Blood and lymph: anemia, leukemia, lymphoma and the exam

How VA rates blood and lymph conditions

38 CFR 4.117

The hemic and lymphatic schedule covers anemias, bone marrow and blood-count disorders, leukemia, lymphoma, myeloma, and the spleen. Most levels are set by treatment: transplants, transfusions, chemotherapy, injections or infusions, and how many times a year they happen.

Blood cancers carry a special rule: a 100% rating applies during active disease or the treatment phase, continues after treatment stops, and is followed by a mandatory VA exam (six months later for most, two years for non-Hodgkin’s lymphoma, five years after diagnosis for symptomatic multiple myeloma). Residuals are then rated under the code that fits.

Presumptive-condition rules may apply to some of these conditions. See presumptive conditions by era and burn pit registry and toxic exposure screening.

Anemias

38 CFR 4.117, DC 7714, 7716, 7720 to 7723

• Iron deficiency anemia (7720): 30% for intravenous iron infusions 4 or more times a year; 10% for 1 to 3 infusions or continuous oral supplementation; 0% if asymptomatic or treated only by diet. Anemia due to blood loss is rated under the condition causing the loss.
• Folic acid deficiency (7721): 10% with continuous high-dose oral supplements; 0% if asymptomatic or diet only.
• Pernicious anemia and B12 deficiency anemia (7722): 100% as of the initial diagnosis requiring transfusion for severe anemia or signs of central nervous system impairment needing parenteral B12, with a mandatory exam six months after discharge or after parenteral B12 stops. Then 10% for continuous B12 treatment, with residuals such as neuropathy or myelopathy rated separately.
• Acquired hemolytic anemia (7723): 100% with a bone marrow transplant or continuous intravenous or immunosuppressive therapy; 60% with immunosuppressive medication four or more times a year; 30% for two or three courses; 10% for one course; 0% asymptomatic. Splenectomy is rated separately and combined.
• Aplastic anemia (7716): 100% with a stem cell transplant, transfusions of platelets or red cells about every six weeks, or infections about every six weeks. 60% for transfusions or infections about every three months, or continuous immunosuppressive or platelet-stimulating therapy. 30% for transfusions or infections at least once a year.
• Sickle cell anemia (7714): 100% for four or more painful episodes a year with residual symptoms precluding even light manual labor; 60% for three episodes, or symptoms precluding other than light manual labor; 30% for one or two episodes; 10% for an asymptomatic case in remission with identifiable organ impairment. Sickle cell trait alone is not a ratable disability.

Leukemia, polycythemia and related disorders

38 CFR 4.117, DC 7703, 7704, 7718, 7719, 7725

• Leukemia, other than chronic myelogenous (7703): 100% with active disease or during treatment. Asymptomatic chronic lymphocytic leukemia or monoclonal B-cell lymphocytosis at Rai Stage 0 is 0%. Symptomatic CLL at Rai Stage I to IV is rated like other leukemia.
• Chronic myelogenous leukemia (7719): 100% with a stem cell transplant or continuous myelosuppressive or immunosuppressive therapy; 60% with intermittent myelosuppressive therapy, a tyrosine kinase inhibitor, or interferon when not in apparent remission; 30% in apparent remission on continuous tyrosine kinase inhibitor therapy.
• Polycythemia vera (7704): 100% with transplant or chemotherapy to ease symptoms; 60% with phlebotomy 6 or more times a year or molecularly targeted therapy; 30% with phlebotomy 4 or 5 times a year or continuous biologic or myelosuppressive therapy; 10% with phlebotomy 3 or fewer times a year or intermittent therapy. Complications such as hypertension, gout, stroke or thrombosis are rated separately.
• Essential thrombocythemia and primary myelofibrosis (7718): 100% with continuous myelosuppressive therapy or for six months after admission for a transplant, chemotherapy or interferon; 70%; 30%; 0% asymptomatic.
• Myelodysplastic syndromes (7725): 100% with a transplant or chemotherapy; 60% with four or more transfusions a year or three or more hospitalizations for infection; 30% with one to three transfusions, one or two hospitalizations for infection, or ongoing biologic therapy.

Lymphoma, myeloma and amyloidosis

38 CFR 4.117, DC 7709, 7712, 7715, 7717, 7724

• Hodgkin’s lymphoma (7709): 100% with active disease or during treatment, continuing after treatment, with a mandatory exam six months after treatment stops.
• Non-Hodgkin’s lymphoma (7715): 100% with active disease, during treatment, or with the indolent, non-contiguous phase of low-grade disease. The mandatory exam comes two years after treatment stops.
• Multiple myeloma (7712): 100% for symptomatic disease, continuing for five years after diagnosis. Asymptomatic, smoldering myeloma or MGUS is 0%.
• Solitary plasmacytoma (7724): 100% with active disease or during treatment. If it develops into multiple myeloma, rate as symptomatic myeloma.
• AL amyloidosis (7717): 100%.

Agranulocytosis, low platelets and the spleen

38 CFR 4.117, DC 7702, 7705 to 7707

• Acquired agranulocytosis (7702): 100% with a bone marrow transplant or infections about every six weeks; 60% with growth factors or continuous immunosuppressive therapy to keep the neutrophil count between 500 and 1,000, or infections about every three months; 30% with intermittent growth factors to keep the count above 1,000, or infections at least once a year; 10% with continuous medication such as antibiotics.
• Immune thrombocytopenia (7705): 100% with chemotherapy for chronic refractory disease or a platelet count of 30,000 or below despite treatment; 70% with immunosuppressive therapy, or a count above 30,000 up to 50,000 with a hospitalization for severe bleeding; 30%; 10%; 0% for a count above 50,000 and asymptomatic, or in remission.
• Splenectomy (7706): 20%, and complications such as infections with encapsulated bacteria are rated separately. It is combined with the rating for the underlying condition. Healed spleen injury (7707) is rated on residuals.

What VA’s blood and lymph exam form covers

VA Hematologic and Lymphatic Conditions DBQ (updated 2025-12-05)

• Diagnoses with ICD codes and dates, including complications such as infections with encapsulated bacteria, splenectomy and spleen injury.
• Cause, onset, course, continuous medication, and whether treatment is complete or ongoing.
• Subsections for aplastic, iron deficiency, folic acid, B12, hemolytic and sickle cell anemia and immune thrombocytopenia: transplants, transfusion frequency, infections, immunosuppressive or platelet-stimulating therapy and sickle cell pain episodes.
• Subsections for leukemia, myeloma, MGUS, agranulocytosis, thrombocythemia, myelofibrosis, myelodysplastic syndromes, lymphomas, polycythemia vera (including phlebotomy frequency) and plasmacytoma, with treatment and remission status.
• Recent hemoglobin, hematocrit, red cell, white cell and platelet results with dates, and functional impact on work.

See Preparing for Your C&P Exam.

What I could not verify

• Rating levels come from the eCFR text of 38 CFR 4.117, current as of October 16, 2026. eCFR is unofficial, and the official text wins over me.
• I summarized the lower levels of several codes, such as essential thrombocythemia (7718) and polycythemia (7704), where the schedule gives specific lab thresholds. Read the schedule for the exact numbers.
• I did not research which blood conditions are presumptive for particular exposures, or the rules for tuberculous adenitis (7710), which is rated under the tuberculosis sections.
• I checked the exam form through a text reader, not line by line. The form itself is the authority.