Cold Agglutinin Disease

DC 7700Hematologic/Lymphatic38 CFR 4.117, DC 7700

A type of autoimmune hemolytic anemia where your immune system makes antibodies that destroy your red blood cells when your body gets cold. This causes anemia, fatigue, and pain or color changes in your fingers and toes. The VA rates cold agglutinin disease based on how often you have hemolysis episodes and whether you need transfusions.

How the VA rates this condition

The VA rates this condition based on how often symptoms occur and how severe each episode is. The examiner will ask about the frequency, duration, and intensity of your episodes, as well as how they affect your ability to work.

Diagnostic code

DC 7700

Rating range

0% – 70%

Rating levels

Rating criteria are defined in 38 CFR 4.117, DC 7700. This guide presents a plain-language summary and is not a substitute for the full regulatory text. Always consult a VSO or VA-accredited attorney for case-specific advice.

Rating Levels

You have severe, frequent hemolysis with very low hemoglobin levels. You need blood transfusions or aggressive immunosuppressive therapy. The disease significantly limits your ability to function.

What the VA looks for

Hemoglobin 7gm/100ml or less
Requires periodic blood transfusions
Aggressive immunosuppressive therapy (rituximab, complement inhibitors)
Severe acrocyanosis or digital ischemia
Unable to tolerate any cold environment

Common Pitfalls

⚠Not documenting hemoglobin levels during hemolysis episodes — the VA rates anemia based on lowest documented hemoglobin levels, so labs drawn during acute episodes are critical evidence.
⚠Failing to describe how cold sensitivity restricts your daily life, work, and geographic limitations — if you cannot work outdoors or live in cold climates, document this impact.
⚠Not providing cold agglutinin titer results and direct antiglobulin test (DAT) results as objective evidence of the autoimmune nature of the disease.
⚠Not filing for secondary conditions such as Raynaud syndrome, peripheral neuropathy from chronic anemia, or depression from lifestyle restrictions caused by the disease.

Related DBQ Forms

DBQ Hematologic and Lymphatic Conditions

View evidence checklist →See secondary conditions →

Condition Rating Guides

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Cold Agglutinin Disease

How the VA rates this condition

Diagnostic code

DC 7700

Rating range

0% – 70%

Rating levels

Rating Levels

You have severe, frequent hemolysis with very low hemoglobin levels. You need blood transfusions or aggressive immunosuppressive therapy. The disease significantly limits your ability to function.

What the VA looks for

Hemoglobin 7gm/100ml or less
Requires periodic blood transfusions
Aggressive immunosuppressive therapy (rituximab, complement inhibitors)
Severe acrocyanosis or digital ischemia
Unable to tolerate any cold environment

Common Pitfalls

⚠Not documenting hemoglobin levels during hemolysis episodes — the VA rates anemia based on lowest documented hemoglobin levels, so labs drawn during acute episodes are critical evidence.

⚠Failing to describe how cold sensitivity restricts your daily life, work, and geographic limitations — if you cannot work outdoors or live in cold climates, document this impact.

⚠Not providing cold agglutinin titer results and direct antiglobulin test (DAT) results as objective evidence of the autoimmune nature of the disease.

⚠Not filing for secondary conditions such as Raynaud syndrome, peripheral neuropathy from chronic anemia, or depression from lifestyle restrictions caused by the disease.