Citation Nr: 0001260 Decision Date: 01/14/00 Archive Date: 01/27/00 DOCKET NO. 97-34 855 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Muskogee, Oklahoma THE ISSUE Entitlement to a compensable evaluation for hemorrhoids. REPRESENTATION Appellant represented by: The American Legion WITNESS AT HEARINGS ON APPEAL Appellant ATTORNEY FOR THE BOARD J. W. Loeb, Counsel INTRODUCTION The veteran served on active duty from March 1955 to August 1956. A June 1997 decision of the Board of Veterans' Appeals (Board) granted service connection for hemorrhoids, and a September 1997 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Muskogee, Oklahoma, assigned a noncompensable evaluation, effective March 25, 1993, for hemorrhoids. The veteran appealed this evaluation. FINDINGS OF FACT 1. All available evidence necessary to an equitable disposition of the issue on appeal has been obtained. 2. The veteran's hemorrhoids are no more than moderate. CONCLUSION OF LAW The criteria for a compensable evaluation for hemorrhoids have not been met. 38 U.S.C.A. §§ 1155, 5107(a) (West 1991); 38 C.F.R. §§ 4.7, 4.114, Diagnostic Code 7336 (1999). REASONS AND BASES FOR FINDINGS AND CONCLUSION The veteran's claim for entitlement to a compensable evaluation for hemorrhoids is well grounded within the meaning of 38 U.S.C.A. § 5107(a). Additionally, the facts relevant to this claim have been properly developed and the statutory obligation of VA to assist the veteran in the development of this claim has been satisfied. Id. Disability evaluations are determined by the application of a schedule of ratings that is based on the average impairment of earning capacity. 38 U.S.C.A. § 1155. Separate diagnostic codes identify the various disabilities. 38 C.F.R. Part 4 (1999). When 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 required for that rating; otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. In accordance with 38 C.F.R. §§ 4.1, 4.2 (1999) and Schafrath v. Derwinski, 1 Vet.App. 589 (1991), the Board has reviewed the service medical records and all other evidence of record pertaining to the history of the veteran's hemorrhoids. The Board has found nothing in the historical record which would lead it to conclude that the current evidence of record is not adequate for rating purposes, nor has the Board found any of the historical evidence in this case to be of sufficient significance to warrant a specific discussion herein. VA outpatient and hospital records from September 1995 to June 1998 do not reveal any treatment or complaints involving hemorrhoids. Blood tests in September 1995, January 1996, and October 1996 contain red blood cell counts from 4.33 to 4.44 M/cmm (normal is 4.6-6.2); hemoglobin and hematocrit levels were within normal limits. The veteran was hospitalized in March 1998 and the hospital discharge diagnoses included congestive heart failure, hypertension, insulin dependent diabetes, and compromised renal function. Blood tests in March 1998 contain a red blood cell count of 4.20, hemoglobin of 12.9 g/dl (normal is 13-18), and hematocrit of 38.7% (normal is 40-54). On VA examination in August 1997, the veteran complained of hemorrhoidal bleeding of no particular frequency. The examination did not reveal any bleeding, anemia, or fecal leakage. Objective findings were of external hemorrhoids, moderate in severity. The diagnosis was external hemorrhoids, mild to moderate. The veteran testified at a personal hearing at the RO in June 1998 that his hemorrhoids cause excessive bleeding, fecal leakage, and pain; that nothing was seen on the August 1997 VA examination because he had cleaned himself shortly before the examination; that his symptoms have not changed since the August 1997 examination; and that the August 1997 examination was inadequate because the examiner did not ask the veteran any questions about his condition. A zero percent evaluation is assigned for hemorrhoids, external or internal, that are mild or moderate; a 10 percent evaluation is warranted for hemorrhoids that are large or thrombotic, irreducible, with excess redundant tissue, evidencing frequent recurrences; a 20 percent evaluation is warranted for hemorrhoids with persistent bleeding and secondary anemia, or with fissures. 38 C.F.R. § 4.114, Diagnostic Code 7336. The veteran has complained of frequent rectal bleeding with pain and fecal leakage. However, the VA outpatient and hospital records on file do not contain any complaints or findings of hemorrhoids. On VA examination of the veteran's hemorrhoids in August 1997, there were mild to moderate external hemorrhoids but no evidence of leakage, bleeding, or anemia. Although blood test results on file show low red blood cell counts, hemoglobin and hematocrit levels were within normal limits except in March 1998. There is no evidence that the veteran has large or thrombotic hemorrhoids, which are irreducible, with excessive redundant tissue that indicates frequent recurrences. There is also no objective evidence of persistent bleeding or fissures. Based on the above, the Board must conclude that the disability picture for the veteran's hemorrhoids does not more nearly approximate the criteria for a compensable evaluation. Although it has been contended by and on behalf of the veteran that the August 1997 VA examination was inadequate because the examiner did not ask the veteran any questions about his hemorrhoids and that, if this case cannot be allowed, it should be remanded for a new examination, the Board notes that the information recorded by the examiner, such as subjective complaints of bleeding, includes the answers to some questions. Moreover, the information recorded in August 1997 is sufficient to rate the veteran under the applicable schedular criteria. Therefore, a remand for another VA examination is not warranted. ORDER A compensable evaluation for hemorrhoids is denied. SHANE A. DURKIN Member, Board of Veterans' Appeals