Diagnostic Code 7704 · 38 CFR §4.117
Polycythemia vera is a blood cancer in which the bone marrow produces too many red blood cells, making the blood thicker and more prone to clotting. This increases the risk of stroke, heart attack, deep vein thrombosis, and pulmonary embolism. Symptoms include headaches, dizziness, itching (especially after warm water exposure), fatigue, blurred vision, and redness of the skin. Veterans may develop polycythemia vera as a result of toxic exposure during service, including radiation and chemical exposures. Treatment typically involves phlebotomy (blood removal) to reduce red blood cell levels, aspirin therapy, and sometimes chemotherapy drugs.
| Rating | Criteria |
|---|---|
| 10% | Polycythemia vera managed with phlebotomy alone on an infrequent basis. |
| 30% | Polycythemia vera requiring regular phlebotomy and/or daily medication to control blood counts, with mild symptoms. |
| 60% | Polycythemia vera requiring frequent phlebotomy and medication, with moderate symptoms and history of complications such as blood clots. |
| 100% | Polycythemia vera with severe complications, transformation to myelofibrosis or acute leukemia, or requiring intensive treatment such as chemotherapy. |
Blood tests showing elevated red blood cell counts, hemoglobin, and hematocrit are needed. A bone marrow biopsy confirming the diagnosis is important. Hematology records documenting ongoing treatment (phlebotomy frequency, medications) demonstrate severity. Service records or exposure documentation linking the condition to service are needed for nexus. Records of complications such as blood clots or cardiovascular events strengthen the claim.
Yes. While the exact cause is often a genetic mutation, toxic and radiation exposures during service can trigger or contribute to the development of polycythemia vera. A hematology nexus opinion connecting the condition to service-related exposure is needed.