Lymphoma VA Rating (Hodgkin's & Non-Hodgkin's)

Overview

Non-Hodgkin's lymphoma is presumptive under Agent Orange (38 CFR § 3.309(e)) and PACT Act.

Hodgkin's disease is also Agent Orange presumptive.

In Depth

Non-Hodgkin's lymphoma and Hodgkin's disease both appear on the Agent Orange presumptive list at 38 CFR § 3.309(e), and lymphoma of any type is included in the PACT Act presumptive list for veterans with qualifying toxic-exposure service. Chronic lymphocytic leukemia and hairy cell leukemia are separately listed and are generally evaluated under their own diagnostic codes.

Evaluation is under 38 CFR § 4.117 — Diagnostic Code 7715 for non-Hodgkin's lymphoma and 7709 for Hodgkin's. Malignancies rated at 100 percent under 38 CFR Part 4 carry a note directing that the total evaluation continues during active disease and for six months following the cessation of surgical, X-ray, antineoplastic chemotherapy, or other therapeutic procedure. VA must then schedule a mandatory examination, and any reduction from the 100 percent evaluation is made under the procedures in 38 CFR § 3.105(e) — advance written notice, at least 60 days to submit evidence, and 30 days to request a predetermination hearing. If the mandatory exam did not happen, or the notice period was not honored, that is a procedural issue separate from the medical question of how bad the residuals are.

After the convalescent period, the evaluation is built from residuals, each rated under the diagnostic code for the affected body system and combined under 38 CFR § 4.25. Common residuals that go unrated because no one claimed them include chemotherapy-induced peripheral neuropathy, fatigue, cognitive complaints, hypothyroidism after radiation to the neck, voiding dysfunction, erectile dysfunction with special monthly compensation for loss of use of a creative organ under 38 CFR § 3.350(a), surgical scars, and mental health conditions secondary to the diagnosis and treatment. In lymphoma, the residuals most commonly documented are chemotherapy-induced peripheral neuropathy (vincristine-class agents), cardiomyopathy after anthracycline therapy, pulmonary toxicity after bleomycin, hypothyroidism after mantle-field or neck radiation, secondary malignancy, and persistent fatigue.

Indolent lymphomas complicate the six-month rule. A patient on watchful waiting is not receiving therapy, and a patient on rituximab maintenance is. The treatment record, including the dates of each cycle, is the evidence that decides which situation the file reflects.

How to Establish Service Connection

• Presumptive: Agent Orange and PACT Act (lymphatic cancer of any type).
• Direct: documented carcinogen exposure.

Rating Criteria

Paraphrased from 38 CFR § 4.117, DC 7709 (Hodgkin's) / DC 7715 (Non-Hodgkin's)

See what each percentage pays in 2026 and how it combines with your current rating →

Evidence Checklist

• Lymph node or marrow biopsy.
• Staging (PET/CT).
• Treatment records.
• Exposure documentation.

Evidence VA Commonly Cites in These Claims

Descriptive summary of evidence types frequently referenced in rating decisions for this condition. Not a checklist of actions to take — every claim is decided on its own facts.

• ★Get the pathology report and the oncology treatment summary into the file — the dates therapy started and stopped are what set the six-month convalescent window.
• ★List every residual separately when the issue is evaluated after treatment; residuals that are never identified are generally never rated.
• ★Ask the treating oncologist to document ongoing surveillance, maintenance therapy, or hormone therapy where it applies — continuing therapy can be relevant to whether the active-disease evaluation should have continued.
• ★For presumptive exposure, put the service documentation in the file: DD-214, unit assignments, deployment orders, or the location and date range establishing covered service.
• ★Where a reduction from 100 percent is proposed, respond within the 60-day evidence window and request the predetermination hearing within 30 days if you want one — those windows are separate.
• ★Obtain the pathology report identifying the specific lymphoma subtype — the diagnostic code and the presumptive analysis both depend on it.
• ★Get post-treatment cardiac and pulmonary function testing into the file where anthracyclines or bleomycin were used.
• ★Ask for thyroid function labs after any radiation involving the neck or mediastinum.

Illustrative Scenarios

These are hypothetical educational examples — not actual case results, predictions, or guarantees of outcomes.

Common pitfalls VA sees

• Assuming the 100 percent evaluation continues indefinitely. It does not; the schedule contemplates reevaluation six months after therapy ends.
• Letting the mandatory post-treatment examination pass without documenting residuals, then disagreeing only after the reduction takes effect.
• Claiming only the cancer and never claiming the neuropathy, scars, fatigue, endocrine, or mental health residuals it produced.
• Missing the 60-day evidence window in a proposed-reduction letter because it looks like a form letter rather than a deadline.

Common Secondary Conditions

Conditions frequently service-connected as secondary to Lymphoma:

What the C&P Exam Documents

General information about how this condition is typically evaluated. This is not coaching on what to say and is not a substitute for medical or legal advice.

• →Bring the treatment summary with regimen names — the examiner needs it to connect residuals to specific agents.
• →Report cardiac symptoms on exertion and any shortness of breath; those point to anthracycline or bleomycin effects.
• →Describe cognitive changes concretely if present — losing track mid-task, needing lists that were never needed before.

Frequently Asked Questions