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7702
§ 4.117 Schedule of ratings—hemic and lymphatic systems.

Acquired agranulocytosis (low white blood cells)

A blood disorder where the body has dangerously low levels of white blood cells needed to fight infection.

What the rating means

Acquired agranulocytosis is rated under diagnostic code 7702 in the hemic and lymphatic systems schedule. VA rates this condition based on how severe your low white blood cell counts are and how much treatment is needed to manage them, including the frequency of infections.

A 10% rating applies if you need continuous medication, such as antibiotics, to keep the condition under control, or if you need intermittent myeloid growth factor to keep your absolute neutrophil count (ANC) at or above 1500 per microliter. A 30% rating applies if you need intermittent myeloid growth factors to maintain an ANC above 1000 per microliter, or if infections recur on average at least once per 12-month period but less than once every three months. A 60% rating applies if you need intermittent myeloid growth factors or continuous immunosuppressive therapy, such as cyclosporine, to keep your ANC above 500 but below 1000 per microliter, or if infections recur at least once every three months on average. A 100% rating applies if you require a bone marrow transplant or if infections recur at least once every six weeks on average. A 100% rating for a bone marrow transplant begins on the date of hospital admission and continues until a mandatory VA examination six months after discharge.

Evidence that helps

Medical records that document your ANC levels over time are central to showing where your condition falls in the rating scale. Lab reports showing repeated blood counts help establish whether your ANC stays above 1500, between 1000 and 1500, between 500 and 1000, or below 500 per microliter.

Records of the treatments you receive matter just as much. Pharmacy records or physician notes showing continuous antibiotic use, prescriptions for myeloid growth factors such as G-CSF or GM-CSF and how often they are given, or records of continuous immunosuppressive therapy such as cyclosporine all help establish the level of treatment required. Hospital admission records documenting a bone marrow transplant, including the admission date and discharge date, are needed to support a 100% rating under that criterion.

Records of infections, including emergency room visits, hospitalizations, or physician notes describing the frequency of infections over a 12-month period, help show whether you meet the recurring-infection criteria at the 30%, 60%, or 100% levels. Statements from you or people who know you describing how frequent infections affect your ability to work or carry out daily activities can also help VA understand the full picture of your condition.

Secondary conditions

Conditions that are often caused or made worse by this one. If you have any of these, they may be claimable as secondary service connection.