The Blood

Topics:

Anemia
Red Blood Cells
White Blood Cells
Platelets
The Spleen
Tuberculosis of the Lymph Nodes
Cancer of the Blood and Lymph Nodes
Other Blood Conditions
DBQs for Blood Conditions
Principles that Apply

Reminder: The VA will give a Military Disability Rating for each service-connected condition a service member has, but the DoD will only rate service-connected conditions that make a service member Unfit for Duty.

 


Anemia

Anemia is a condition where there are not enough red blood cells. The red blood cells transport oxygen throughout the body.

Code 7700: Anemia that is caused by low levels of iron or B12 in the body is rated under this code. This condition is rated based on the amount of hemoglobin in the blood and symptoms directly related to it. If the anemia causes other complications, like dementia or neuropathy, that are not rated under this code, then those conditions can be rated separately.

The normal hemoglobin level for an adult female is 12 to 16 grams per 100 milliliters of blood (g/dL). For an adult male it is 13.5 – 17.5 g/dL. If the hemoglobin level in the blood is 5 g/dL or less and causes symptoms like difficulty breathing or congestive heart failure, then it is rated 100%. If the hemoglobin level is 7 g/dL or less and causes symptoms like difficulty breathing, an enlarged heart, high blood pressure, or fainting (at least 3 times in the last 6 months), then it is rated 70%. If the hemoglobin level is 8 g/dL or less and causes symptoms like weakness, headaches, fatigue, lightheadedness, or shortness of breath, then it is rated 30%. If the hemoglobin level is 10 g/dL or less and causes symptoms like weakness, fatigue or headaches, then it is rated 10%. If the hemoglobin level is 10 g/dL or less but does not cause any symptoms, then it is rated 0%.

It is important to note that these ratings are based on the hemoglobin level and the symptoms. After the hemoglobin level for each rating, it says “or less,” meaning that if the condition has an enlarged heart (rated 70%) and the hemoglobin level is 5gm/100ml (rated 100%), then the rating would only be 70% since the hemoglobin level for 70% states 7gm/100ml or less. Regardless of how low the hemoglobin level is, the rating can only go up if the symptoms support it. On the contrary, if the hemoglobin level is higher than the requirement for a particular rating, then it cannot receive a lower rating. For example, if the hemoglobin level is 8gm/100ml (rated 30%) and there is an enlarged heart (rated 70%), the rating would only be 30% since the hemoglobin level is too high for the 70% rating. Finally, if there is a significant heart condition, but only mild anemia, then the condition is only rated on the heart condition under a heart code.

Code 7714: Sickle cell anemia is a kind of anemia where the red blood cells that carry the oxygen become shaped like a sickle (or a boomerang). Because of this, they are not able to carry as much oxygen to the body, and they sometimes get stuck in small blood vessels, blocking the blood flow to the tissues. A diagnosis of this condition alone is not enough to get a rating. There must be proof of significant symptoms that limit your ability to function in some way. This condition is genetic, and so it technically did exist prior to service (EPTS), and may not be ratable by the DoD.

If there are regular severe painful episodes, blood clots, and other symptoms that all cause the condition to be severe enough that even light manual labor cannot be performed, then it is rated 100%. If there are severe painful episodes multiple times a year with symptoms that restrict activity to just light manual labor, then it is rated 60%. If there have been episodes of severe active destruction of red blood cells and these episodes cause symptoms that continue after the episode is over, then it is rated 30%. If the condition has been properly diagnosed and it affects some organs, but there are no symptoms, then it is rated 10%.

Code 7716: Aplastic anemia is a condition where the bone marrow does not make enough new blood cells. If the condition requires a bone marrow transplant, then it is rated 100%. This 100% rating will continue for 6 months following the transplant surgery. After this time, the condition will be reevaluated and rated on its need for continuing transfusions or medications as detailed below.

If the condition does not need a transplant, but requires a transfusion of red blood cells or platelets at least once every 6 weeks or if there are infections that occur at least every 6 weeks, then it is rated 100%. If it requires a transfusion at least once every 3 months or if there are infections occurring every 3 months, then it is rated 60%. If it requires a transfusion at least once a year or if there are infections occurring at least once a year, then it is rated 30%. If the condition at least requires continuous medication, then it is rated 10%.

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Red Blood Cells

Code 7704: Polycythemia vera is the opposite of anemia. Instead of having too few red blood cells, the bone marrow produces too many red blood cells. This can cause shortness of breath, bleeding, dizziness and many serious symptoms. If this condition causes a serious side effect like high blood pressure, gout, a stroke or a blood clot, then those conditions are rated separately. They must be serious enough to cause a significant decrease in the ability to function in order to qualify for a rating. For example, slightly high blood pressure that does not limit the amount of activity a person can do is not enough for high blood pressure to be rated separately.

Polycythemia vera is not curable but can be treated. If it requires treatment of myelosuppressants then it is rated 100%. This 100% rating continues for 3 months following the last myelosuppressant treatment. The condition is then reevaluated and re-rated.

Whether or not myelosuppressants were used, if the condition is severe enough that a phlebotomy has to be routinely performed, then it is rated 40%. If the condition is stable whether or not medication is being taken, then it is rated 10%.

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White Blood Cells

Code 7702: Agranulocytosis (also known as granulopenia and agranulosis) is a condition where the bone marrow does not produce enough white blood cells. This significantly decreases the body’s immune system and makes the body very vulnerable to infection and disease. If the condition requires a bone marrow transplant, it is rated 100%. This 100% rating continues for 6 months following the transplant. The condition will then be reevaluated and re-rated.

Whether or not a transplant is performed, if the condition requires a transfusion of platelets or red blood cells at least once every 6 weeks, or if infections occur at least once every 6 weeks, it is rated 100%. If a transfusion or an infection occurs at least once every 3 months, then it is rated 60%. If a transfusion or an infection occurs at least once a year, then it is rated 30%. If the condition at least requires continuous medication, then it is rated 10%.

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Platelets

Platelets are small bits of cells in the blood that help stop bleeding and form blood clots.

Code 7705: Thrombocytopenia is a condition where the platelet count in the blood is low. The normal amount of platelets in a microliter of blood is between 150,000 to 450,000. If the platelet count is less than 20,000 and there is bleeding that requires medication and transfusions, then it is rated 100%. If the count is between 20,000 and 70,000 but there is no bleeding and it does not require treatment, then it is rated 70%. If the platelet count is stable and between 70,000 and 100,000 and there is no bleeding, then it is rated 30%. A stable count of 100,000 or more with no bleeding is rated 0%.

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The Spleen

The spleen is an organ that filters the blood and removes old red blood cells.

Code 7706: If the spleen is completely or partially removed, then it is rated 20%. If there are any complications, then those symptoms are rated separately.

Code 7707: All other spleen conditions are rated under this code. This code does not have its own rating system but is rated analogously with the symptoms the spleen condition causes. So if the spleen does not filter properly and causes a heart condition, then it would be rated under that heart condition. The final code would look like this: 7707-4593. The first four-digit code defines the condition as a spleen condition and the second four-digit code is how the condition is rated.

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Tuberculosis of the Lymph Nodes

Code 7710: Tuberculous adenitis (or “scrofula”) is a tuberculous infection of the lymph nodes in the neck. This condition is rated 100% while it is active. This 100% rating will continue for 1 year, after which the condition will be reexamined and rated based on the lasting symptoms or complications.

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Cancer of the Blood and Lymph Nodes

Code 7703: Leukemia is a cancer of the blood or bone marrow that causes the over-production of immature white blood cells. There are many different kinds of leukemia, but all are rated the same. If it is active and undergoing treatment, then it is rated 100%. This 100% rating continues for 6 months after the last treatment. Then the condition will be reevaluated and re-rated. If the leukemia is not active or being treated, then it is rated as anemia or aplastic anemia, whichever gives the higher rating. The final code would look like this: 7703-7700. The first four-digit code defines the condition as leukemia, and the second four-digit code says that it is rated as anemia.

Code 7709: Hodgkin’s disease is a cancer of the white blood cells (lymphoma) that spreads across the lymph nodes. Hodgkin’s disease is “staged” based on the severity of the cancer. The military will usually place the individual with a lower stage cancer on TDRL and may place him back on active duty after treatment. An individual with a more severe cancer will usually be medically retired.

If the cancer is active or undergoing treatment, then it is rated 100%. This rating continues for 6 months following the last treatment. The condition is then reevaluated and re-rated based on the ongoing symptoms.

Code 7715: Lymphomas that are not Hodgkin’s are rated under this code. Lymphomas are the growth of lymphoid cells in areas they are not meant to be. If the cancer is active or undergoing treatment, then it is rated 100%. This rating continues for 6 months following the last treatment. It is then reevaluated and re-rated based on the ongoing symptoms.

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Other Blood Conditions

Code 7717: Primary amyloidosis (a.k.a. AL amyloidosis, primary systemic amyloidosis, PSA, or amyloid light-chain amyloidosis) is a condition which causes the body to produce abnormal proteins that can build up and interfere with the functioning of the organs. It's a bit of an odd condition since it's not really a blood condition at all, but the VASRD stuck it in this category since there really wasn't a better option. We don't know what causes amyloidosis, and it can affect any organ or function in the body. While it is hard to categorize, it is easy to rate: any diagnosis of this condition is rated 100%.

All other blood conditions will be rated analogously (see the Analogous and Equivalent Codes page) with the above ratings. The bottom line rule is to rate any condition under the code that BEST describes it, even if it is not exact.

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DBQs for Blood Conditions

Here are the Disability Benefits Questionnaires (DBQs) used for blood conditions: Hairy Cell and Other B-Cell Leukemias DBQ and Leukemia and Other Blood Conditions DBQ.

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Principles that Apply

Probative Value: If two exams record the condition differently, the exam with the most thorough data and performed by the most qualified person in that specialty will be the exam the rating is based on.

A Tie Goes to the Veteran: If there are two equally strong exams with conflicting information, or if the condition can be equally rated under two different codes, then the one that gives the highest rating will be assigned. Every conflict should be resolved in favor of the higher rating.

Pyramiding: A single condition can only be rated once! However, if a heart condition or other condition exists that is additional to the blood condition (not simply caused by it), then it can also be rated.

Accurate Measurements: It is essential that the necessary information to rate your condition is recorded by the physician in your exam. With the information on this page, you should know what needs to be measured and recorded. Make sure this happens correctly to ensure that you receive a proper rating.

Hospital or Convalescent Ratings: Some conditions require periods of hospitalization or constant medical care (at-home nurse, etc.). Any condition that requires this is rated 100% during this intensive treatment. Once it ends, then the 100% rating will continue for a certain period. This period is 3 months unless another length (6 months, 1 year, etc.) is directly specified in the condition ratings. Some patients may need more time to recover than others, so the physician or Rating Authorities can lengthen this time period if they see fit.

Please see the VASRD Principles page for further guidance.

For conditions of the circulatory system, see The Heart or The Arteries and Veins pages.

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