Citation Nr: 18131273
Decision Date: 08/31/18	Archive Date: 08/31/18

DOCKET NO. 16-02 854
DATE:	August 31, 2018
ORDER
Entitlement to an initial 10 percent rating for hemorrhoids, but not greater, is granted, subject to the laws and regulations governing the payment of monetary benefits.
FINDING OF FACT
The evidence is in relative equipoise that the appellant’s hemorrhoids manifest as large or thrombotic, irreducible, with excessive redundant tissue evidencing frequent recurrences, and persistent bleeding.  They do not manifest with anemia, and the appellant does not have anal fissures.  
CONCLUSION OF LAW
The criteria for entitlement to an initial 10 percent rating, but no greater, for hemorrhoids is granted.  38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.6, 4.7, 4.10, 4.114, Diagnostic Code 7336.  
REASONS AND BASES FOR FINDING AND CONCLUSION
The appellant served on active duty in the United States Air Force from February 1990 to August 2013.  
1. Entitlement to an initial 10 percent rating, but no greater, for hemorrhoids is granted.
The appellant contends that he should have been assigned a 10 percent initial rating for his service connected hemorrhoids.  He asserts that his initial examination for hemorrhoids was inadequate because the examiner did not give him sufficient time to complete the questionnaire and did not ask about his symptoms.  After a review of the evidence of record, the Board finds that an initial 10 percent rating, but not greater, is warranted for service connected hemorrhoids.  
At a December 2013 VA examination for his hemorrhoids, the appellant was noted to have hemorrhoids with mild to moderate symptoms.  No external hemorrhoids were seen during the examination, although it was noted that he did have skin tags.  He was noted to have intermittent symptoms of achy pain.  
Subsequently, the appellant submitted a private medical examination in January 2015, which described his hemorrhoids as large or thrombotic, with excessive redundant tissue evidencing frequent recurrences, and persistent bleeding.  The appellant was not noted to have any fissures or secondary anemia.  He was noted to have both reducible and irreducible external hemorrhoids on examination of the area.  While this initial examination report did not have the treating physician’s medical license number, the appellant provided that information in a January 2016 submission to the RO.  
The appellant has also stated in his January 2015 notice of disagreement that he experiences regular bleeding, 4-5 times per week during bowel movements, with continuous discomfort, and a severe flare-up approximately every 4-6 weeks lasting 3-4 days which makes sitting, walking, running, and exercising more difficult and painful.  
Weighing the evidence of record, the Board finds that it is in relative equipoise as to the nature and severity of the appellant’s hemorrhoids and their symptoms.  Both examinations were conducted by licensed professionals with adequate training in diagnosing and determining the severity of hemorrhoids.  Further, the Board notes that the appellant is competent to relay symptoms he experiences from his hemorrhoids.  As such, the Board, granting the appellant the benefit of the doubt, finds that an initial 10 percent rating is warranted in this instance.  38 C.F.R. §§ 4.3, 4.7, 4.114, Diagnostic Code 7336.  
The Board notes that the appellant does not have secondary anemia or fissures, which would entitle him to a 20 percent rating for his hemorrhoids.  38 C.F.R. § 4.114, Diagnostic Code 7336.  Neither the appellant nor his representative have contended otherwise.  As such, the Board finds that an initial rating greater than 10 percent is not warranted, and that a rating greater than 10 percent is not warranted for any of the period on appeal.  
The appellant has not raised any other issues with respect to the rating for his hemorrhoids nor have any other assertions been reasonably raised by the record.  See Doucette v. Shulkin, 28 Vet. App. 366, 369-70 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record).
 
K. Conner
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	K. Kleponis, Associate Counsel 

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