Diagnostic Code 7714 · 38 CFR §4.117
Sickle cell disease is a genetic blood disorder where red blood cells become rigid and crescent-shaped, blocking blood flow and causing intense pain episodes (sickle cell crises), organ damage, chronic anemia, and increased susceptibility to infections. While sickle cell disease is a genetic condition present from birth, military service can aggravate it significantly through physical stress, dehydration, altitude changes, extreme temperatures, and limited access to medical care during deployments. Veterans with sickle cell disease who experienced worsening of their condition during service may claim aggravation. The VA rates sickle cell disease based on the frequency of painful crises and the extent of organ damage.
| Rating | Criteria |
|---|---|
| 0% | Sickle cell trait is present but has not produced symptomatic crises or organ damage. |
| 10% | Occasional painful crises (one or two per year) that resolve with treatment and do not cause lasting organ damage. |
| 30% | Painful crises occurring several times per year, requiring medical treatment and causing missed work. Chronic anemia is present with hemoglobin typically below 10 g/dL. |
| 60% | Frequent painful crises (multiple per year) requiring hospitalization, along with evidence of organ damage affecting the spleen, kidneys, liver, or lungs. Daily functioning is substantially limited by chronic pain and fatigue. |
| 100% | Repeated severe crises requiring frequent hospitalizations and blood transfusions, with significant multi-organ damage. You are unable to maintain employment due to the unpredictability and severity of crises. |
A confirmed diagnosis of sickle cell disease through hemoglobin electrophoresis is required. Hospital and emergency room records documenting pain crises — dates, duration, treatments, and outcomes — are the most important evidence. Serial blood work showing chronic anemia, organ function tests (kidney, liver, spleen imaging), and records of blood transfusions document severity. If claiming aggravation, you need evidence comparing your condition before and during/after service. Lay statements describing the frequency and impact of pain crises on daily life are helpful.
Yes, through aggravation. If military service made your sickle cell disease worse — more frequent crises, new organ damage, increased severity — the VA can service-connect the condition on an aggravation basis. The rating would reflect the degree of aggravation beyond the natural progression of the disease.
Sickle cell trait (carrying one copy of the sickle gene) is generally asymptomatic and is not rated unless it causes documented symptoms. Sickle cell disease (carrying two copies) produces the painful crises and complications that are rated under DC 7714.