Citation Nr: 18152245
Decision Date: 11/21/18	Archive Date: 11/21/18

DOCKET NO. 16-06 967
DATE:	November 21, 2018
ORDER
A 100 percent rating for hemorrhoids is granted.
FINDING OF FACT
The competent and probative evidence is at least in equipoise as to whether the Veteran has complete loss of sphincter control, which is proximately related to an in-service hemorrhoidectomy.
CONCLUSION OF LAW
The criteria for entitlement to a 100 percent rating for hemorrhoids have been met.  38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.10, 4.114, Diagnostic Codes (DCs) 7332, 7336.
REASONS AND BASES FOR FINDING AND CONCLUSION
The Veteran served on active duty from March 1956 to March 1960.  
This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a January 2014 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO).
In May 2018, the Veteran and his spouse testified before the undersigned at a Board hearing in Columbia, South Carolina.  A transcript of that hearing has been associated with the virtual file and reviewed.
Entitlement to a compensable rating for hemorrhoids.
The Veteran contends that he is entitled to a compensable rating for hemorrhoids, evaluated under Diagnostic Code 7336.  
Under Diagnostic Code 7336, the maximum schedular rating of 20 percent is assigned for hemorrhoids with persistent bleeding and secondary anemia or fissures.  Large or thrombotic hemorrhoids, irreducible, with excessive redundant tissue, evidencing frequent recurrences warrants a 10 percent rating.  A noncompensable rating is assigned for mild or moderate hemorrhoids.  38 C.F.R. § 4.114, DC 7336.  
The Veteran contends that his impaired sphincter control is due to his service-connected hemorrhoids, to include an in-service hemorrhoidectomy.  The Veteran reports a history of chronic fecal incontinence following the in-service hemorrhoidectomy.  12/04/2015, CAPRI.  A VA specialist board-certified in General Surgery and Colon and Rectal Surgery opined that it is at least likely as not that the Veteran’s impaired sphincter control has been aggravated by the Veteran’s service-connected hemorrhoids, to include the in-service hemorrhoidectomy.  11/19/2018, Other.  Accordingly, the Board finds that the competent and probative evidence is at least in equipoise as to whether the Veteran’s impaired sphincter control/fecal incontinence is proximately due to his service-connected hemorrhoids, and will consider such symptoms as part of the rating for hemorrhoids.  
Under Diagnostic Code 7332 for rectum and anus, impairment of sphincter control, a 10 percent rating is warranted for constant slight, or occasional moderate leakage; a 30 percent rating is assigned for occasional involuntary bowel movements necessitating the wearing of a pad; a 60 percent rating is warranted for extensive leakage and fairly frequent involuntary bowel movements; and complete loss of sphincter control warrants the maximum 100 percent rating.  38 C.F.R. § 4.114, DC 7332.
After reviewing the relevant medical and lay evidence and applying the above laws and regulations, the Board finds that a rating of 100 percent is warranted.  
In November 2015, a VA examiner indicated that the Veteran has complete loss of sphincter control.  11/05/2015, C&P Exam.  Accordingly, the Board finds that a 100 percent rating is warranted for complete loss of sphincter control, which is proximately related to the in-service hemorrhoidectomy.  
 
Paul Sorisio
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	J.A. Gelber, Associate Counsel