VA Diagnostic Code 7718Essential thrombocythemia and primary myelofibrosis:

Essential Thrombocythemia and Primary Myelofibrosis (VA Diagnostic Code 7718)

Hemic and Lymphatic Systems — 38 CFR § 4.117

Understanding the Condition

Essential thrombocythemia and primary myelofibrosis are disorders of the bone marrow and blood (the hemic and lymphatic systems). Under the VA rating schedule, these conditions are evaluated under Diagnostic Code 7718 in § 4.117.

Because managing these conditions often involves ongoing treatment, the VA rating focuses on the type of therapy required and, in some cases, blood cell counts such as platelet count and white blood cell (WBC) count.

Rating Levels

The VA assigns a disability rating based on the following levels:

100%

Requiring either continuous myelosuppressive therapy, or, for six months following hospital admission for any of the following treatments: peripheral blood or bone marrow stem cell transplant, or chemotherapy, or interferon treatment.

70%

Requiring continuous or intermittent myelosuppressive therapy, or chemotherapy, or interferon treatment to maintain a platelet count of less than 500 × 10⁹/L.

30%

Requiring continuous or intermittent myelosuppressive therapy, or chemotherapy, or interferon treatment to maintain a platelet count of 200,000–400,000, or a white blood cell (WBC) count of 4,000–10,000.

0%

Asymptomatic.

What the VA Looks For

When rating this condition, the VA considers:

• The type of treatment required — such as myelosuppressive therapy, chemotherapy, interferon treatment, or a peripheral blood or bone marrow stem cell transplant.
• Whether treatment is continuous or intermittent.
• Blood cell counts — including platelet count and white blood cell (WBC) count where relevant to the rating level.
• Whether the condition is asymptomatic.

Important Notes

• Note (1): If the condition undergoes leukemic transformation, it is evaluated as leukemia under Diagnostic Code 7703.
• Note (2): A 100 percent evaluation is assigned as of the date of hospital admission for peripheral blood or bone marrow stem cell transplant, or during the period of treatment with chemotherapy (including myelosuppressants) or interferon treatment. Six months following hospital discharge — or, in the case of chemotherapy treatment, six months after completion of treatment — the appropriate disability rating is determined by a mandatory VA examination. Any reduction in evaluation based upon that or any subsequent examination is subject to the provisions of § 3.105(e).