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Polycythemia Vera VA Disability Rating
DC 7704 | 38 C.F.R. § 4.117 | M21-1, Part IV.ii.2.G
OVERVIEW
Polycythemia Vera (PV) is rated under DC 7704 at 38 C.F.R. § 4.117. Rating based on frequency of phlebotomy per year or type and intensity of medication required. PV that undergoes leukemic transformation is rated as leukemia under DC 7703. PV is a presumptive condition for veterans with ionizing radiation exposure under 38 C.F.R. § 3.311.
RATING CRITERIA (4 LEVELS)
100% — Requiring transplant or chemotherapy for symptom burden
Requiring peripheral blood or bone marrow stem-cell transplant; OR chemotherapy (including myelosuppressants) for ameliorating the symptom burden.
60% — Requiring phlebotomy 6+ times per year or molecularly targeted therapy
Requiring phlebotomy 6 or more times per 12-month period; OR molecularly targeted therapy for controlling RBC count.
30% — Phlebotomy 4-5 times per year or continuous biologic therapy
Phlebotomy 4-5 times per 12-month period; OR continuous biologic therapy or myelosuppressive agents (interferon) to maintain platelets <200,000 or WBC <12,000.
10% — Phlebotomy 3 or fewer times per year or intermittent biologic therapy
Phlebotomy 3 or fewer times per 12-month period; OR biologic therapy or interferon on intermittent basis.
KEY EVIDENCE TO GATHER
-JAK2 mutation testing confirming diagnosis
-Bone marrow biopsy results
-CBC history showing erythrocytosis
-Phlebotomy treatment records with frequency documentation
-Records of hydroxyurea, ruxolitinib, or other medication
-Documentation of complications: stroke, thrombotic events, gout, hypertension
SECONDARY CONDITIONS (3 MAPPED)
DC 8007/8008
PV causes thrombotic stroke due to hyperviscosity — rate residuals separately.
DC 5017
PV causes hyperuricemia and gout.
DC 7101
PV associated with hypertension.
C&P EXAM TIPS (4)
1.Count phlebotomy frequency precisely — the number per year directly determines the rating.
2.Molecularly targeted therapy (ruxolitinib/Jakafi) automatically qualifies for 60%.
3.Complications (hypertension, gout, stroke) are rated separately — file each.
4.Ionizing radiation exposure (nuclear test sites) supports service connection under § 3.311.
RELEVANT CASE LAW
38 C.F.R. § 4.117, DC 7704 Notes
Rate complications such as hypertension, gout, stroke, or thrombotic disease separately. If condition undergoes leukemic transformation, evaluate as leukemia under DC 7703.
DOLLAR IMPACT
10%: $175.03/mo. 60% (frequent phlebotomy/targeted therapy): $1,131.68/mo. 100%: $3,938.58/mo.
EDUCATIONAL TOOL ONLY. NOT LEGAL OR MEDICAL ADVICE.
NOT AFFILIATED WITH THE U.S. DEPARTMENT OF VETERANS AFFAIRS.
CLAIM RECON 2026