Diagnostic Code 7720 · 38 CFR §4.117
Iron deficiency anemia is the most common type of anemia, occurring when the body does not have enough iron to produce adequate hemoglobin for red blood cells. Without sufficient hemoglobin, your tissues and organs do not receive enough oxygen. Symptoms include persistent fatigue, weakness, pale skin, shortness of breath during activity, dizziness, cold extremities, brittle nails, headaches, and difficulty concentrating. For veterans, iron deficiency anemia commonly develops secondary to gastrointestinal conditions that cause chronic blood loss (ulcers, gastritis from NSAIDs prescribed for musculoskeletal pain), malabsorption from GI damage, dietary deficiencies related to service conditions, or blood loss from service-connected injuries. Women veterans may also experience iron deficiency from heavy menstrual bleeding related to service-connected reproductive conditions. The VA rates iron deficiency anemia based on hemoglobin levels and the functional impact of symptoms.
| Rating | Criteria |
|---|---|
| 0% | Iron deficiency anemia is diagnosed but hemoglobin levels are maintained near normal with iron supplementation and there are no significant symptoms affecting daily functioning. |
| 10% | Hemoglobin levels remain mildly reduced despite treatment, with noticeable fatigue and decreased stamina that affects your ability to sustain physical activity but does not prevent employment. |
| 30% | Hemoglobin is persistently low despite oral iron therapy, requiring parenteral iron infusions or more aggressive treatment. You experience ongoing fatigue, weakness, and shortness of breath with moderate activity that requires rest breaks during the day. |
| 70% | Hemoglobin remains significantly depressed despite aggressive treatment. Severe fatigue, dizziness, and breathlessness with minimal exertion substantially limit your ability to work and perform daily activities. |
| 100% | Refractory iron deficiency anemia with dangerously low hemoglobin requiring repeated blood transfusions. Severe symptoms including heart strain, extreme fatigue, and inability to perform any sustained physical or mental activity. |
Serial complete blood count (CBC) results showing low hemoglobin, low MCV (mean corpuscular volume indicating small red blood cells), and iron studies (serum iron, ferritin, total iron-binding capacity) are the core evidence. Multiple lab draws over time showing persistent anemia despite treatment are more persuasive than a single result. Treatment records documenting oral iron supplementation, parenteral iron infusions, or transfusions demonstrate severity. If the anemia is secondary to a service-connected GI condition causing blood loss, a nexus opinion explaining the connection is essential. Lay statements describing how fatigue, weakness, and reduced stamina affect your daily life and work capacity add important context.
Yes, and this is one of the most common pathways. Conditions like peptic ulcer disease, gastritis (often from long-term NSAID use for service-connected pain), or inflammatory bowel disease can cause chronic blood loss that depletes iron stores. A nexus opinion linking the anemia to the GI condition is needed.
Even if treatment controls your hemoglobin, the need for ongoing supplementation and any residual symptoms can still support a rating. The 0 percent rating specifically covers cases where supplements keep levels near normal, establishing service connection for future worsening.