Thrombocytopenia (Low Platelets) — VA Disability Rating Criteria (DC 7705)

Diagnostic Code 7705 · 38 CFR §4.117

What Is It?

Thrombocytopenia means an abnormally low platelet count, which leaves the blood unable to clot properly: easy bruising, petechiae, bleeding gums, nosebleeds, prolonged bleeding from small cuts and, at very low counts, dangerous internal bleeding. It is a finding rather than a single disease, and the cause matters to the claim. 38 CFR 4.117 has one entry in this area, DC 7705, and the revision that took effect 9 December 2018 titled it "Immune thrombocytopenia" — the autoimmune form in which the body destroys its own platelets. Its criteria are built on the platelet count and the treatment the disease requires, with thresholds at 30,000 and 50,000. Low platelets arising some other way are handled differently. Where thrombocytopenia is a manifestation of another service-connected condition — chronic liver disease, leukaemia, aplastic anaemia, chemotherapy, an autoimmune disease, or a medication — it is generally evaluated as part of the rating for that condition rather than a second time, because 38 CFR 4.14 bars evaluating the same disability picture twice. Where it stands alone and is not immune-mediated, 38 CFR 4.20 allows evaluation by analogy under a closely related code, and DC 7705 is the closest analogue, which is why its criteria are set out below. And where the immune form is the diagnosis, this code applies directly.

Rating Criteria

Evidence Needed

Serial complete blood counts across months, not one result, because the criteria read on thresholds of 30,000 and 50,000 and on whether the count stays low despite treatment. The diagnostic workup that established why the platelets are low — bone marrow biopsy where one was done, antibody and viral testing, medication review, liver and spleen imaging — because the cause decides whether this code applies directly, by analogy, or not at all. The treatment record in the schedule's own categories: no treatment, oral corticosteroids or intravenous immune globulin, immunosuppressive therapy, or chemotherapy for chronic refractory disease. A dated bleeding history, including any platelet transfusion or hospitalisation for severe bleeding. And the operative report for any splenectomy, which Note (1) directs be separately evaluated under DC 7706 and combined.

C&P Exam Tips

Bring the laboratory history and point out the lowest counts and their dates. Be precise about the diagnosis: immune thrombocytopenia is what DC 7705 is written for, and if a haematologist has used that term, make sure it appears in the examination report. If the low count is secondary to something else that is service connected — liver disease, an autoimmune condition, a medication taken for a service-connected disease — say so, because service connection on a secondary basis under 38 CFR 3.310 is the route, and the rating usually belongs to the underlying condition. Name treatments by class. Describe bleeding in the entry's own terms — mucous membrane bleeding, severe bleeding requiring hospitalisation, intravenous immune globulin, high-dose parenteral corticosteroids, platelet transfusions. And raise any splenectomy so it is separately rated at 20 percent under DC 7706 and combined.

How to File

File on VA Form 21-526EZ with the serial counts, the diagnostic workup and the treatment record. Name the diagnosis as precisely as the record allows: if it is immune thrombocytopenia, DC 7705 applies directly; if the low count is a manifestation of another service-connected disease, file that condition and let the thrombocytopenia be part of its evaluation rather than a second claim that 38 CFR 4.14 will bar; and if it stands alone from another cause, 38 CFR 4.20 allows evaluation by analogy, with DC 7705 the closest fit. Note (1) authorises a separate 20 percent for splenectomy under DC 7706, combined rather than absorbed. Note (2) provides that a 100 percent evaluation continues beyond the end of chemotherapy, with a mandatory VA examination six months after treatment stops and 38 CFR 3.105(e) protections on any reduction.

Common Mistakes

Submitting one platelet count rather than a series. Claiming thrombocytopenia separately from the service-connected disease that causes it, which invites a pyramiding denial under 38 CFR 4.14 instead of a higher evaluation for the underlying condition. Describing treatment loosely — the entry distinguishes oral corticosteroids from high-dose parenteral corticosteroids, and the two sit 40 points apart. Overlooking the 0 percent row, which covers a count above 50,000 and asymptomatic or disease in remission and which preserves service connection. And leaving a splenectomy inside the claim instead of asking for the separate 20 percent evaluation Note (1) authorises.

Frequently Asked Questions

Is DC 7705 only for immune thrombocytopenia?

The entry is titled "Immune thrombocytopenia," so it applies directly to that diagnosis. Low platelets from another cause are usually evaluated as part of the underlying service-connected disease, or, where the condition stands alone, by analogy under 38 CFR 4.20 — and DC 7705 is the closest analogous code, which is why its criteria still govern the numbers.

What platelet counts does the schedule use?

Thresholds of 30,000 and 50,000. A count of 30,000 or below despite treatment, or chemotherapy for chronic refractory disease, is 100 percent. A count above 30,000 but not above 50,000 is 10, 30 or 70 percent depending on treatment and bleeding history. Above 50,000 and asymptomatic, or in remission, is 0 percent.

My low platelets come from liver disease. How is that rated?

Generally as part of the liver disease rather than as a separate rating, because 38 CFR 4.14 bars evaluating the same disability picture twice. Where the liver condition is service connected, the thrombocytopenia supports the severity of that evaluation, and secondary service connection under 38 CFR 3.310 is the route for any distinct consequence it causes.

Can splenectomy be rated separately?

Yes. Note (1) to DC 7705 directs that splenectomy be separately evaluated under DC 7706 — a flat 20 percent — and combined with the rating under this code rather than absorbed into it.

Is a 0 percent rating worth anything?

It establishes service connection, which is the hard part of any claim. A count above 50,000 with no symptoms, or disease in remission, is the 0 percent row. If the count falls later, the claim becomes a request for increase rather than a fresh fight about whether the condition began in service.