VA Disability Rating for Hematomyelia (DC 8012)
Diagnostic Code 8012 · 38 CFR §4.124a
What Is It?
Hematomyelia is bleeding into the substance of the spinal cord itself. The blood destroys cord tissue directly and produces deficits below the level of the bleed — weakness or paralysis, a sensory level, neuropathic pain, and bladder and bowel dysfunction. It follows spinal trauma, vascular malformations, anticoagulation and clotting disorders, and occasionally spinal surgery. The level and extent of the hemorrhage determine what is lost. It is not on any presumptive list, so service connection runs through the direct route — an injury or event documented in service — or as secondary to a service-connected condition. 38 CFR §4.124a opens the neurological schedule with a bracketed instruction: disability from the diseases it lists "may be rated from 10 percent to 100 percent in proportion to the impairment of motor, sensory, or mental function," referring the rater to the appropriate body system of the schedule for each manifestation. Inside the 8000–8025 block the schedule prints either a single flat percentage, a single minimum rating, or no percentage at all — there is no severity ladder anywhere in it. A Note closing the block adds two conditions: the minimum ratings for residuals require ascertainable residuals, and when a rating above the minimum is assigned, the diagnostic codes used as the basis of that evaluation must be cited alongside the code identifying the diagnosis. DC 8012 prints two figures: 100 percent for six months, and a minimum of 10 percent once the evaluation moves to residuals. Six months is the right clock for this code and for the brain-vessel codes DC 8007 through 8009; the two-year clock in §4.124a belongs to the malignant neoplasm codes DC 8002 and DC 8021.
Rating Criteria
| Rating | Criteria |
|---|---|
| 100% | For 6 months. The schedule assigns 100 percent for six months from the hemorrhage. It is a fixed period tied to the event, not a severity tier — when it ends, the evaluation moves to the residuals below. |
| 10% | Rate residuals, minimum. After the six-month period the evaluation is made on the residuals, with 10 percent as the floor and no steps printed between it and 100. §4.124a's preamble and §4.120 both govern what happens above the floor: disability in this field is rated in proportion to the impairment of motor, sensory, or mental function, with partial loss of use of one or more extremities from a neurological lesion rated by comparison with the mild, moderate, severe, or complete paralysis of the relevant peripheral nerves. The Note closing the 8000–8025 block requires ascertainable residuals for the minimum and requires that any rating above it cite the diagnostic codes used as its basis. |
Evidence Needed
Spinal MRI showing the hemorrhage, its level, and the extent of cord damage is the central study, with follow-up imaging documenting the residual cavity or myelomalacia. Records of the causative event — the trauma, the vascular malformation, the anticoagulation — carry the service-connection argument. Because the percentage after six months is built in proportion to impairment, the findings that set it are the quantified ones: strength grade by muscle group and the cord level of injury, the sensory level and its distribution, reflexes and tone, urodynamic testing for bladder dysfunction, and a bowel program description. EMG and nerve conduction studies characterize the extent of involvement, and rehabilitation records show what recovered and what plateaued.
C&P Exam Tips
Ask that the examiner document the exact cord level and the specific deficits at and below it, rather than describing the injury in general terms — the codes that build the rating are distribution-specific. Demonstrate the weakness and let the examiner grade it by muscle group. Map the sensory change precisely, including where normal sensation ends. Report bladder and bowel function in full, including catheterization schedules and incontinence frequency. Describe the neuropathic pain by type, location, and severity. List the assistive devices you use and every daily task that now requires help, and request a special monthly compensation evaluation where loss of use of a limb or the need for aid and attendance applies.
How to File
File VA Form 21-526EZ claiming hematomyelia under DC 8012 and cite 38 CFR §4.124a. Attach the spinal MRI, the records of the causative event, and a detailed current neurological examination. Claim each residual by name and by level — the weakness by limb and muscle group, the sensory level, the bladder and bowel dysfunction, the pain — because those are the codes any evaluation above the 10 percent floor must be built from and cited under. Where the hemorrhage followed a service-connected condition or its treatment, file it as secondary with the medical evidence linking them.
Common Mistakes
Reading 10 / 30 / 60 / 100 as a severity ladder. The schedule prints a six-month 100 percent and a 10 percent residual floor, and nothing in between. Accepting a single evaluation for the whole injury instead of documenting each deficit under its own code. Not documenting the exact cord level, without which the nerve codes cannot be applied. Leaving bladder and bowel dysfunction out of the claim. Confusing this code with the malignant neoplasm codes, whose 100 percent runs two years rather than six months.
Frequently Asked Questions
Is the 100 percent for six months or two years?
Six months, for DC 8012. The schedule prints "For 6 months — 100" directly under hematomyelia, and the same six-month clock covers the brain-vessel codes DC 8007 through 8009. The two-year clock that appears elsewhere in §4.124a belongs to the malignant neoplasm codes — DC 8002 for malignant brain tumors and DC 8021 for malignant spinal cord tumors — where a Note continues the 100 percent for two years following cessation of surgical, chemotherapeutic, or other treatment. Mixing the two clocks is a common error worth checking any source for.
How is hematomyelia different from a spinal cord injury?
Hematomyelia is specifically bleeding within the cord. Spinal cord injury is the broader category and also covers contusion, compression, and transection. For rating purposes the mechanism matters less than the deficit: after the six-month period the evaluation is built in proportion to the impairment of motor and sensory function under the codes for the affected distributions, which is the same approach regardless of how the cord was damaged. Where the mechanism does matter is service connection, since the causative event is what ties the injury to service.
Will my rating be reduced as I recover?
Some improvement is typical in the first year as swelling resolves and surviving pathways compensate, and meaningful recovery after that is uncommon. If VA proposes a reduction, the procedural protections in 38 CFR §3.105(e) apply first — notice of the proposed action, a period to respond, and the opportunity for a hearing. 38 CFR §3.344 adds requirements for evaluations that have continued at the same level for five years or more, and §3.951(b) protects an evaluation held for twenty years or more from reduction except on a showing of fraud.