Pernicious anemia and Vitamin B 12 deficiency anemia DC 7722
VA rates it under diagnostic code 7722 in 38 CFR 4.117. Body system: Other.
How VA rates it
The schedule allows 2 rating levels for this code: 10%, and 100%. VA picks the level whose criteria best match your symptoms and records.
Source: 38 CFR 4.117 on eCFR. Read the full criteria there before you file.
Rating levels and criteria
| Rating | What the schedule says |
|---|---|
| 100% | For initial diagnosis requiring transfusion due to severe anemia, or if there are signs or symptoms related to central nervous system impairment, such as encephalopathy, myelopathy, or severe peripheral neuropathy, requiring parenteral B 12 therapy |
| 10% | Requiring continuous treatment with Vitamin B 12 injections, Vitamin B 12 sublingual or high-dose oral tablets, or Vitamin B 12 nasal spray or gel |
| 10% | Note: A 100 percent evaluation for pernicious anemia and Vitamin B 12 deficiency shall be assigned as of the date of the initial diagnosis requiring transfusion due to severe anemia or parenteral B 12 therapy and shall continue with a mandatory VA examination six months following hospital discharge or cessation of parenteral B 12 therapy. Any reduction in evaluation based upon that or any subsequent examination shall be subject to the provisions of § 3.105(e) of this chapter. Thereafter, evaluate at 10 percent and separately evaluate any residual effects of pernicious anemia, such as neurologic involvement causing peripheral neuropathy, myelopathy, dementia, or related gastrointestinal residuals, under the most appropriate diagnostic codetrue |
Criteria text from 38 CFR 4.117, eCFR as of November 10, 2026. The eCFR is the official source if anything here differs.
Notes in the schedule (1)
Note: A 100 percent evaluation for pernicious anemia and Vitamin B 12 deficiency shall be assigned as of the date of the initial diagnosis requiring transfusion due to severe anemia or parenteral B 12 therapy and shall continue with a mandatory VA examination six months following hospital discharge or cessation of parenteral B 12 therapy. Any reduction in evaluation based upon that or any subsequent examination shall be subject to the provisions of § 3.105(e) of this chapter. Thereafter, evaluate at 10 percent and separately evaluate any residual effects of pernicious anemia, such as neurologic involvement causing peripheral neuropathy, myelopathy, dementia, or related gastrointestinal residuals, under the most appropriate diagnostic code
Related medications
Medications that can cause or worsen it
If you take one of these for a service-connected condition, this condition may be claimable as secondary to that condition. You need a diagnosis, your prescription records, and a medical opinion.
Metformin (for example metformin) Established link
Metformin labels warn that it can lower vitamin B12 over time.
Sources: FDA label: Metformin (DailyMed); Metformin-induced vitamin B12 deficiency in type 2 diabetes (PubMed)
Proton pump inhibitors (PPIs) (for example omeprazole, esomeprazole, pantoprazole, lansoprazole) Possible link
PPI labels warn that years of use can lower vitamin B12.
Sources: FDA label: Omeprazole (DailyMed); Risks and benefits of long-term proton pump inhibitor use (PubMed)
Medications prescribed for it
A prescription shows the condition was diagnosed. It still needs its own link to service.
- Cyanocobalamin. FDA labels: Cyanocobalamin (DailyMed)
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Rating schedule data as of November 10, 2026. Secondary and presumptive links checked November 13, 2026.
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