Lymphoma VA Rating

Lymphoma is one of the cancers where two separate questions decide the claim, and they don't move together. The first question is service connection: did the cancer arise from a qualifying exposure. For non-Hodgkin's lymphoma and Hodgkin's disease, the answer is often a presumptive yes, which takes the nexus fight off the table for many of these claims. The second question is the rating, and that's where veterans get blindsided. A lymphoma rating is not a permanent number. It is 100% while the disease is active and during the treatment phase, then it converts to a residual-based rating after a mandatory examination.

That conversion is the part that catches people. A veteran finishes chemotherapy, goes into remission, and assumes the 100% rating holds. It doesn't. The regulation builds in a re-examination at the end of the treatment-phase period, and the rating is then based on whatever residuals remain: peripheral neuropathy from chemotherapy, chronic fatigue, organ damage, immune compromise, secondary malignancies. If the residuals are minimal, the rating can drop sharply. The protection on the way down is procedural: any reduction has to follow the 38 CFR § 3.105(e) process, with notice and an opportunity to respond.

This page walks through both lymphoma diagnostic codes under 38 CFR § 4.117, DC 7709 for Hodgkin's lymphoma and DC 7715 for non-Hodgkin's lymphoma, how the active-phase 100% rating works, how the residual-based conversion works after treatment ends, the Agent Orange, PACT Act, Camp Lejeune and radiation presumptions that drive service connection, the secondary residual conditions under 38 CFR § 3.310 that keep the rating up after the cancer itself goes quiet, and why VA denies lymphoma claims.

TL;DR

• Lymphoma is rated under 38 CFR § 4.117 (hemic and lymphatic systems): DC 7709 for Hodgkin's lymphoma and DC 7715 for non-Hodgkin's lymphoma.
• Both codes carry a 100% evaluation while the disease is active or during a treatment phase. DC 7715 also assigns 100% for the indolent and non-contiguous phase of low-grade non-Hodgkin's lymphoma.
• After treatment ends, the rating converts to a residual-based evaluation following a mandatory VA re-examination: six months after treatment ends for Hodgkin's lymphoma (DC 7709) and two years after treatment ends for non-Hodgkin's lymphoma (DC 7715).
• Any reduction from the 100% rating must follow the 38 CFR § 3.105(e) procedure, which requires notice and a chance to respond before the lower rating takes effect.
• Hodgkin's disease and non-Hodgkin's lymphoma are both Agent Orange presumptives under 38 CFR § 3.309(e). Non-Hodgkin's lymphoma is also on the Camp Lejeune list in § 3.309(f) and the radiation-exposed veteran list in § 3.309(d).
• Under the PACT Act, 38 USC § 1120 presumes lymphoma of any type for a covered veteran.
• A strong claim pairs the pathology report (confirming the lymphoma subtype) with proof of qualifying exposure (herbicide, Gulf War or post-9/11 service, Camp Lejeune service dates).
• Residuals under § 3.310 keep the rating up after remission: chemotherapy-induced peripheral neuropathy, fatigue, secondary malignancies, immune compromise.
• Across 1,093 decided Board rulings on lymphoma from 2021 to 2026, 31.9% were granted, 28.2% denied and 39.9% remanded. A ruling is one issue the Board decided in one decision; one decision often rules on several issues. Remand is the most common outcome, and the grant rate is 7.2 points above the Board-wide grant rate of 24.7 percent.

Lymphoma VA rating criteria (DC 7709 and DC 7715)

The hemic and lymphatic section of 38 CFR § 4.117 handles lymphoma through two codes that work the same way structurally.

DC 7709, Hodgkin's lymphoma. This covers Hodgkin's lymphoma, which the Agent Orange regulation calls Hodgkin's disease. Its classic form is marked on biopsy by Hodgkin and Reed-Sternberg cells.

DC 7715, Non-Hodgkin's lymphoma. This covers the B-cell and T-cell lymphomas that are not Hodgkin's lymphoma. It is the form on the Camp Lejeune and radiation lists, and it shares the Agent Orange list with Hodgkin's lymphoma.

Both codes follow the same two-phase logic that VA uses across most active malignancies. The note to DC 7709 reads as follows.

A 100 percent evaluation shall continue beyond the cessation of any surgical therapy, radiation therapy, antineoplastic chemotherapy, or other therapeutic procedures. Six months after discontinuance of such treatment, the appropriate disability rating shall be determined by mandatory VA examination. Any reduction in evaluation based upon that or any subsequent examination shall be subject to the provisions of § 3.105(e) of this chapter. If there has been no local recurrence or metastasis, rate on residuals under the appropriate diagnostic code(s)

The note to DC 7715 is the same in substance with one important difference: for non-Hodgkin's lymphoma, the mandatory examination comes two years after treatment stops, not six months. DC 7715 also assigns 100% for the indolent and non-contiguous phase of low-grade non-Hodgkin's lymphoma.

The practical meaning: while the lymphoma is active, or while you are in chemotherapy, radiation, or other antineoplastic treatment, you are rated at 100%. That rating does not stop the day treatment stops. It continues through the treatment phase and into a defined window afterward (six months for Hodgkin's lymphoma, two years for non-Hodgkin's lymphoma), and only then does the mandatory examination determine what comes next. The point to hold onto is that the 100% does not evaporate at the last chemo session.

Lymphoma residuals after treatment: where the rating lands

This is the part of a lymphoma claim that is most often misunderstood, and where the real fight usually happens.

After the treatment-phase period ends, VA schedules a mandatory examination. The 100% rating is then replaced by a rating based on residuals. There is no minimum rating in DC 7709 or DC 7715 the way DC 5055 gives a total knee replacement a 30% minimum. Instead, the residuals are rated under whatever diagnostic codes fit the actual damage left behind.

That means the post-treatment rating can be anything from 100% down to 0%, depending entirely on what the examination documents. A veteran with significant residual organ damage, severe peripheral neuropathy, and disabling fatigue can hold a high combined rating. A veteran who reads as fully recovered on a thin examination can drop to a very low rating or zero.

The procedural protection is real but limited. Under 38 CFR § 3.105(e), VA cannot simply lower the rating. It has to issue a proposed reduction, give the veteran 60 days to submit evidence, offer a predetermination hearing if requested within 30 days of the notice, and only then implement the change, with the reduction taking effect on a delayed schedule. If VA skips those steps, the reduction did not follow § 3.105, and that is a ground for appeal separate from the medical question.

The substantive side is about evidence. The notes to DC 7709 and DC 7715 tie a reduction to § 3.105(e) only; unlike the multiple myeloma code, DC 7712, they do not also invoke the § 3.344 rules for stabilized ratings. So the new rating rests on what the mandatory examination documents. A one-day examination that captures a good day and records "in remission, no residuals" leaves out neuropathy, fatigue or organ damage the treatment records show. This is the lymphoma analogue to the flare-up problem in orthopedic claims: the snapshot is not the disability.

Agent Orange lymphoma and the other presumptions

Service connection is where lymphoma claims have an advantage, because four separate presumptions reach lymphoma. When the cancer type matches a recognized exposure, the veteran does not have to prove a medical nexus from scratch. The law presumes the connection.

Agent Orange: Hodgkin's and non-Hodgkin's lymphoma

Non-Hodgkin's lymphoma is on the list of conditions presumptively connected to herbicide exposure under 38 CFR § 3.309(e). Hodgkin's disease is likewise a herbicide presumptive. Qualifying service starts with Vietnam and its offshore waters from January 9, 1962 to May 7, 1975, and the PACT Act added service at Thailand bases, in Laos, at Mimot or Krek in Cambodia, on Guam or American Samoa, and on Johnston Atoll during set dates; service near the Korean DMZ also qualifies. You establish the qualifying service, you establish the lymphoma diagnosis by pathology, and the connection is presumed. There is no need for a private nexus opinion tying the cancer to the herbicide. In the Board data, lymphoma service connection rulings that raised a presumption were granted somewhat more often than lymphoma rulings overall; the Board section below shows the claim theory breakdown. That is an association, not a cause.

PACT Act: lymphoma of any type

The PACT Act presumption in 38 USC § 1120 lists "lymphoma cancer of any type" for a covered veteran. Section 1119 defines a covered veteran by service, including the airspace above, on or after August 2, 1990 in Bahrain, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, Somalia, or the United Arab Emirates, or on or after September 11, 2001 in Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, Yemen, Uzbekistan, or another country the Secretary determines relevant. Unlike the Camp Lejeune and radiation lists, this presumption covers every lymphoma subtype, Hodgkin's and non-Hodgkin's alike, subject to the rebuttal rules in 38 USC § 1113.

Camp Lejeune: non-Hodgkin's lymphoma

Non-Hodgkin's lymphoma is on the Camp Lejeune contaminated-water list in 38 CFR § 3.309(f). For the veteran's disability presumption under 38 CFR §§ 3.307(a)(7) and 3.309(f), the proof is at least 30 days of service at Camp Lejeune, consecutive or not, between August 1, 1953 and December 31, 1987, plus the pathology-confirmed diagnosis. Hodgkin's lymphoma is not on that list.

Radiation exposure

For veterans who took part in a radiation-risk activity, such as atmospheric nuclear testing or the occupation of Hiroshima or Nagasaki, 38 CFR § 3.309(d) presumes "lymphomas (except Hodgkin's disease)." For other documented in-service radiation exposure, § 3.311 lists lymphomas other than Hodgkin's disease as radiogenic diseases, which means a dose estimate and a causation review rather than an automatic presumption.

What every presumption needs

What every pathway requires, and what gets missed, is documentation of two distinct facts: the qualifying exposure and the lymphoma subtype. The pathology report matters because two of the presumptions, Camp Lejeune and radiation, cover non-Hodgkin's lymphoma only. A generic "lymphoma" note in a primary care record without the biopsy classification gives the rater a reason to ask for development rather than grant. Attach the biopsy or oncology report that names the diagnosis precisely, alongside the exposure proof (service records, unit location, Camp Lejeune dates). To check which presumptions your service supports, use the presumptive conditions tool.

Lymphoma residuals and secondary conditions (38 CFR § 3.310)

Once the active cancer resolves, the rating depends on residuals, and residuals are also where secondary service connection under 38 CFR § 3.310 comes in. A condition caused by the service-connected lymphoma or its treatment can be service connected. So can a condition aggravated by it, meaning it would be less severe but for the lymphoma or its treatment; aggravation was recognized in Allen v. Brown and is now written into § 3.310(b). For lymphoma, the residual and secondary chains to look for are these.

Chemotherapy-induced peripheral neuropathy. Some lymphoma chemotherapy, such as vincristine, is neurotoxic, and survivors can be left with long-term peripheral neuropathy in the hands and feet: numbness, cramps, burning, weakness, loss of sensation. This is rated under the peripheral nerve codes, and the peripheral nerves DBQ is the exam form. It can be missed when the oncology notes focus on the cancer rather than the nerves. A veteran reporting persistent numbness after chemo should make sure that complaint is in the record and tied to the treatment.

Chronic fatigue and weakness. Persistent fatigue is a recognized late effect of Hodgkin lymphoma treatment, and in non-Hodgkin's lymphoma survivors it is worse in those with chemotherapy neuropathy. It is harder to rate cleanly because fatigue maps onto multiple body systems, but it is a real functional loss that belongs in the post-treatment examination.

Secondary malignancies. Some lymphoma treatments, particularly radiation and certain chemotherapy agents, carry a long-term risk of secondary cancers. A secondary malignancy that develops as a consequence of the service-connected lymphoma or its treatment is itself a candidate for secondary service connection under § 3.310.

Heart disease. Radiation therapy and anthracycline chemotherapy raise the long-term risk of heart failure and heart valve disease in Hodgkin lymphoma survivors. A heart condition tied to that treatment is another § 3.310 claim.

Immune compromise. Lymphoma and its treatment can leave lasting immune deficiency. Rituximab, for example, depletes B cells and can lower antibody levels, which raises the risk of infections. Where that immune compromise produces a separately ratable condition, the chain runs through § 3.310.

The standard for any of these is the same as in every secondary claim: a medical opinion that identifies the mechanism, addresses the time course, and explains why the residual is caused or aggravated by the service-connected lymphoma or its treatment rather than by an unrelated cause. A bare assertion does not carry it; a reasoned opinion does.

The lymphoma C&P exam

The lymphoma C&P examination carries unusual weight because it is the examination that converts the 100% active rating into a residual rating. A thin examination here costs the veteran directly.

A complete examination should document these points.

• The current status of the lymphoma: active, in remission, in surveillance, or relapsed, with the supporting oncology records.
• The treatment history and the date treatment ended, which anchors the treatment-phase calculation that determines whether the 100% rating still applies.
• Each residual separately: peripheral neuropathy (which nerves, severity, sensory versus motor), fatigue and its functional impact, organ damage, immune status, and any secondary condition.
• Objective findings tied to each residual, not a global "in remission, no residuals" conclusion that flattens the picture.

The failure mode is an examination that confirms remission and stops. Remission answers the cancer question; it does not answer the residual question. When the examiner does not separately evaluate neuropathy, fatigue, and other residuals, the rating defaults low, and the veteran is left appealing on the strength of records the examiner should have considered the first time.

The Board data points the same way. An inadequate VA exam or opinion is one of the two most common reasons the Board sends a lymphoma claim back. And appeals for a higher lymphoma rating, where residual disputes usually land, were granted less often than service connection appeals; the Board section below shows results by what the appeal asked for. That fits the structural problem: the examination has to do two jobs, confirm cancer status and inventory residuals, and the residual inventory is the part that gets shortchanged.

Why VA denies lymphoma claims

Lymphoma claims do better at the Board than the average claim. Across 1,093 decided Board rulings on lymphoma from 2021 to 2026, 31.9% were granted, 28.2% denied and 39.9% remanded. That grant rate is 7.2 points above the Board-wide 24.7 percent.

When the Board denied lymphoma service connection, it most often found no link to service, and often found no qualifying in-service event or exposure; less often, the record did not show a current diagnosis. A few patterns sit behind those findings.

Missing or imprecise pathology. Two of the presumptions cover non-Hodgkin's lymphoma only. A record that says "history of lymphoma" without the biopsy classification leaves the rater unable to apply the right presumption cleanly. The fix is the actual pathology or oncology report naming the diagnosis.

Exposure not documented. Even when the cancer type is presumptive, the exposure has to be established. Vietnam-era veterans sometimes lack unit records placing them in a qualifying location, and Camp Lejeune claims need service dates inside the August 1, 1953 to December 31, 1987 window. The presumption is only as good as the exposure proof behind it.

Residuals not separately claimed or examined. This matters most after treatment ends. Veterans assume the lymphoma rating covers everything, so they never separately claim the chemotherapy-induced neuropathy or the chronic fatigue. When the 100% converts to a residual rating, there is nothing in the file documenting the residuals, and the rating drops further than it should.

Treating the 100% as permanent. A veteran who does not understand the treatment-phase conversion can be caught off guard by the mandatory re-examination and the proposed reduction. A response inside the 60-day window under § 3.105(e), with residual documentation, does more than an appeal after the reduction is final.

Reduction notice defects. On the VA side, reductions from the 100% rating sometimes skip the § 3.105 steps. Where the proposed-reduction notice, the 60-day period, or the hearing opportunity is missing, that is a procedural ground for appeal, separate from the medical question.

When the Board sends a lymphoma claim back instead of deciding it, the most common reason is records VA still had to get, followed closely by an inadequate VA exam or opinion. That fits the evidence dynamics above. The Board section below shows how often each denial and remand reason came up, how claims argued as direct and presumptive fared, and what the Board did with medical opinions.

Questions veterans ask about lymphoma

Is lymphoma presumptive for Agent Orange?

Yes. Hodgkin's lymphoma and non-Hodgkin's lymphoma are both on the Agent Orange list in 38 CFR § 3.309(e). With qualifying service in Vietnam or its offshore waters, at Thailand bases, in Laos, Cambodia, Guam, American Samoa or Johnston Atoll, or near the Korean DMZ during the covered dates, the link to service is presumed.

Is lymphoma covered by the PACT Act?

Yes. 38 USC § 1120 lists lymphoma cancer of any type for a covered veteran, meaning service in the listed countries on or after August 2, 1990 or September 11, 2001. Every lymphoma subtype qualifies.

Is non-Hodgkin's lymphoma presumptive for Camp Lejeune?

Yes. Non-Hodgkin's lymphoma is on the Camp Lejeune list in 38 CFR § 3.309(f) for veterans with at least 30 days of service there between August 1, 1953 and December 31, 1987. Hodgkin's lymphoma is not on that list.

How long does a 100 percent lymphoma rating last?

The 100 percent rating continues while the disease is active and during treatment. For Hodgkin's lymphoma, a mandatory VA exam comes six months after treatment ends; for non-Hodgkin's lymphoma, two years after. Low-grade non-Hodgkin's lymphoma in an indolent, non-contiguous phase is also rated 100 percent.

Can chemotherapy neuropathy be rated after lymphoma?

Yes. Peripheral neuropathy caused by lymphoma chemotherapy can be rated under the peripheral nerve codes as a residual or secondary condition. The record needs the diagnosis and a medical opinion tying it to the treatment.

Is lymphoma presumptive for radiation exposure?

For non-Hodgkin's lymphoma, yes, when the veteran took part in a radiation-risk activity listed in 38 CFR § 3.309(d). Hodgkin's lymphoma is excluded from that list and from the radiogenic disease list in § 3.311.

Bottom Line

Lymphoma claims split into two questions that move independently. Service connection is the easier one: Hodgkin's and non-Hodgkin's lymphoma are Agent Orange presumptives, any lymphoma is a PACT Act presumptive for a covered veteran, and non-Hodgkin's lymphoma is also a Camp Lejeune and radiation presumptive, so a documented exposure plus a pathology-confirmed diagnosis usually carries the connection without a private nexus opinion. The rating is the harder one. The 100% evaluation under DC 7709 or DC 7715 holds during active disease and the treatment phase, then converts to a residual-based rating after a mandatory examination. That conversion is where ratings fall, and the protection on the way down is partly procedural (§ 3.105(e) notice) and partly evidentiary (the new rating rests on what the examination documents). The veterans who hold a meaningful rating after remission are the ones who documented the residuals, the chemotherapy-induced neuropathy, the fatigue, the secondary conditions under § 3.310, before the re-examination, not after the reduction notice arrived. Same cancer, different paper trail, different long-term rating.

Related Conditions

Lymphoma sits alongside the other cancers in Claim Raven's oncology set, which share a similar two-phase 100%-then-residuals structure under their own body-system codes and the same presumptive-exposure logic. See leukemia, another hemic and lymphatic malignancy with overlapping Agent Orange and Camp Lejeune pathways, and the solid-tumor cancers that follow the same active-then-residual rating pattern: lung cancer, prostate cancer, and colon cancer. Veterans converting from a 100% active rating to a residual rating should review the secondary conditions tool and document chemotherapy and radiation residuals before the mandatory re-examination.

Methodology and Limitations

• Data source: Rating criteria from 38 CFR § 4.117, DC 7709 (Hodgkin's lymphoma) and DC 7715 (non-Hodgkin's lymphoma), with DC 7712 for comparison and DC 5055 in § 4.71a. Reduction procedure from § 3.105(e) and (i). Presumptive service connection from § 3.309(e) and 38 USC § 1116 (herbicide), 38 USC §§ 1119 and 1120 (PACT Act), §§ 3.307(a)(7) and 3.309(f) (Camp Lejeune), and §§ 3.309(d) and 3.311 (radiation). Secondary service connection from § 3.310, with aggravation under Allen v. Brown, 7 Vet. App. 439 (1995). Medical sources, read as PubMed abstracts: Alonso-Alonso and colleagues, International Journal of Molecular Sciences (2026), on Hodgkin and Reed-Sternberg cells; Jung Wu and colleagues, Oncology Nursing Forum (2025), and Su and colleagues, European Journal of Oncology Nursing (2024), on chemotherapy-induced peripheral neuropathy, including long-term vincristine neuropathy and its link to fatigue, in lymphoma survivors; van Leeuwen and Ng, Hematology, American Society of Hematology Education Program (2016), on second cancers, heart disease and persistent fatigue after Hodgkin lymphoma treatment; and Perrone and colleagues, Annals of Hematology (2026), on rituximab, low antibody levels and infections.
• Board snapshot: Across 1,093 decided Board rulings on lymphoma from 2021 to 2026, 31.9% were granted (including partial grants and mixed outcomes), 28.2% denied and 39.9% remanded. Dismissed, withdrawn and moot rulings are excluded. These are appealed claims, not your personal odds.
• Sample size: Patterns in this post are drawn from Claim Raven's read of 511,036 Board decisions from 2021 to 2026, which contain 1,378,030 rulings, including 1,220 rulings on lymphoma (1,093 with decided outcomes). Within those, 349 rulings were granted, 308 denied and 436 remanded. Breakdowns by claim theory, appeal type, medical opinion and denial and remand reasons appear in the Board section below, computed from the same data.
• Classification approach: Diagnostic code definitions drawn from the regulatory text of § 4.117. The two-phase rating structure (active/treatment 100%, then residual-based after mandatory examination) follows the regulation. Presumptive analysis follows § 3.309(d), (e) and (f), § 3.311, and 38 USC § 1120.
• Limitations:
• Compensation outcomes depend on documented residuals after treatment ends. There is no minimum residual rating in DC 7709 or DC 7715, so post-treatment ratings vary widely.
• The regulation sets the mandatory re-examination at six months after treatment ends for Hodgkin's lymphoma (DC 7709) and two years after treatment ends for non-Hodgkin's lymphoma (DC 7715); the actual dates depend on the individual treatment record.
• Presumptive eligibility depends on the specific exposure facts (qualifying location and service dates) and the lymphoma subtype on pathology. The Camp Lejeune and radiation presumptions cover non-Hodgkin's lymphoma only.
• Selection bias: BVA-level patterns reflect cases that appealed. Most lymphoma claims resolve at the RO level and are not in any BVA dataset.
• Claim theory comparisons include remands and are associations, not causes.
• These observations reflect patterns from the regulatory text, presumptive provisions, and BVA decisions. They are not predictions of individual outcomes.