HEMORRHOIDS EXTERNAL OR INTERNAL

Summary

The Veteran, who served in the United States Marine Corps Reserve from January 2009 to July 2009 and the United States Army from September 2010 to April 2014 with multiple periods of service, appeals the April 2020 denial of service connection for internal or external hemorrhoids. The Veteran claims the condition originated during his Marine Corps Officer Candidate School (OCS) training in Quantico, Virginia, in late 2008/early 2009, leading to an operation and a Line of Duty determination for follow-up treatment. The Board reviewed a November 2019 VA C&P examination which diagnosed hemorrhoids and provided a positive nexus opinion, stating the condition was at least as likely as not incurred in or caused by service, citing treatment in service and continued symptoms. The Regional Office had denied the claim, stating the injury did not occur during qualifying service. However, the Veteran testified credibly that his condition developed at OCS, requiring surgery and follow-up treatment under a Line of Duty, and that symptoms continued during his Army service. Medical records from Luke Air Force Base confirmed treatment for hemorrhoids in May 2009 while the Veteran was in the Marine Corps Reserve. The Board found the evidence in approximate balance and resolved the doubt in the Veteran's favor, granting service connection for internal or external hemorrhoids.

Rationale

Competent evidence of current disability; Evidence of in-service onset and continuation; Positive nexus opinion from VA examiner; Benefit of the doubt applied due to approximate balance of evidence

Full Decision Text

Citation Nr: A26039000
Decision Date: 04/27/26	Archive Date: 04/27/26

DOCKET NO. 200506-86837
DATE: April 27, 2026

ORDER

Entitlement to service connection for internal or external hemorrhoids is granted.

FINDING OF FACT

Resolving reasonable doubt in the Veteran's favor, the probative evidence of record indicate that the Veteran's hemorrhoids condition is at least as likely as not related to an in-service injury, event, or illness.

CONCLUSION OF LAW

The criteria for service connection for hemorrhoids have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served in the United States Marine Corp Reserve from January 2008 to March 2009 and the United States Army from September 2010 to March 2011, April 2011 to August 2011, and March 2013 to April 2014. 

This matter comes before the Board of Veterans' Appeals (Board) from an April 2020 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) which denied service connection for internal or external hemorrhoids. See April 2020 rating decision.

In the May 2020 VA Form 10182 Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A Board hearing was held on April 30, 2024, before the undersigned Veterans Law Judge (VLJ).  The transcript has been added to the file.  See April 2024 Hearing Transcript. Therefore, the Board may only consider the evidence of record at the time of the April 2020 agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran or his representative at the hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a). If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the Board hearing, or (2) more than 90 days following the hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(a), 20.801. 

Service Connection

Service connection may be granted for any disease diagnosed after discharge, when all evidence, including that pertinent to service, establishes that the disability was incurred in service. 38 C.F.R. § 3.303(d). The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a nexus or a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004).

The standard of proof to be applied in decisions on claims for VA benefits is set forth in 38 U.S.C. § 5107(b). Under that provision, VA shall consider all information and lay and medical evidence of record in a case before the Secretary with respect to benefits under laws administered by the Secretary. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. Id.; see also Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 

1. Entitlement to service connection for internal or external hemorrhoids is granted.

The Veteran was given a Compensation & Pension (C&P) examination in November 2019. See November 2019 C&P Exam. The Veteran was diagnosed with internal or external hemorrhoids at the examination. As such, the first element of service connection has been satisfied. 

The Veteran reported in service injury or illness. Id. The Veteran had a hemorrhoidecotmy operation in 2009 due to severe symptoms. Id. The Veteran's symptoms continued over the years, mostly with straining. The Veteran treats his condition with OTC medications as needed. Id. 

The November 2019 examiner provided a positive nexus opinion and opined that the Veteran's condition was at least as likely as not incurred in or caused by an in-service injury, event or illness. See November 2019 medical opinion. The examiner provided the following rationale: 

After extensive medical records review and research. Noted treatment in STRs for hemorrhoids with hemorrhoidecotmy procedure noted in Jan 2009. Continued treatments with suppositories and creams. As
 Id. The Veteran had a hemorrhoidecotmy operation in 2009 due to severe symptoms. Id. The Veteran's symptoms continued over the years, mostly with straining. The Veteran treats his condition with OTC medications as needed. Id. 

The November 2019 examiner provided a positive nexus opinion and opined that the Veteran's condition was at least as likely as not incurred in or caused by an in-service injury, event or illness. See November 2019 medical opinion. The examiner provided the following rationale: 

After extensive medical records review and research. Noted treatment in STRs for hemorrhoids with hemorrhoidecotmy procedure noted in Jan 2009. Continued treatments with suppositories and creams. As condition had onset with treatment in service with continued treatments since discharge, at least as likely as not incurred in or caused by service.

The RO denied service connection stating that the injury did not occur during qualifying service. See April 2020 rating decision. During the April 2024 Hearing, the Veteran representative noted that unfortunately, the Department of Veterans Affairs did not recognize that the original injury was in an active period in the Line of Duty. The RO indicated that the Veteran wasn't on active duty when his condition occurred. 

However, during the April 2024 Hearing, the Veteran testified that his condition did in fact occur and continue in service. The Veteran had symptoms while on active duty.  The Veteran testified that:  

December 2008, January 2009, I attended Marine Corps OCS in Quantico, Virginia. During my time at the OCS, is when I developed hemorrhoids, and this specific instance is I had an external thrombosed hemorrhoid. Which essentially got infected and caused a blood clot and they had to operate on it. Based off of that, I was what the Marine Corps deemed not physically qualified to continue with training and was basically sent home from training. From that, I received an LOD or a Line of Duty to have follow-up treatment at the Luke Air Force Base which is local to Phoenix, where I live, and to get follow-up treatment in regard to that hemorrhoids that occurred at Marine Corps OCS.

The Veteran further testified that while he was in the Army, he continued to have issues and instances with hemorrhoids. 

A June 2024 Military History Information Report shows honorable service in the Marine Corps reserves from January 9, 2009, to July 9, 2009. 

Health records from the Copper Clinic Medical Group which is the Air Force Base at Luke note hemorrhoids on May 8, 2009. The patient category noted is USMC Active Reserve showing Marine Corps Reserve status. See Medical Treatment Record - Government Facility

The RO indicated that the Veteran wasn't on active duty when hemorrhoids occurred. But based on the Veteran's testimony and health records, he was in fact at OCS at Quantico when his condition occurred. The Veteran testified that prior to reporting to Quantico, he did not have any issues with hemorrhoids or had never received treatment for hemorrhoids prior to service.

(CONTINUED ON NEXT PAGE.)

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The Board therefore finds that the competent evidence of record indicates that the Veteran has a current internal/external hemorrhoids disability that was present in service and has continued ever since. As the Board finds that the evidence for and against the claim is in approximate balance; therefore, the benefit of the doubt must be resolved in favor of the Veteran, and entitlement to service connection for hemorrhoids is warranted. 38 U.S.C. § 5107 (b) (2018); Lynch v. McDonough, 999 F.3d 1391 (Fed. Cir. 2021).

 

 

Paulette Vance Burton

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Gaminchi, Yasmin

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.