C&P Exam for Hemorrhoids: What to Expect and How to Prepare

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In this article, VA disability expert Brian Reese reveals and explains everything you need to know to successfully navigate a VA C&P exam for hemorrhoids.

After you’ve filed a VA claim for hemorrhoids, you’ll likely be scheduled for a Compensation and Pension (C&P) exam by a private company contracted by the VA.

Hemorrhoids are very common among military veterans.

According to our data, Hemorrhoids are the #41 most claimed VA disability of the top 50 most common VA claims.

Pro Tip: VA ratings for hemorrhoids vary based on the severity of symptoms, with possible ratings of 0%, 10%, and a maximum of 20%. For the most severe cases, where hemorrhoids lead to constant bleeding, significant blood loss, anemia, or are accompanied by fissures, the rating is 20%. Moderate cases characterized by blood clots, persistent swelling, and excessive redundant tissue are rated at 10%. The least severe cases, which are moderate and involve only occasional bleeding, are rated at 0% non-compensable.

Summary of Key Points

The VA rates hemorrhoids from 0% to 20% with a break at 10% based on their severity of symptoms. A 0% rating is given for mild symptoms, a 10% rating for frequent symptoms with considerable discomfort, and a 20% rating for persistent, severe symptoms that cause bleeding and anemia.
The C&P exam for hemorrhoids evaluates if you have the condition diagnosed, determines if there’s a “nexus” to your military service or other service connected disabilities, and assesses your severity of symptoms including frequency, severity, and duration, as well as negative impacts to your work, life, and social functioning.
Be prepared to talk about your life before, during, and after the military to include the approximate timeframe of when your hemorrhoid symptoms began. Risk factors for veterans developing hemorrhoids include prolonged sitting, heavy lifting, and considerable strain during bowel movements, all of which could have occurred during their service.

What to Expect at a C&P Exam for Hemorrhoids

A C&P exam for hemorrhoids is designed to assess whether (#1) you have the condition diagnosed, (#2) if there is a “nexus” for service connection (meaning your hemorrhoids were caused or made worse by your military service or by another service connected disability for secondary service connection), and (#3) the severity of your symptoms in terms of frequency, severity, and duration along with any negative impacts to your work, life, and social functioning.

Here’s what you can expect during a VA C&P exam for hemorrhoids:

• Review of Medical History: The C&P examiner will review your medical records that pertain to any gastrointestinal or anorectal conditions, focusing specifically on those relevant to hemorrhoids. This includes past diagnoses, treatments, and evaluations related to hemorrhoidal symptoms. The examiner will have access to the medical records and documents you’ve already submitted to the VA, so you don’t need to bring additional records to the exam unless you believe they will aid in recalling important details.

• History and Onset: The discussion will include your military service history and any previous incidents or conditions that might have contributed to your hemorrhoids. Several risk factors increase the likelihood of veterans developing hemorrhoids, such as prolonged sitting, heavy lifting, and significant strain during bowel movements, all of which may have occurred during service. The examiner will explore these factors and their potential connections to your current condition.

• Discussion of Symptoms: You will be asked about the specific symptoms of your hemorrhoids, such as their onset, frequency, and severity. Common symptoms include pain, swelling, bleeding, and possibly the presence of lumps around the anus. The discussion will also cover any complications such as significant discomfort, blood loss, or impact on daily functioning.

• Negative Impacts on Work, Life, and Social Functioning: The examiner will need to understand how your hemorrhoids affect your ability to work, perform daily activities, and engage socially. Issues such as pain, bleeding, and discomfort during sitting or standing can impact job performance, restrict personal activities, and decrease social interactions, leading to broader effects on mental health and quality of life.

• Physical Examination: The physical exam will focus on the anorectal area. The examiner will assess for any visible signs of hemorrhoids such as external hemorrhoids, prolapse, and assess the severity of any internal hemorrhoids using appropriate clinical tools. They will look for signs of pain, bleeding, and any other discomfort that impacts your quality of life.

• Completion of the Disability Benefits Questionnaire (DBQ) for Hemorrhoids: The examiner will document their findings on the DBQ for the rectum and anus, which is then submitted to the VA Rater for further processing. The VA Rater will use this information to approve, deny, or defer your claim based on the severity of the hemorrhoids and any negative impacts to your work, life, and social functioning.

List of Questions You Might Get Asked at a Hemorrhoids C&P Exam

Here’s a detailed list of questions from 9 sections of the DBQ for the rectum and anus, including hemorrhoids, that veterans can expect to be asked during their C&P exam:

SECTION I – DIAGNOSIS

• Have you ever been diagnosed with any conditions of the rectum or anus to include hemorrhoids? If yes, please specify.

• When were you diagnosed with these conditions? Please provide dates.

SECTION II – MEDICAL HISTORY

• Can you describe the history, including the onset and course, of your rectum or anus conditions?

• Are you currently on any continuous medication for these conditions? If yes, what medications are you taking?

SECTION III – SIGNS AND SYMPTOMS

• Do you experience any signs or symptoms related to your diagnosed conditions? If yes, please specify.

• For hemorrhoids: Are they internal or external? Describe any symptoms such as pain, bleeding, or protrusion.

• For anal/perianal fistula: Is there any impairment of sphincter control or leakage? How often does this occur?

• For rectal prolapse: Describe the severity and frequency of any leakage or other symptoms.

• Are there any other symptoms or complications such as persistent bleeding, secondary anemia, or fissures? Please provide details.

SECTION IV – EXAM

• What were the findings from the most recent physical examination of the rectal/anal area?

• Were any abnormalities like external hemorrhoids, anal fissures, or skin tags noted?

SECTION V – TUMORS AND NEOPLASMS

• Have you ever been diagnosed with a benign or malignant neoplasm related to the rectum or anus? If yes, is it currently active or in remission?

• Have you undergone any treatment for these neoplasms, such as surgery, radiation therapy, or chemotherapy? Please provide details including dates.

SECTION VI – OTHER PERTINENT PHYSICAL FINDINGS, COMPLICATIONS, CONDITIONS, SIGNS, SYMPTOMS, AND SCARS

• Do you have any other physical findings, complications, or conditions related to your rectum or anus conditions that have not been previously mentioned?

• Are there any scars related to these conditions or their treatment? If yes, describe the scars including location and measurements.

SECTION VII – DIAGNOSTIC TESTING

• Have you had any laboratory tests such as a Complete Blood Count (CBC) due to anemia? Please provide the date of the test and results.

• Have any imaging studies or diagnostic procedures been performed? If yes, what were the types of tests, dates, and results?

SECTION VIII – FUNCTIONAL IMPACT

• Does your condition impact your ability to work? If yes, can you provide examples of how each condition affects your daily and professional life?

SECTION IX – REMARKS

• Are there any additional comments or remarks you would like to add concerning your condition or its treatment?

Examples of Work, Life, and Functional Impacts of Hemorrhoids

Work Impacts

• Decreased Productivity: Hemorrhoids can cause intense pain and discomfort, making it difficult to concentrate on tasks at hand. This reduced focus can lead to decreased productivity in the workplace.

• Increased Absenteeism: Severe hemorrhoids may require medical treatment and recovery time, resulting in frequent absenteeism from work. Episodes of acute pain or bleeding might necessitate days off to manage symptoms.

• Limited Employment Opportunities: Jobs that involve prolonged sitting or physical exertion can exacerbate hemorrhoid symptoms, limiting employment opportunities for individuals with severe cases. Certain professions, such as truck driving or construction work, may become challenging due to the discomfort associated with hemorrhoids.

Life Impacts

• Social Withdrawal: Chronic pain and embarrassment related to hemorrhoids may lead individuals to withdraw from social activities, causing them to miss out on gatherings with friends and family. Fear of discomfort or embarrassment can result in isolation and decreased quality of life.

• Emotional Health: Living with hemorrhoids can take a toll on mental well-being, leading to feelings of frustration, embarrassment, and even depression. Coping with the symptoms, especially if they are recurrent or severe, can contribute to emotional distress and a decreased overall sense of happiness.

• Sleep Disturbances: Hemorrhoids can cause discomfort, itching, and pain, particularly during nighttime. Sleep disturbances due to these symptoms can lead to insomnia or poor sleep quality, resulting in fatigue and daytime drowsiness.

Functional Impacts

• Reduced Mobility: Hemorrhoids can make it painful to sit or move, limiting mobility and making activities such as walking or exercising uncomfortable. Individuals may find themselves avoiding certain movements or positions to minimize discomfort.

• Impaired Sensation: Hemorrhoids may cause itching, burning, or a feeling of fullness in the rectal area, affecting sensation and making it difficult to discern between normal bodily sensations and symptoms of the condition. This can lead to difficulties in managing hygiene or recognizing the need for medical intervention.

• Weakness: Chronic pain and discomfort associated with hemorrhoids can weaken the muscles in the pelvic area. This muscle weakness may lead to difficulties in activities that require strength, such as lifting heavy objects or performing strenuous physical tasks. Additionally, the fear of exacerbating symptoms can lead to avoidance of activities that might strain the affected area, further contributing to muscle weakness and deconditioning.

Tips to Help You Prepare for Your VA C&P Exam for Hemorrhoids

Here are some tips to help you prepare for your hemorrhoids C&P exam:

• Gather Records and Documents: Collect all pertinent medical records, including diagnoses, treatment histories, medication lists, and any relevant correspondence regarding your hemorrhoids. These documents serve as crucial evidence to support your claim during the examination. Review them thoroughly and bring hard copies to the C&P exam for reference.

• Maintain a Symptoms Diary: Keep a detailed record of your hemorrhoid symptoms, noting the frequency, severity, and duration of flare-ups. Record any factors that exacerbate or alleviate your symptoms, such as dietary habits or lifestyle changes. This diary will play a vital role in illustrating the impact of hemorrhoids on your daily life and functionality during the examination.

• List Functional Impacts: Document specific ways in which hemorrhoids affect your daily functioning. For example, hemorrhoids can cause pain, itching, and discomfort, making it challenging to sit for prolonged periods or engage in physical activities. They may also lead to bleeding during bowel movements, impacting hygiene and causing emotional distress. Additionally, the fear of exacerbating symptoms may lead to avoidance behaviors, further affecting quality of life.

• Review the DBQ for Rectum and Anus Conditions: Familiarize yourself with the Disability Benefits Questionnaire (DBQ) for anorectal conditions before your exam. Focus on sections relevant to hemorrhoids and be prepared to discuss the onset, progression, and current status of your condition. Describe any treatments you have undergone and their effectiveness. The examiner will use this information to complete the DBQ for Hemorrhoids, which will then be reviewed by the VA Rater for further assessment of your claim.

DBQ for Hemorrhoids [Download]

The examiner will follow the sections and questions of the electronic DBQ for Hemorrhoids to evaluate the severity of disability caused by hemorrhoids.

We’ve made a copy available for review and download below:

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