Mastocytosis

DC 7799-7718Hematologic/Lymphatic38 CFR 4.117, DC 7799-7718

A condition where too many mast cells build up in your body, usually in the skin, bone marrow, liver, or gut. Mast cells release chemicals like histamine that cause flushing, itching, stomach pain, and in severe cases, life-threatening allergic reactions (anaphylaxis). The VA rates mastocytosis based on how often you have mast cell activation episodes and whether your organs are affected.

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 7799-7718

Rating range

10% – 100%

Rating levels

Rating criteria are defined in 38 CFR 4.117, DC 7799-7718. 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

Your mastocytosis has progressed to aggressive disease or mast cell leukemia with organ damage. You have frequent life-threatening episodes and are unable to work.

What the VA looks for

Aggressive systemic mastocytosis or mast cell leukemia diagnosis
Organ damage (hepatosplenomegaly, bone lesions, cytopenias)
Recurrent life-threatening anaphylaxis requiring emergency treatment
Cytoreductive chemotherapy or targeted therapy (midostaurin, avapritinib)
Unable to maintain gainful employment due to disease severity

Common Pitfalls

⚠Not obtaining a bone marrow biopsy to confirm systemic disease — skin-only mastocytosis is rated lower, but many veterans have undiagnosed systemic involvement that a biopsy would reveal.
⚠Not documenting every mast cell activation episode, including near-misses — the frequency and severity of episodes directly determine the rating percentage.
⚠Not connecting mastocytosis to military service — environmental exposures, insect stings, chemical exposures, and physical stress during service can trigger the onset or worsening of mast cell disease.
⚠Not filing for secondary conditions: mast cell activation causes osteoporosis (from bone marrow infiltration), anxiety and depression (from living with unpredictable anaphylaxis risk), and GI conditions that can each be rated separately.
⚠Not carrying and documenting your epinephrine auto-injector prescriptions — this demonstrates the life-threatening nature of the condition to VA raters.

Related DBQ Forms

DBQ Hematologic and Lymphatic Conditions

View evidence checklist →See secondary conditions →

Condition Rating Guides

Understand what the VA looks for at each rating level — loading conditions…

Mastocytosis

How the VA rates this condition

Diagnostic code

DC 7799-7718

Rating range

10% – 100%

Rating levels

Rating Levels

Your mastocytosis has progressed to aggressive disease or mast cell leukemia with organ damage. You have frequent life-threatening episodes and are unable to work.

What the VA looks for

Aggressive systemic mastocytosis or mast cell leukemia diagnosis
Organ damage (hepatosplenomegaly, bone lesions, cytopenias)
Recurrent life-threatening anaphylaxis requiring emergency treatment
Cytoreductive chemotherapy or targeted therapy (midostaurin, avapritinib)
Unable to maintain gainful employment due to disease severity

Common Pitfalls

⚠Not obtaining a bone marrow biopsy to confirm systemic disease — skin-only mastocytosis is rated lower, but many veterans have undiagnosed systemic involvement that a biopsy would reveal.

⚠Not documenting every mast cell activation episode, including near-misses — the frequency and severity of episodes directly determine the rating percentage.

⚠Not connecting mastocytosis to military service — environmental exposures, insect stings, chemical exposures, and physical stress during service can trigger the onset or worsening of mast cell disease.

⚠Not filing for secondary conditions: mast cell activation causes osteoporosis (from bone marrow infiltration), anxiety and depression (from living with unpredictable anaphylaxis risk), and GI conditions that can each be rated separately.

⚠Not carrying and documenting your epinephrine auto-injector prescriptions — this demonstrates the life-threatening nature of the condition to VA raters.