Anemia (Iron Deficiency and Related Anemias)
Anemia is a shortage of healthy red blood cells causing fatigue, weakness, and shortness of breath. Since VA's 2018 hematologic revision, the old catch-all anemia code (DC 7700) is gone - anemia is now rated by type, most commonly iron deficiency anemia under DC 7720, based on the treatment required.
How the VA rates it
The 2018 revision to 38 CFR 4.117 retired legacy DC 7700 (hypochromic-microcytic and megaloblastic anemia) and replaced it with type-specific codes. Iron deficiency anemia (DC 7720) is rated on treatment intensity: 30 percent for four or more IV iron infusions per year, 10 percent for one to three infusions or continuous oral iron, 0 percent if asymptomatic or managed by diet alone. Pernicious anemia/B12 deficiency (DC 7722) rates 100 percent at initial diagnosis when transfusion or central nervous system signs require parenteral B12, then 10 percent for continuous B12 therapy with residuals (neuropathy, myelopathy, dementia) rated separately. Acquired hemolytic anemia (DC 7723) rates 10 to 100 percent based on immunosuppressive therapy needs.
Rating criteria by percentage
Rated up to 30%Iron deficiency anemia requiring intravenous iron infusions 4 or more times per 12-month period.
Requiring IV iron infusions at least once but fewer than 4 times per 12-month period, or requiring continuous treatment with oral iron supplementation.
Asymptomatic, or requiring treatment only by dietary modification.
Secondary condition strategy
Commonly claimed secondary to this
Conditions veterans often develop from this one — each can be its own rating under 38 CFR 3.310.
- Fatigue-related functional impairment — Anemia's fatigue and exertional symptoms are considered within the rating; there is no separate common secondary condition.
This is often secondary to
If you already have one of these service-connected, it may support connecting this condition.
- Peptic Ulcer Disease — GI bleeding from a service-connected ulcer commonly causes iron deficiency anemia. Note: anemia due to blood loss is rated as part of the condition causing the blood loss, not separately under DC 7720.
- Endometriosis — Heavy menstrual bleeding from service-connected gynecological conditions can cause anemia; blood-loss anemia is factored into the causing condition's evaluation.
- Chronic kidney disease — Anemia of chronic kidney disease is commonly claimed secondary to service-connected renal disease (including diabetic nephropathy).
Evidence that strengthens this claim
- Identify the type of anemia in your records (iron deficiency, B12/pernicious, hemolytic, aplastic) - each has its own diagnostic code and very different criteria since the 2018 revision.
- Keep infusion records - the number of IV iron infusions per year is the main driver under DC 7720 (4 or more per year supports 30 percent).
- Document continuous prescription oral iron or B12 therapy; over-the-counter supplementation still counts if medically required and charted.
- If your anemia comes from bleeding caused by another service-connected condition, claim it through that condition - the rules require blood-loss anemia to be evaluated as part of the condition causing the bleeding.
Filing notes
Iron deficiency anemia due to blood loss is NOT rated under DC 7720; it is evaluated under the criteria for the condition causing the blood loss (note to DC 7720). Veterans rated under legacy DC 7700 before the 2018 revision keep their existing evaluations, but new claims use the current type-specific codes.
Rating rules to know
For pernicious anemia/B12 deficiency (DC 7722), residual effects such as peripheral neuropathy, myelopathy, dementia, or gastrointestinal residuals are rated separately in addition to the 10 percent for continuous therapy.
Related diagnostic codes
Disclaimer: Valor Rating is not affiliated with the U.S. Department of Veterans Affairs. This content is for educational purposes only and does not constitute legal or medical advice. Always review your documents carefully before submitting to the VA. For official guidance, consult an accredited VSO, claims agent, or attorney.