38 CFR Part 4 — 38 CFR § 4.117
Aplastic Anemia
dc-7716-aplastic-anemia
Hematologic / lymphatic
Diagnostic code
7716
Why your DC matters: DC 7716 is the exact code the VA uses to rate this condition. It determines which symptoms unlock which percentage, what evidence the rater looks for, and which secondaries are most likely to be approved.
Last verified against 38 CFR (eCFR Part 4):
Rating criteria (38 CFR Part 4)
Diagnostic code 7716 — Aplastic Anemia — is listed under 38 CFR § 4.117 in 38 CFR Part 4. The paragraphs below summarize how this code is used; the official schedule text controls exact percentages, formulas, and notes.
Schedule summary (educational, not a substitute for the regulation): Educational index row from the rating schedule naming convention; confirm exact diagnostic code, effective date, and criteria in the current eCFR Part 4.
Exact rating criteria: Open Part 4 in the eCFR (link under “Official source” below). Locate your diagnostic code number (7716) in the correct body-system subpart, or use Find in Page (Ctrl+F / ⌘F) for “7716”. Copy the verbatim rating table, including any parenthetical notes, exceptions, and cross-references, for the version of Part 4 that applies to your effective date.
Effective dates & which schedule version applies
Which diagnostic code, percentage, and effective date apply depends on the facts of your claim and the version of the rating schedule in force for the period being decided. Generally, VA applies the schedule in effect at the specified time under 38 U.S.C. § 5110 and implementing rules, subject to exceptions (e.g., protected ratings, liberalizing law changes—see regulation and VA manual policy as applicable).
For older claims, the **current** eCFR may not match the text that applied years ago. If your decision references a prior percentage or code, compare against the Part 4 text **as of** your claim’s relevant dates; historical Federal Register / CFR snapshots may be needed for precise comparison.
The “Last verified” date on this page is when we last checked this educational summary against the electronic CFR—not the date of any VA policy or your personal claim decision.
Notes for your claim
Evidence: Show that your diagnosis and severity match the factors the schedule names for DC 7716 (e.g., measurements, frequency, treatment, functional loss), with medical and lay evidence as appropriate.
C&P exams: Results should reflect the schedule’s requirements (correct joints measured, correct formulas). If the exam omits required findings, consider submitting records or requesting clarification.
If you disagree with the DC, percentage, or effective date, review the Part 4 text for your period and consider a supplemental claim or appeal with a VA-accredited representative.
This site does not provide legal advice.
Official source
38 CFR Part 4 (eCFR) — locate diagnostic code 7716 in the subpart for your body system (use Find in Page if needed).
DC 7716 (aplastic anemia) rates on a treatment-intensity tier ladder from 30% (annual transfusion / infection) to 100% (stem cell transplant required or transfusion / infection at least every 6 weeks). Aplastic anemia is bone marrow failure — pancytopenia (low RBCs, WBCs, platelets) from suppression or destruction of hematopoietic stem cells. Etiologies: idiopathic, drug-induced (chemotherapy, chloramphenicol), radiation, viral (parvovirus, hepatitis), autoimmune. The chemo-secondary path matters for veterans with prior service-connected cancer treated with bone marrow-suppressive chemotherapy. Distinct from iron-deficiency anemia (DC 7720) and other hemolytic anemias — aplastic anemia is bone marrow failure, not red cell destruction or iron deficiency.
Rating Tiers — What Each Percentage Requires
| Rating | What It Takes | Evidence That Supports It |
|---|---|---|
| 100% | Aplastic anemia requiring bone marrow / stem cell transplantation, OR requiring transfusion of platelets or red blood cells at least every 6 weeks, OR infections recurring at least every 6 weeks (in any combination) over the past 12-month period. | Transplant records (allogeneic or autologous stem cell), transfusion log showing frequency, infection log with culture data. |
| 60% | Aplastic anemia requiring transfusion of platelets or red blood cells at least every 3 months, OR infections recurring at least every 3 months (in any combination) over the past 12-month period. | Transfusion log + infection log over 12-month window. |
| 30% | Aplastic anemia requiring transfusion of platelets or red blood cells at least once, OR infections recurring at least once over the past 12-month period. | Single transfusion or single significant infection event in 12-month period. |
What Qualifies Under DC 7716?
Bone marrow failure with pancytopenia
Bone marrow biopsy showing hypocellularity (<25% cellularity) + pancytopenia on CBC (low RBCs, WBCs, platelets). Distinguishes from iron deficiency, hemolytic anemia, MDS, leukemia infiltration.
Treatment-intensity tier ladder
Tier based on transplant requirement + transfusion / infection frequency over 12-month period:
- • 30% — Transfusion/infections ≥ once per 12 months
- • 60% — Transfusion/infections ≥ every 3 months
- • 100% — Stem cell transplant required OR transfusion/infections ≥ every 6 weeks
Multiple SC pathways
Idiopathic + toxic exposure framework, drug-induced (chemotherapy from SC cancer = direct secondary), radiation-induced (atomic veteran § 3.309(d)), viral, autoimmune. Etiology determines lane.
Language Your Rater Needs to See
These are the exact (or near-exact) regulatory phrases that unlock specific tiers. If your DBQ or C&P report doesn't use this vocabulary, the rater may default to a lower percentage even when symptoms qualify.
“Requires bone marrow / stem cell transplantation OR transfusion/infections at least every 6 weeks”
100% gate. Transplant requirement (referral, eligibility workup, or actual transplant) anchors 100% alone — don't wait for actual transplant if transplant-eligible status is documented. Transfusion/infection frequency is the alternative path.
“Transfusion/infections at least every 3 months”
60% gate. Document each transfusion event and significant infection in the 12-month window. CBC trending + transfusion log.
“Transfusion/infections at least once per 12 months”
30% floor — clinically significant aplastic anemia with at least one transfusion or significant infection. Don't accept 0% for an established diagnosis with even one event.
“Bone marrow biopsy showing hypocellularity + pancytopenia on CBC”
Anchors aplastic anemia (vs. iron deficiency, hemolytic, or other anemia). Bone marrow biopsy <25% cellularity + pancytopenia confirms.
Evidence Checklist — Specific to This Condition
Bone marrow biopsy showing hypocellularity (<25% cellularity)
CRITICALDefinitive diagnostic anchor for aplastic anemia. Distinguishes from infiltrative diseases (myelodysplasia, leukemia, lymphoma).
CBC trend showing pancytopenia
CRITICALHemoglobin, white blood cells, and platelets all reduced. Severity grading: severe (ANC <500), very severe (ANC <200).
Transfusion log over past 12 months
CRITICALPlatelet and red blood cell transfusion frequency drives tier. ≥ every 6 weeks = 100%; ≥ every 3 months = 60%; ≥ once = 30%.
Infection log with cultures
CRITICALSignificant infections requiring hospitalization, IV antibiotics, or febrile neutropenia management. Same frequency tiers as transfusions.
Stem cell / bone marrow transplant referral or eligibility documentation
CRITICALTransplant eligibility OR actual transplant anchors 100% gate. Even pre-transplant referral status supports 100%.
Etiology workup — drug history, radiation, viral, autoimmune
IMPORTANTEstablishes service-connection pathway. Chemotherapy-induced aplastic anemia secondary to SC cancer treatment is direct secondary lane.
Immunosuppressive therapy records (ATG, cyclosporine, eltrombopag)
IMPORTANTFirst-line treatment for non-transplant candidates. Documents treatment intensity.
C&P Exam Tips
Bring bone marrow biopsy + CBC trend + transfusion/infection log
All three drive the rating. Examiner needs the 12-month log to anchor tier.
Document transplant eligibility / referral status even if pre-transplant
Transplant requirement (including eligibility status) anchors 100% gate.
Identify etiology pathway for service connection
Idiopathic vs. drug-induced vs. radiation vs. viral. Chemo-induced post-SC cancer = direct secondary.
Don't confuse with iron-deficiency anemia (DC 7720)
Aplastic anemia is bone marrow failure (DC 7716, pancytopenia). Iron-deficiency anemia (DC 7720) is hemoglobin-only deficiency from low iron. Different DCs, different schedules.
Common Mistakes That Cost Veterans Points
Settling for 30% when transfusion frequency supports 60% or 100%
Tier driven by transfusion + infection frequency over 12-month window. Document each event meticulously. Even monthly transfusion = ≥ every 6 weeks = 100% gate.
Not pursuing chemo-induced aplastic anemia as direct secondary
If prior service-connected cancer (e.g., DC 7709 Hodgkin's, DC 7715 NHL, DC 7712 multiple myeloma, others) was treated with bone marrow-suppressive chemotherapy and aplastic anemia developed post-treatment, file as direct secondary. Chemo-induced aplastic anemia is well-documented.
Confusing with myelodysplastic syndrome (MDS)
Aplastic anemia (DC 7716) is bone marrow failure with hypocellular marrow. MDS is dysplastic but typically normocellular or hypercellular marrow with abnormal maturation. Bone marrow biopsy distinguishes. MDS has its own evolving presumptive lane.
Filing under iron-deficiency anemia (DC 7720) by mistake
DC 7720 is iron-deficiency anemia only — different etiology, different schedule. Aplastic anemia (pancytopenia from marrow failure) is DC 7716. File the correct code.
Tactical Plays
⚡ Document transplant eligibility — anchors 100% gate
DC 7716 100% gate is 'requires bone marrow / stem cell transplantation OR transfusion/infections at least every 6 weeks.' Transplant requirement is anchored by transplant referral, eligibility workup, or actual transplant. Don't wait for actual transplant if transplant-eligible status is documented. Pull hematology referral letters.
⚡ Keep meticulous transfusion + infection logs
12-month rolling window drives tier. Each transfusion event and each significant infection (hospitalization, IV antibiotics, febrile neutropenia) counts. Frequency tiers: ≥ every 6 weeks = 100%; ≥ every 3 months = 60%; ≥ once per year = 30%. Without the log, examiners default to lower tiers.
⚡ Pursue chemo-induced secondary if prior SC cancer
If prior service-connected cancer (Hodgkin's, NHL, multiple myeloma, others) was treated with bone marrow-suppressive chemotherapy and aplastic anemia developed afterward, file as direct secondary to SC cancer. Chemo-induced marrow toxicity is well-documented. The secondary pathway avoids relitigating service connection.
⚡ Audit etiology — viral, drug, radiation, autoimmune
Etiology determines SC pathway. Chloramphenicol or other in-service drug exposure → direct SC. In-service hepatitis or parvovirus → viral-induced aplastic anemia secondary. Atomic veteran radiation → § 3.309(d) presumptive. Idiopathic + chronic stressor exposure → consider toxic-exposure framework.
Secondary Conditions to File With This One
Chemo-induced aplastic anemia (post-SC cancer)
STRONGIf prior SC cancer (Hodgkin's, NHL, multiple myeloma, others) treated with bone marrow-suppressive chemotherapy, aplastic anemia is direct secondary. Chemo-induced marrow toxicity is well-documented.
Stem cell transplant complications (graft-vs-host disease, infections)
STRONGAllogeneic transplant complications — acute and chronic GVHD, opportunistic infections, secondary malignancies. Rates separately.
Iron overload from chronic transfusion
MODERATETransfusion-dependent aplastic anemia accumulates iron over time. Hemosiderosis affecting liver, heart, endocrine. Rates separately if symptomatic.
Secondary leukemia / MDS transformation
MODERATEAplastic anemia carries risk of clonal evolution to MDS or AML. Rates under DC 7703 leukemia if transformation occurs.
Depression secondary to chronic illness / transfusion burden
STRONGDC 9434
Transfusion dependence + transplant-related morbidity drive depression. Well-documented.
Immunodeficiency / recurrent infections
MODERATEAplastic anemia + treatment causes profound immunosuppression. Recurrent infections rate as separate consideration.
Special Monthly Compensation (SMC-L (statutorily housebound))
100% DC 7716 (transplant or every-6-week transfusion/infection) + additional independent disabilities combining to 60%+. Transplant complications, chronic infections, iron overload residuals stack to SMC L predicate.
SMC-L (statutorily housebound) monthly add-on
+$4,805.45
Added on top of your schedular rating.
Compensation Scenarios
2026 rates (effective Dec 1, 2025, per va.gov)
30% — single, no dependents
Base rating
$552.47
TOTAL
$552.47/mo
Transfusion or significant infection at least once per 12-month period.
60% — single, no dependents
Base rating
$1,435.02
TOTAL
$1,435.02/mo
Transfusion or infections at least every 3 months.
100% — single, no dependents
Base rating
$3,938.58
TOTAL
$3,938.58/mo
Stem cell transplant required OR transfusion/infections at least every 6 weeks.
100% DC 7716 + 100% chemo-induced secondary cancer (DC 7703) → SMC L
Base rating
$4,805.45
TOTAL
$4,805.45/mo
Aplastic anemia + secondary leukemia transformation = SMC L predicate.
Note: Amounts are approximations rounded to nearest dollar. Actual comp varies with effective date, dependents (spouse, children, parents — each adds), Aid & Attendance, and additional disabilities. Combined ratings use VA Math (§ 4.25), not simple addition.
Key Definitions
🩸What is Aplastic Anemia?
Aplastic anemia is bone marrow failure — pancytopenia (low RBCs, WBCs, platelets) from suppression or destruction of hematopoietic stem cells. Bone marrow biopsy shows hypocellularity (<25% cellularity, often near-empty in severe disease). Etiologies include idiopathic, drug-induced (chemotherapy, chloramphenicol), radiation, viral (parvovirus, hepatitis), autoimmune.
↔️Aplastic Anemia vs. Iron-Deficiency Anemia?
Aplastic anemia (DC 7716) = bone marrow failure with pancytopenia. All three cell lines reduced. Iron-deficiency anemia (DC 7720) = isolated hemoglobin deficiency from low iron stores. Different DCs, different schedules. Aplastic anemia is more severe and treatment-intensive.
💯What treatments anchor the 100% gate?
Two paths: (1) bone marrow / stem cell transplantation requirement (including referral or eligibility status), OR (2) transfusion of platelets/RBCs at least every 6 weeks OR infections recurring at least every 6 weeks (in any combination) over the past 12-month period.
💊Is chemo-induced aplastic anemia a direct secondary?
Yes — if prior service-connected cancer (e.g., Hodgkin's lymphoma, non-Hodgkin's lymphoma, multiple myeloma, others) was treated with bone marrow-suppressive chemotherapy and aplastic anemia developed afterward, it's a direct secondary to the SC cancer. Chemo-induced marrow toxicity is well-documented.
How to File Your Claim
Pull bone marrow biopsy + CBC trend + 12-month transfusion/infection log
All three anchor the rating. Without the log, examiners default to lower tiers.
Document transplant referral / eligibility status if applicable
Transplant requirement (including pre-transplant eligibility) anchors 100% gate.
Identify etiology + service-connection pathway
Chemo-induced (post-SC cancer) = direct secondary. Radiation-induced (atomic veteran) = § 3.309(d). Drug-induced (in-service) = direct SC. Idiopathic = toxic exposure framework.
File 21-526EZ specifying 'aplastic anemia (DC 7716)' under the applicable lane
If chemo-induced post-SC cancer, file as direct secondary. Otherwise pursue applicable presumption / direct SC pathway.
Build residuals secondary file — transplant complications, iron overload, depression
GVHD, opportunistic infections, hemosiderosis, secondary leukemia transformation, depression. Each rateable separately.
Typical Claim Timeline
File initial claim
Day 0–7: Submit VA Form 21-526EZ with all medical evidence on file
VA acknowledges claim
Week 1–2: Receive confirmation letter and claim tracking number
C&P examination scheduled
Month 1–3: VA contracts an exam vendor and sends you appointment notice
Attend C&P exam
Bring your full evidence package; describe symptoms on your worst days, not your best
Decision & rating notice
Month 3–6: Decision letter with rating percentage and effective date
First payment & retro back pay
Within 15 days of decision; retroactive to claim date (or effective date if earlier)
Timeline varies by case complexity and VA regional office workload. Some claims resolve faster; others take longer.
Important Considerations
Tier driven by 12-month transfusion + infection log
Without the log, examiners default to lower tiers. Document each event meticulously.
Transplant eligibility anchors 100% gate
Transplant referral or eligibility status (not just actual transplant) supports 100%. Pull hematology referrals.
Chemo-induced post-SC cancer = direct secondary lane
Avoid relitigating service connection. File as direct secondary to existing SC cancer rating.
Distinct from iron-deficiency anemia (DC 7720)
Aplastic anemia (DC 7716) = bone marrow failure with pancytopenia. Different DC, different schedule. File the correct code.
Related Tools & Resources
Frequently Asked Questions
What's the difference between DC 7716 (aplastic anemia) and DC 7720 (iron-deficiency anemia)?
DC 7716 (aplastic anemia) is bone marrow failure with pancytopenia — all three cell lines (RBCs, WBCs, platelets) reduced. Treatment-intensive (transfusion-dependent, often transplant-required). DC 7720 (iron-deficiency anemia) is isolated hemoglobin deficiency from low iron stores — typically treated with iron supplementation or IV iron. Different DCs, different schedules, different severity. File the diagnosis that matches your bone marrow + CBC findings.
Can chemotherapy from my service-connected cancer cause secondary aplastic anemia?
Yes — bone marrow-suppressive chemotherapy (used for many cancers including Hodgkin's lymphoma, non-Hodgkin's lymphoma, multiple myeloma) can cause secondary aplastic anemia. If your prior cancer is service-connected and aplastic anemia developed after treatment, file as direct secondary to the SC cancer. The chemo-induced marrow toxicity pathway avoids relitigating the underlying service connection.
Does the 100% gate require actual stem cell transplant?
No — transplant REQUIREMENT anchors the 100% gate. Transplant referral, eligibility workup, or actual transplant all count. Pull hematology referral letters even if you're pre-transplant. The alternative 100% path is transfusion of platelets/RBCs OR infections recurring at least every 6 weeks (in any combination) over the past 12 months.
How do I document the transfusion / infection frequency?
Keep a meticulous 12-month log: each platelet transfusion, each RBC transfusion, each significant infection (hospitalization, IV antibiotics, febrile neutropenia). Frequency drives tier: ≥ every 6 weeks = 100%; ≥ every 3 months = 60%; ≥ once per 12 months = 30%. Without the log, examiners default to lower tiers.
What presumptive lanes apply to aplastic anemia?
Multiple pathways: (1) Chemo-induced post-SC cancer = direct secondary. (2) Radiation-induced (atomic veteran) = § 3.309(d) radiogenic presumption. (3) In-service drug exposure (chloramphenicol, others) = direct SC. (4) Idiopathic + qualifying toxic exposure (Camp Lejeune, burn pit, etc.) = consider applicable presumption framework. Etiology determines lane — work the strongest applicable pathway.
Official Regulatory Source
Aplastic anemia rates under 38 CFR § 4.117, DC 7716 — 30%/60%/100% based on transplant requirement + transfusion/infection frequency over 12-month period.
38 CFR § 4.117 — Hemic and Lymphatic Systems (eCFR) →Scroll to DC 7716. Compare DC 7720 (iron-deficiency anemia) for differential — different schedule.
Next Steps
If your rating decision lists DC 7716, compare your current symptoms and documentation against the criteria above. Consider:
- Requesting a copy of your rating decision and C&P exam report from the VA
- Gathering all relevant medical records (VA and private providers)
- Documenting functional limitations and how they impact work and daily activities
- Obtaining a nexus letter if needed to establish or strengthen service connection
- Filing for secondary conditions that may be related to this primary condition
- Contacting a VA-accredited VSO, claims agent, or attorney to review your file
This is general educational information only — not legal or medical advice.
Also: DC code lookup (tools) lists the same index in a compact layout.
Source: 38 CFR Part 4, Diagnostic Code 7716 • va.gov
⚠️ Important Disclaimer
This page provides general educational information only based on public VA regulations (38 CFR) and va.gov resources. It is not legal, medical, or claims assistance. Ratings and service connections are decided case-by-case by the VA based on the individual veteran’s evidence. We do not prepare claims, generate documents, or provide personalized advice. Always consult a VA-accredited Veterans Service Organization (VSO), attorney, or your physician for help with your specific situation. Verify the latest rules on va.gov.