Hemic and Lymphatic Systems§ 4.117Updated
Rating criteria

VA Diagnostic Code 7722Pernicious anemia and Vitamin B12 deficiency anemia:

Rated from 10% to 100% under § 4.117. Here is what the VA requires at each level.

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What each rating requires

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  1. 100%

    For initial diagnosis requiring transfusion due to severe anemia, or if there are signs or symptoms related to central nervous system impairment, such as encephalopathy, myelopathy, or severe peripheral neuropathy, requiring parenteral B12 therapy

  2. 10%

    Requiring continuous treatment with Vitamin B12 injections, Vitamin B12 sublingual or high-dose oral tablets, or Vitamin B12 nasal spray or gel

From the schedule

Notes on this code

These notes are part of the regulation. They change how the levels above are applied.

  • Note: A 100 percent evaluation for pernicious anemia and Vitamin B12 deficiency shall be assigned as of the date of the initial diagnosis requiring transfusion due to severe anemia or parenteral B12 therapy and shall continue with a mandatory VA examination six months following hospital discharge or cessation of parenteral B12 therapy. Any reduction in evaluation based upon that or any subsequent examination shall be subject to the provisions of § 3.105(e) of this chapter. Thereafter, evaluate at 10 percent and separately evaluate any residual effects of pernicious anemia, such as neurologic involvement causing peripheral neuropathy, myelopathy, dementia, or related gastrointestinal residuals, under the most appropriate diagnostic code

Pernicious Anemia & Vitamin B12 Deficiency Anemia (VA Diagnostic Code 7722)

Understanding This Condition

Pernicious anemia and Vitamin B12 deficiency anemia are conditions affecting the Hemic and Lymphatic Systems. The VA rates these conditions under Diagnostic Code 7722, found in § 4.117 of the VA's rating schedule.

Because these conditions can range from requiring ongoing maintenance treatment to causing serious complications, the VA uses a rating structure that reflects both the initial severity of the condition and its long-term management.

Available Rating Levels

The VA assigns one of the following disability ratings based on how the condition presents and the treatment it requires:

100% Rating

Assigned for the initial diagnosis requiring a transfusion due to severe anemia, or when there are signs or symptoms related to central nervous system impairment — such as encephalopathy, myelopathy, or severe peripheral neuropathy — requiring parenteral B12 therapy (B12 given by injection or infusion rather than orally).

10% Rating

Assigned when the condition requires continuous treatment with any of the following:

  • Vitamin B12 injections
  • Vitamin B12 sublingual or high-dose oral tablets
  • Vitamin B12 nasal spray or gel

What the VA Looks For When Rating This Condition

When evaluating pernicious anemia and Vitamin B12 deficiency anemia, the VA considers the following:

  • Timing and basis of the 100% evaluation. A 100 percent evaluation is assigned as of the date of the initial diagnosis requiring transfusion due to severe anemia or parenteral B12 therapy.

  • Mandatory follow-up examination. The 100 percent evaluation continues, with a mandatory VA examination six months following hospital discharge or cessation of parenteral B12 therapy.

  • Rules governing reductions. Any reduction in evaluation based on that examination — or any subsequent examination — is subject to the provisions of § 3.105(e) of the applicable chapter.

  • Ongoing evaluation. Thereafter, the condition is evaluated at 10 percent.

  • Separate evaluation of residual effects. Any residual effects of pernicious anemia — such as neurologic involvement causing peripheral neuropathy, myelopathy, dementia, or related gastrointestinal residuals — are evaluated separately under the most appropriate diagnostic code.

This overview is based on the VA rating schedule criteria for Diagnostic Code 7722 (§ 4.117). Individual evaluations depend on the specific facts of each case and the findings of VA examinations.

These criteria are a rendering of § 4.117, diagnostic code 7722. The official version is the one that governs your rating.

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What next

How to claim this

Knowing the criteria is the first half. Getting your file to show them is the second.

  1. Find your level in the stack

    Read each rung against what your medical records already say. The level your records document today is the one the VA can support today.

  2. Name the gap

    Look at the rung above yours and write down exactly what it asks for that your file does not show yet — a diagnosis, a measurement, a prescribed brace, a doctor’s opinion linking it to service.

  3. Claim it by code

    File under diagnostic code 7722 and attach the evidence for the level you are asking for. Other Hemic and Lymphatic Systems codes may cover your secondary conditions.

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