Hematologic And Lymphatic Conditions, Including Leukemia DBQ: Official VA Form

The public Hematologic and Lymphatic Conditions, Including Leukemia Disability Benefits Questionnaire records medical information for VA evaluation. The form itself provides its current questions, definitions, examination and clinician requirements. A completed form is evidence; it does not establish service connection or guarantee an evaluation.

Related Diagnostic Code Subjects

21 code subjects are associated with this form in this educational directory. These editorial subject associations are not official VA assignments, and the form may not be appropriate for every examination or claim.

• DC 7702: Agranulocytosis, acquired
• DC 7703: Leukemia (except for chronic myelogenous leukemia)
• DC 7704: Polycythemia vera
• DC 7705: Immune thrombocytopenia
• DC 7706: Splenectomy
• DC 7707: Spleen, injury of, healed
• DC 7709: Hodgkin's lymphoma
• DC 7710: Adenitis, tuberculous, active or inactive
• DC 7712: Multiple myeloma
• DC 7714: Sickle cell anemia
• DC 7715: Non-Hodgkin's lymphoma
• DC 7716: Aplastic anemia
• DC 7717: AL amyloidosis (primary amyloidosis)
• DC 7718: Essential thrombocythemia and primary myelofibrosis
• DC 7719: Chronic myelogenous leukemia (CML) (chronic myeloid leukemia or chronic granulocytic leukemia)
• DC 7720: Iron deficiency anemia
• DC 7721: Folic acid deficiency
• DC 7722: Pernicious anemia and Vitamin B12 deficiency anemia
• DC 7723: Acquired hemolytic anemia
• DC 7724: Solitary plasmacytoma
• DC 7725: Myelodysplastic syndromes

Read The Form Before Arranging An Examination

Review who may complete the form, which conditions it includes or excludes, and whether testing is required. VA can still request a claim examination. Report actual findings; this reference does not provide suggested answers.

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