negative for prolapse and thrombosis; Veteran's lay assertions regarding severity not medically supported

Special Benefit

NO SPECIAL BENEFIT

Diagnostic Code

7336

Docket No.

251213-614292

Full Decision Text

Citation Nr: A26035677
Decision Date: 04/16/26 Archive Date: 04/16/26

DOCKET NO. 251213-614292
DATE: April 16, 2026

ORDER

Entitlement to an initial compensable disability rating for hemorrhoids, pruritus ani, is denied.

Entitlement to an initial disability rating higher than 20 percent for irritable bowel syndrome (IBS) is denied.

Entitlement to an initial 50 percent disability rating for an adjustment disorder with anxiety is granted.

FINDINGS OF FACT

1. The evidence demonstrates that the Veteran has not had prolapsed internal hemorrhoids with two or less episodes per year of thrombosis, or external hemorrhoids with three or more episodes per year of thrombosis.

2. The evidence demonstrates that IBS has not caused abdominal pain related to defecation at least one day per week during the previous three months.

3. There is an approximate balance of positive and negative evidence indicating that an adjustment disorder with anxiety has caused occupational and social impairment with reduced reliability and productivity throughout the appeal period, but the evidence demonstrates that the disorder has not caused deficiencies in most areas of the Veteran's life.

CONCLUSIONS OF LAW

1. The criteria for a compensable initial disability rating for hemorrhoids are not met. 38 U.S.C. § 1155; 38 C.F.R. § 4.114.

2. The criteria for an initial disability higher than 20 percent for IBS are not met. 38 U.S.C. § 1155; 38 C.F.R. § 4.114.

3. The criteria for an initial 50 percent disability rating for an adjustment disorder with anxiety are met. 38 U.S.C. § 1155; 38 C.F.R. §§ 4.3, 4.130.

4. The criteria for a 70 percent disability rating for an adjustment disorder with anxiety are not met. 38 U.S.C. § 1155; 38 C.F.R. § 4.130.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from September 2019 until December 2024.

This matter comes to the Board of Veterans' Appeals (Board) on appeal of December 2024 and June 2025 rating decisions by a U.S. Department of Veterans Affairs (VA) Regional Office (RO).

The Veteran appealed the decisions in a December 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), on which he selected the Evidence Submission docket.

In the decision below, the Board may only consider the evidence of record at the time of the rating decisions on appeal, and the evidence submitted within 90 days following receipt of the VA Form 10182. See 38 C.F.R. § 20.303. If the Veteran wishes to pursue this matter further, information for doing so is included with this decision.

Claims for a Higher Disability Rating

The Veteran was discharged from service on December 11, 2024. Several months earlier, he claimed entitlement to service connection for multiple disorders to include hemorrhoids, IBS, and psychiatric disability. In the rating decisions on appeal, the RO granted the claims and assigned disability ratings effective the day following service discharge. The Veteran claims entitlement to higher initial ratings.

Disability ratings are determined by applying the criteria set forth in VA's Schedule for Rating Disabilities, which is based on the average impairment of earning capacity. Individual disabilities are assigned separate diagnostic codes. 38 U.S.C. § 1155; 38 C.F.R. § 4.1.

Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7.

When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the benefit of the doubt will be granted to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 4.3.

Except as otherwise provided, the effective date of an evaluation and award of pension, compensation, or dependency and indemnity compensation based on an initial claim or supplemental claim will be the date of receipt of the claim or the date entitlement arose, whichever is later. See 38 U.S.C. § 5110 (a); 38 C.F.R. § 3.400. For direct service connection, the effective date shall be the day following separation from active service or date entitlement arose if claim
any issue material to the determination of a matter, the benefit of the doubt will be granted to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 4.3.

Except as otherwise provided, the effective date of an evaluation and award of pension, compensation, or dependency and indemnity compensation based on an initial claim or supplemental claim will be the date of receipt of the claim or the date entitlement arose, whichever is later. See 38 U.S.C. § 5110 (a); 38 C.F.R. § 3.400. For direct service connection, the effective date shall be the day following separation from active service or date entitlement arose if claim is received within 1 year after separation from service. See 38 C.F.R. § 3.400 (b) (2) (i).

Hemorrhoids and IBS

Hemorrhoids have been rated noncompensable since discharge from service in December 2024. The RO has rated IBS 20 percent disabling since then.

Regulations pertaining to digestive disability were amended effective May 19, 2024, prior to discharge from service and the rating decisions on appeal. As such, the new regulations apply in this case. See 38 C.F.R. § 4.114.

Under DC 7336, hemorrhoids are rated. A 10 percent rating is warranted for 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 maximum 20 percent rating is warranted for internal or external hemorrhoids with persistent bleeding and anemia, or continuously prolapsed internal hemorrhoids with three or more episodes per year of thrombosis.

IBS is rated under DC 7319 of 38 C.F.R. § 4.114, which authorizes 10, 20, and 30 percent ratings. The question before the Board is whether the 30 percent rating has been warranted. A 30 percent rating is warranted for abdominal pain related to defecation at least one day per week during the previous three months; and two or more of the following: (1) change in stool frequency, (2) change in stool form, (3) altered stool passage (straining and/or urgency), (4) mucorrhea, (5) abdominal bloating, or (6) subjective distension. See 38 C.F.R. § 4.114.

The evidence relevant to these claims consists of lay statements from the Veteran, service treatment records (STRs), and VA examination reports dated in October 2024.

With regard to hemorrhoids, a compensable rating is not warranted under DC 7336 because the only medical evidence addressing the disability - found in STRs and an October 2024 VA report - is negative for prolapsed hemorrhoids and for thrombosis. The STRs note the Veteran's complaints of itching, pain, and bleeding, as does the VA report. But the STRs are negative for prolapse and thrombosis while the VA report specifically states that examination found the Veteran normal and specifically states that the Veteran's reported history of hemorrhoids has not involved prolapse or thrombosis. Lastly, the results of a December 2025 colonoscopy, which the Veteran refers to in a December 2025 lay statement, are negative for prolapse and thrombosis.

With regard to IBS, a 30 percent rating is not warranted under DC 7319 because the only medical evidence addressing the disability - found in STRs and an October 2024 VA report - is negative for the relevant criteria. The STRs do not note abdominal pain during defecation while the October 2024 report notes pain during defecation three times per month but not once per week. See 38 C.F.R. § 4.114, DC 7319.

In evaluating these claims, the Board has considered the Veteran's lay assertions regarding the degree of his hemorrhoids and IBS, particularly the statement he submitted in December 2025. He is competent to describe observable symptomatology such as pain, itching, and bleeding. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). However, he is not competent to determine the nature and severity of hemorrhoids or of his bowel disease, which are mostly not observable. These are medical questions. See Woehlaert v. Nicholson, 21 Vet. App. 456, 462 (2007). On these more complex questions, the medical evidence is more credible than his assertions. See Smith v. Derwinski
the degree of his hemorrhoids and IBS, particularly the statement he submitted in December 2025. He is competent to describe observable symptomatology such as pain, itching, and bleeding. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). However, he is not competent to determine the nature and severity of hemorrhoids or of his bowel disease, which are mostly not observable. These are medical questions. See Woehlaert v. Nicholson, 21 Vet. App. 456, 462 (2007). On these more complex questions, the medical evidence is more credible than his assertions. See Smith v. Derwinski, 1 Vet. App. 235 (1991) (credibility is determined by the fact finder).

In sum, the evidence demonstrates that the criteria for a compensable rating are not approximated here for hemorrhoids, and the criteria for a 30 percent rating are not approximated for IBS. As such, the reasonable doubt doctrine does not apply and these claims must be denied. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7.

Adjustment Disorder with Anxiety

The RO has rated service-connected psychiatric disability as 10 percent disabling from December 2024 until February 2025, and as 50 percent disabling since.

Acquired psychiatric disability is rated under 38 C.F.R. § 4.130. The RO rated the Veteran's psychiatric disability under DC 9440. This DC addresses the acquired psychiatric disability of chronic adjustment disorder. See 38 C.F.R. § 4.130. This DC authorizes compensable ratings of 10, 30, 50, 70, and 100 percent. As the disorder has been rated as at least 10 percent disabling throughout the appeal period, the Board's inquiry will focus on whether a higher rating has been warranted at any time during the appeal period.

Diagnostic Code 9411 and other DCs addressing psychiatric disabilities are addressed under the General Rating Formula for Mental Disorders. See 38 C.F.R. § 4.130. Ratings are assigned according to the manifestation of particular symptoms.

A 50 percent rating is warranted for occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships.

A 70 percent rating is warranted for occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships.

A 100 percent rating is warranted for a mental disorder when there is total occupational and social impairment due to such symptoms as gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; and memory loss for names of close relatives, own occupation or own name. 38 C.F.R. § 4.130.

The "such symptoms as" language of the diagnostic codes for mental disorders in 38 C.F.R. § 4.130 means "for example" and does not represent an exhaustive list of symptoms that must be found before granting the rating of that category. See Mauerhan v. Principi, 16 Vet. App. 436, 442 (2002).

The relevant evidence in this matter consists of lay statements from the Veteran, STRs, VA treatment records, and October 2024 and June 2025 VA examination reports.

There is an approximate balance of positive and negative evidence regarding whether the criteria for a 50 percent rating under DC 9440 have been approximated throughout the appeal period. Certain evidence counters the claim for a higher rating. For example, the October 2024 VA examiner found the criteria for a 10 percent rating approximated in indicating that the Veteran's adjustment disorder caused impairment due to mild or transient symptoms. However, other evidence indicates that the higher rating should apply. For example, less than one year after discharge from service, the June 2025 VA examiner characterized the adjustment disorder as causing reduced reliability and productivity, thus matching the criteria for a 50 percent rating. 38 C.F.R. § 4.130.

As such, the Board cannot find that the evidence demonstrates that the 50 percent rating assigned effective in June 2025 should not be effective six months earlier at service discharge. See 38 C.F.R. § 3.400. Rather, the evidence is divided on the question. This is therefore an appropriate case in which to invoke VA's doctrine of reasonable doubt, grant the Veteran the benefit of the doubt, and grant the claim for a higher initial rating. See 38 C.F.R. §§ 4.3, 4.130.

The next-highest rating of 70 percent has been unwarranted throughout the appeal period, however.

In a December 2025 lay statement, the Veteran described problems with concentration, mental fatigue, stress, depression, anger, inconsistent hygiene, and trouble with activities of daily living such as cooking, cleaning, and shopping.

Each of the VA reports note the Veteran's complaints of anxiety, depression, sleep impairment, self-doubt, excessive worry/overthinking, difficulty concentrating, mild memory loss, and disturbances of motivation and mood. Nevertheless, each VA report indicates that the Veteran has been alert, cooperative, oriented, adequately groomed and dressed, with fair concentration, intact judgment and insight, normal speech and thought processes, without any delusions or hallucinations, and without suicidal or homicidal ideations. The reports also show that the Veteran is competent to handle financial affairs and is socially engaged with close relationships with his mother and sibling, his wife, and with friends he associates with. He also is active as a student in college and exercises frequently at a gym. Lastly, as indicated earlier, neither VA examiner found the criteria for a 70 percent rating approximated here. See 38 C.F.R. § 4.130.

Moreover, STRs and VA treatment records dated between service discharge in December 2024 and the July 2025 rating decision indicate that the Veteran's symptoms were mild to moderately disabling. These records note complaints of anxiety and depression. But the records are negative for any evidence indicating the criteria for a 70 percent rating. Rather, the records show that the Veteran engaged with healthcare providers for his many service-connected problems in a coherent, alert, and cooperative manner.

In evaluating this claim, the Board has considered the Veteran's lay assertions. He is competent to describe observable symptomatology such as pain and worry. See Jandreau, supra. However, the Veteran is not competent to determine the nature and severity of his psychiatric disorder. Psychiatric disability is an internal matter that is beyond his ability to observe. It is a medical matter. See Woehlaert, supra. On this more complex question, the medical evidence is more credible than his assertions. See Smith, supra.

In sum, the evidence dated during the appeal period does not support the assignment of a rating higher than 50 percent. Indeed, the criteria the 70 percent rating are not approximated here. The evidence has not shown chronic suicidal ideation, obsessional rituals, illogical, obscure, or irrelevant speech, near-continuous panic or depression affecting the ability to function independently, appropriately and effectively, impaired impulse control, spatial disorientation, neglect of personal appearance and hygiene, difficulty in adapting to stressful circumstances, and an inability to establish and maintain effective relationships. See 38 C.F.R. § 4.130. Despite the Veteran's symptoms, he has not exhibited the type of emotional and cognitive impairment reserved for a 70 percent rating under 38 C.F.R. § 4.130. See 38 C.F.R. § 4.3.

A 50 percent rating is warranted
approximated here. The evidence has not shown chronic suicidal ideation, obsessional rituals, illogical, obscure, or irrelevant speech, near-continuous panic or depression affecting the ability to function independently, appropriately and effectively, impaired impulse control, spatial disorientation, neglect of personal appearance and hygiene, difficulty in adapting to stressful circumstances, and an inability to establish and maintain effective relationships. See 38 C.F.R. § 4.130. Despite the Veteran's symptoms, he has not exhibited the type of emotional and cognitive impairment reserved for a 70 percent rating under 38 C.F.R. § 4.130. See 38 C.F.R. § 4.3.

A 50 percent rating is warranted during the appeal period. However, the evidence demonstrates that the higher rating is unwarranted. The benefit-of-the-doubt doctrine does not apply to the claim of entitlement to a higher initial rating. It must be denied, therefore. See 38 C.F.R. § 4.3.

G. A. WASIK

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Christopher McEntee

The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.

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