VA Diagnostic Code 7702Agranulocytosis, acquired:

Acquired Agranulocytosis — VA Disability Rating (Diagnostic Code 7702)

Body System: Hemic and Lymphatic Systems Regulation: 38 CFR § 4.117, Diagnostic Code 7702

Understanding the Condition

Agranulocytosis is a serious condition affecting the blood, in which the body has a very low number of a certain type of white blood cell (neutrophils). Because these cells help fight off infection, a low count can make a person more vulnerable to recurring infections. "Acquired" means the condition developed over the course of life rather than being present from birth.

The VA rates acquired agranulocytosis under Diagnostic Code 7702, part of its evaluation framework for the Hemic and Lymphatic Systems. Ratings are based largely on the treatment required to manage the condition and how often infections recur.

Available Rating Levels

The VA assigns one of the following disability evaluation levels based on the specific criteria met:

100%

Requiring bone marrow transplant; or infections recurring, on average, at least once every six weeks per 12-month period.

60%

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/µl but less than 1000/µl; or infections recurring, on average, at least once every three months per 12-month period.

30%

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.

10%

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.

What the VA Looks For

When evaluating acquired agranulocytosis, the VA focuses on:

• Treatment required to manage the condition, such as whether a bone marrow transplant is needed, whether myeloid growth factors (G-CSF or GM-CSF) are used intermittently, whether continuous immunosuppressive therapy (such as cyclosporine) is used, or whether continuous medication (such as antibiotics) is required for control.
• Absolute neutrophil count (ANC) levels that treatment is intended to maintain — for example, greater than 500/µl but less than 1000/µl, greater than 1000/µl, or greater than or equal to 1500/µl.
• Frequency of recurring infections measured on average across a 12-month period — ranging from at least once every six weeks, to once every three months, to at least once per year but less than once every three months.

Important Note on Bone Marrow Transplant

A 100 percent evaluation for bone marrow transplant is assigned as of the date of hospital admission and continues with a mandatory VA examination six months following hospital discharge. Any change in evaluation based upon that or any subsequent examination is subject to the provisions of § 3.105(e) of this chapter.