|
Rating |
| 7702
Agranulocytosis, acquired: |
|
| Requiring bone
marrow transplant; or infections recurring, on average, at least
once every six weeks per 12-month period |
100 |
| Requiring
intermittent myeloid growth factors (granulocyte colony-stimulating
factor (G-CSF) or granulocyte-macrophage colony-stimulating factor
(GM-CSF) or continuous immunosuppressive therapy such as
cyclosporine to maintain absolute neutrophil count (ANC) greater
than 500/microliter (µl) but less than 1000/µl; or infections
recurring, on average, at least once every three months per
12-month period |
60 |
| Requiring
intermittent myeloid growth factors to maintain ANC greater than
1000/µl; or infections recurring, on average, at least once per
12-month period but less than once every three months per 12-month
period |
30 |
| Requiring
continuous medication (e.g., antibiotics) for control; or requiring
intermittent use of a myeloid growth factor to maintain ANC greater
than or equal to 1500/µl |
10 |
| Note: A 100
percent evaluation for bone marrow transplant shall be assigned as
of the date of hospital admission and shall continue with a
mandatory VA examination six months following hospital discharge.
Any change in evaluation based upon that or any subsequent
examination shall be subject to the provisions of § 3.105(e) of
this chapter |
|
| 7703 Leukemia
(except for chronic myelogenous leukemia): |
|
| When there is
active disease or during a treatment phase |
100 |
| Otherwise rate
residuals under the appropriate diagnostic code(s) |
|
| Chronic
lymphocytic leukemia or monoclonal B-cell lymphocytosis (MBL),
asymptomatic, Rai Stage 0 |
0 |
| Note
(1): A 100 percent evaluation shall continue beyond the cessation
of any surgical therapy, radiation therapy, antineoplastic
chemotherapy, or other therapeutic procedures. Six months after
discontinuance of such treatment, the appropriate disability rating
shall be determined by mandatory VA examination. Any change in
evaluation based upon that or any subsequent examination shall be
subject to the provisions of § 3.105(e) of this chapter. If there
has been no recurrence, rate on residuals |
| Note
(2): Evaluate symptomatic chronic lymphocytic leukemia that is at
Rai Stage I, II, III, or IV the same as any other leukemia
evaluated under this diagnostic code |
| Note
(3): Evaluate residuals of leukemia or leukemia therapy under the
appropriate diagnostic code(s). Myeloproliferative Disorders:
(Diagnostic Codes 7704, 7718, 7719) |
| 7704 Polycythemia
vera: |
|
| Requiring
peripheral blood or bone marrow stem-cell transplant or
chemotherapy (including myelosuppressants) for the purpose of
ameliorating the symptom burden |
100 |
| Requiring
phlebotomy 6 or more times per 12-month period or molecularly
targeted therapy for the purpose of controlling RBC count |
60 |
| Requiring
phlebotomy 4-5 times per 12-month period, or if requiring
continuous biologic therapy or myelosuppressive agents, to include
interferon, to maintain platelets <200,000 or white blood cells
(WBC) <12,000 |
30 |
| Requiring
phlebotomy 3 or fewer times per 12-month period or if requiring
biologic therapy or interferon on an intermittent basis as needed
to maintain all blood values at reference range levels |
10 |
|
Note (1): Rate complications such as hypertension, gout, stroke, or
thrombotic disease separately |
|
Note (2): If the condition undergoes leukemic transformation,
evaluate as leukemia under diagnostic code 7703 |
| Note
(3): A 100 percent evaluation shall be assigned as of the date of
hospital admission for peripheral blood or bone marrow stem cell
transplant; or during the period of treatment with chemotherapy
(including myelosuppressants). Six months following hospital
discharge or, in the case of chemotherapy treatment, six months
after completion of treatment, the appropriate disability rating
shall be determined by mandatory VA examination. Any reduction in
evaluation based upon that or any subsequent examination shall be
subject to the provisions of § 3.105(e) of this chapter |
| 7705 Immune
thrombocytopenia: |
|
| Requiring
chemotherapy for chronic refractory thrombocytopenia; or a platelet
count 30,000 or below despite treatment |
100 |
| Requiring
immunosuppressive therapy; or for a platelet count higher than
30,000 but not higher than 50,000, with history of hospitalization
because of severe bleeding requiring intravenous immune globulin,
high-dose parenteral corticosteroids, and platelet
transfusions |
70 |
| Platelet count
higher than 30,000 but not higher than 50,000, with either immune
thrombocytopenia or mild mucous membrane bleeding which requires
oral corticosteroid therapy or intravenous immune globulin |
30 |
| Platelet count
higher than 30,000 but not higher than 50,000, not requiring
treatment |
10 |
| Platelet count
above 50,000 and asymptomatic; or for immune thrombocytopenia in
remission |
0 |
|
Note (1): Separately evaluate splenectomy under diagnostic code
7706 and combine with an evaluation under this diagnostic code |
|
Note (2): A 100 percent evaluation shall continue beyond the
cessation of chemotherapy. Six months after discontinuance of such
treatment, the appropriate disability rating shall be determined by
mandatory VA examination. Any reduction in evaluation based upon
that or any subsequent examination shall be subject to the
provisions of § 3.105(e) of this chapter |
| 7706
Splenectomy |
20 |
|
Note: Separately rate complications such as systemic infections
with encapsulated bacteria |
|
Note: Separately rate complications such as systemic infections
with encapsulated bacteria |
| 7707 Spleen,
injury of, healed. |
|
| Rate for any
residuals. |
|
| 7709 Hodgkin's
lymphoma: |
|
| With active
disease or during a treatment phase |
100 |
| Note: A 100
percent evaluation shall continue beyond the cessation of any
surgical therapy, radiation therapy, antineoplastic chemotherapy,
or other therapeutic procedures. Six months after discontinuance of
such treatment, the appropriate disability rating shall be
determined by mandatory VA examination. Any reduction in evaluation
based upon that or any subsequent examination shall be subject to
the provisions of § 3.105(e) of this chapter. If there has been no
local recurrence or metastasis, rate on residuals under the
appropriate diagnostic code(s) |
|
| 7710 Adenitis,
tuberculous, active or inactive: |
|
| Rate under §
4.88c or 4.89 of this part, whichever is appropriate |
|
| 7712 Multiple
myeloma: |
|
| Symptomatic
multiple myeloma |
100 |
| Asymptomatic,
smoldering, or monoclonal gammopathy of undetermined significance
(MGUS) |
0 |
|
Note (1): Current validated biomarkers of symptomatic multiple
myeloma and asymptomatic multiple myeloma, smoldering, or
monoclonal gammopathy of undetermined significance (MGUS) are
acceptable for the diagnosis of multiple myeloma as defined by the
American Society of Hematology (ASH) and International Myeloma
Working Group (IMWG) |
|
Note (2): The 100 percent evaluation shall continue for five years
after the diagnosis of symptomatic multiple myeloma, at which time
the appropriate disability evaluation shall be determined by
mandatory VA examination. Any reduction in evaluation based upon
that or any subsequent examination shall be subject to the
provisions of § 3.105(e) and § 3.344 (a) and (b) of this
chapter |
| 7714 Sickle cell
anemia: |
|
| With at least 4
or more painful episodes per 12-month period, occurring in skin,
joints, bones, or any major organs, caused by hemolysis and
sickling of red blood cells, with anemia, thrombosis, and
infarction, with residual symptoms precluding even light manual
labor |
100 |
| With 3 painful
episodes per 12-month period or with symptoms precluding other than
light manual labor |
60 |
| With 1 or 2
painful episodes per 12-month period |
30 |
| Asymptomatic,
established case in remission, but with identifiable organ
impairment |
10 |
|
Note: Sickle cell trait alone, without a history of directly
attributable pathological findings, is not a ratable disability.
Cases of symptomatic sickle cell trait will be forwarded to the
Director, Compensation Service, for consideration under §
3.321(b)(1) of this chapter |
| 7715 Non-Hodgkin's
lymphoma: |
|
| When there is
active disease, during treatment phase, or with indolent and
non-contiguous phase of low grade NHL |
100 |
|
Note: A 100 percent evaluation shall continue beyond the cessation
of any surgical therapy, radiation therapy, antineoplastic
chemotherapy, or other therapeutic procedures. Two years after
discontinuance of such treatment, the appropriate disability rating
shall be determined by mandatory VA examination. Any reduction in
evaluation based upon that or any subsequent examination shall be
subject to the provisions of § 3.105(e) of this chapter. If there
has been no recurrence, rate on residuals under the appropriate
diagnostic code(s) |
| 7716 Aplastic
anemia: |
|
| Requiring
peripheral blood or bone marrow stem cell transplant; or requiring
transfusion of platelets or red cells, on average, at least once
every six weeks per 12-month period; or infections recurring, on
average, at least once every six weeks per 12-month period |
100 |
| Requiring
transfusion of platelets or red cells, on average, at least once
every three months per 12-month period; or infections recurring, on
average, at least once every three months per 12-month period; or
using continuous therapy with immunosuppressive agent or newer
platelet stimulating factors |
60 |
| Requiring
transfusion of platelets or red cells, on average, at least once
per 12-month period; or infections recurring, on average, at least
once per 12-month period |
30 |
|
Note (1): A 100 percent evaluation for peripheral blood or bone
marrow stem cell transplant shall be assigned as of the date of
hospital admission and shall continue with a mandatory VA
examination six months following hospital discharge. Any change in
evaluation based upon that or any subsequent examination shall be
subject to the provisions of § 3.105(e) of this chapter |
|
Note (2): The term “newer platelet stimulating factors” includes
medication, factors, or other agents approved by the United States
Food and Drug Administration |
| 7717 AL
amyloidosis (primary amyloidosis) |
100 |
| 7718 Essential
thrombocythemia and primary myelofibrosis: |
|
| Requiring
either continuous myelosuppressive therapy or, for six months
following hospital admission, peripheral blood or bone marrow stem
cell transplant, or chemotherapy, or interferon treatment |
100 |
| Requiring
continuous or intermittent myelosuppressive therapy, or
chemotherapy, or interferon treatment to maintain platelet count
<500 × 10 9/L |
70 |
| Requiring
continuous or intermittent myelosuppressive therapy, or
chemotherapy, or interferon treatment to maintain platelet count of
200,000-400,000, or white blood cell (WBC) count of
4,000-10,000 |
30 |
|
Asymptomatic |
0 |
|
Note (1): If the condition undergoes leukemic transformation,
evaluate as leukemia under diagnostic code 7703 |
|
Note (2): A 100 percent evaluation shall be assigned as of the date
of hospital admission for peripheral blood or bone marrow stem cell
transplant; or during the period of treatment with chemotherapy
(including myelosuppressants). Six months following hospital
discharge or, in the case of chemotherapy treatment, six months
after completion of treatment, the appropriate disability rating
shall be determined by mandatory VA examination. Any reduction in
evaluation based upon that or any subsequent examination shall be
subject to the provisions of § 3.105(e) of this chapter |
| 7719 Chronic
myelogenous leukemia (CML) (chronic myeloid leukemia or chronic
granulocytic leukemia): |
|
| Requiring
peripheral blood or bone marrow stem cell transplant, or continuous
myelosuppressive or immunosuppressive therapy treatment |
100 |
| Requiring
intermittent myelosuppressive therapy, or molecularly targeted
therapy with tyrosine kinase inhibitors, or interferon treatment
when not in apparent remission |
60 |
| In apparent
remission on continuous molecularly targeted therapy with tyrosine
kinase inhibitors |
30 |
|
Note (1): If the condition undergoes leukemic transformation,
evaluate as leukemia under diagnostic code 7703 |
|
Note (2): A 100 percent evaluation shall be assigned as of the date
of hospital admission for peripheral blood or bone marrow stem cell
transplant; or during the period of treatment with chemotherapy
(including myelosuppressants). Six months following hospital
discharge or, in the case of chemotherapy treatment, six months
after completion of treatment, the appropriate disability rating
shall be determined by mandatory VA examination. Any reduction in
evaluation based upon that or any subsequent examination shall be
subject to the provisions of § 3.105 of this chapter |
| 7720 Iron
deficiency anemia: |
|
| Requiring
intravenous iron infusions 4 or more times per 12-month period |
30 |
| Requiring
intravenous iron infusions at least 1 time but less than 4 times
per 12-month period, or requiring continuous treatment with oral
supplementation |
10 |
| Asymptomatic or
requiring treatment only by dietary modification |
0 |
|
Note: Do not evaluate iron deficiency anemia due to blood loss
under this diagnostic code. Evaluate iron deficiency anemia due to
blood loss under the criteria for the condition causing the blood
loss |
| 7721 Folic acid
deficiency: |
|
| Requiring
continuous treatment with high-dose oral supplementation |
10 |
| Asymptomatic or
requiring treatment only by dietary modification |
0 |
| 7722 Pernicious
anemia and Vitamin B12 deficiency anemia: |
|
| For initial
diagnosis requiring transfusion due to severe anemia, or if there
are signs or symptoms related to central nervous system impairment,
such as encephalopathy, myelopathy, or severe peripheral
neuropathy, requiring parenteral B12 therapy |
100 |
| Requiring
continuous treatment with Vitamin B12 injections, Vitamin B12
sublingual or high-dose oral tablets, or Vitamin B12 nasal spray or
gel |
10 |
|
Note: A 100 percent evaluation for pernicious anemia and Vitamin
B12 deficiency shall be assigned as of the date of the initial
diagnosis requiring transfusion due to severe anemia or parenteral
B12 therapy and shall continue with a mandatory VA examination six
months following hospital discharge or cessation of parenteral B12
therapy. Any reduction in evaluation based upon that or any
subsequent examination shall be subject to the provisions of §
3.105(e) of this chapter. Thereafter, evaluate at 10 percent and
separately evaluate any residual effects of pernicious anemia, such
as neurologic involvement causing peripheral neuropathy,
myelopathy, dementia, or related gastrointestinal residuals, under
the most appropriate diagnostic code |
| 7723 Acquired
hemolytic anemia: |
|
| Requiring a
bone marrow transplant or continuous intravenous or
immunosuppressive therapy (e.g., prednisone, Cytoxan, azathioprine,
or rituximab) |
100 |
| Requiring
immunosuppressive medication 4 or more times per 12-month
period |
60 |
| Requiring at
least 2 but less than 4 courses of immunosuppressive therapy per
12-month period |
30 |
| Requiring one
course of immunosuppressive therapy per 12-month period |
10 |
|
Asymptomatic |
0 |
|
Note (1): A 100 percent evaluation for bone marrow transplant shall
be assigned as of the date of hospital admission and shall continue
for six months after hospital discharge with a mandatory VA
examination six months following hospital discharge. Any reduction
in evaluation based upon that or any subsequent examination shall
be subject to the provisions of § 3.105(e) of this chapter |
|
Note (2): Separately evaluate splenectomy under diagnostic code
7706 and combine with an evaluation under diagnostic code 7723 |
| 7724 Solitary
plasmacytoma: |
|
| Solitary
plasmacytoma, when there is active disease or during a treatment
phase |
100 |
|
Note (1): A 100 percent evaluation shall continue beyond the
cessation of any surgical therapy, radiation therapy,
antineoplastic chemotherapy, or other therapeutic procedures
(including autologous stem cell transplantation). Six months after
discontinuance of such treatment, the appropriate disability rating
shall be determined by mandatory VA examination. Any change in
evaluation based upon that or any subsequent examination shall be
subject to the provisions of § 3.105(e) of this chapter. If there
has been no recurrence, rate residuals under the appropriate
diagnostic codes |
|
Note (2): Rate a solitary plasmacytoma that has developed into
multiple myeloma as symptomatic multiple myeloma |
|
Note (3): Rate residuals of plasma cell dysplasia (e.g.,
thrombosis) and adverse effects of medical treatment (e.g.,
neuropathy) under the appropriate diagnostic codes |
| 7725
Myelodysplastic syndromes: |
|
| Requiring
peripheral blood or bone marrow stem cell transplant; or requiring
chemotherapy |
100 |
| Requiring 4 or
more blood or platelet transfusions per 12-month period; or
infections requiring hospitalization 3 or more times per 12-month
period |
60 |
| Requiring at
least 1 but no more than 3 blood or platelet transfusions per
12-month period; infections requiring hospitalization at least 1
but no more than 2 times per 12-month period; or requiring biologic
therapy on an ongoing basis or erythropoiesis stimulating agent
(ESA) for 12 weeks or less per 12-month period |
30 |
|
Note (1): If the condition progresses to leukemia, evaluate as
leukemia under diagnostic code 7703 |
|
Note (2): A 100 percent evaluation shall be assigned as of the date
of hospital admission for peripheral blood or bone marrow stem cell
transplant, or during the period of treatment with chemotherapy,
and shall continue with a mandatory VA examination six months
following hospital discharge or, in the case of chemotherapy
treatment, six months after completion of treatment. Any reduction
in evaluation based upon that or any subsequent examination shall
be subject to the provisions of § 3.105(e) of this chapter. If
there has been no recurrence, residuals will be rated under the
appropriate diagnostic codes |