Polycythemia Vera — VA Disability Rating Criteria (DC 7704)
Diagnostic Code 7704 · 38 CFR §4.117
What Is It?
Polycythemia vera is a blood cancer in which the bone marrow produces too many red blood cells, making the blood thicker and more prone to clotting. This increases the risk of stroke, heart attack, deep vein thrombosis, and pulmonary embolism. Symptoms include headaches, dizziness, itching (especially after warm water exposure), fatigue, blurred vision, and redness of the skin. Veterans may develop polycythemia vera as a result of toxic exposure during service, including radiation and chemical exposures. Treatment typically involves phlebotomy (blood removal) to reduce red blood cell levels, aspirin therapy, and sometimes chemotherapy drugs.
Rating Criteria
| Rating | Criteria |
|---|---|
| 100% | Polycythemia vera with severe complications, transformation to myelofibrosis or acute leukemia, or requiring intensive treatment such as chemotherapy. |
| 60% | Polycythemia vera requiring frequent phlebotomy and medication, with moderate symptoms and history of complications such as blood clots. |
| 30% | Polycythemia vera requiring regular phlebotomy and/or daily medication to control blood counts, with mild symptoms. |
| 10% | Polycythemia vera managed with phlebotomy alone on an infrequent basis. |
Evidence Needed
Blood tests showing elevated red blood cell counts, hemoglobin, and hematocrit are needed. A bone marrow biopsy confirming the diagnosis is important. Hematology records documenting ongoing treatment (phlebotomy frequency, medications) demonstrate severity. Service records or exposure documentation linking the condition to service are needed for nexus. Records of complications such as blood clots or cardiovascular events strengthen the claim.
C&P Exam Tips
Describe your symptoms: headaches, dizziness, itching, fatigue, vision changes. Explain your treatment regimen — how often you need phlebotomy and what medications you take. Describe any complications you have experienced (blood clots, cardiovascular events). Explain how the condition and its treatment affect your daily life and work.
How to File
File on VA Form 21-526EZ with DC 7704. Submit hematology records, bone marrow biopsy results, treatment records, and evidence of the service-connected cause. A hematology nexus opinion is recommended.
Common Mistakes
Not documenting the frequency of required phlebotomy and its impact on daily life leads to an incomplete picture of the condition burden. Not filing for secondary conditions caused by the elevated blood viscosity (cardiovascular events, deep vein thrombosis) misses additional compensation.
Frequently Asked Questions
Can polycythemia vera be service-connected?
Yes. While the exact cause is often a genetic mutation, toxic and radiation exposures during service can trigger or contribute to the development of polycythemia vera. A hematology nexus opinion connecting the condition to service-related exposure is needed.