Body system: Hemic and Lymphatic SystemsRegulation: 38 CFR § 4.117
Solitary plasmacytoma is a rare type of blood cancer where abnormal plasma cells (infection-fighting cells) form a single tumor, usually in bone or soft tissue. The VA rates this condition at 100% disability whenever there's active disease or you're receiving treatment like chemotherapy or radiation. This means full disability benefits while you're fighting the cancer or recovering from treatment.
Rating levels
- 100% — Veterans receive this rating when they have solitary plasmacytoma (a type of blood cancer where abnormal plasma cells form a tumor in bone or soft tissue) that is currently active and spreading, or when they are actively receiving treatment like chemotherapy or radiation therapy. The condition must be ongoing rather than in remission or cured.
- -1% — The 100% rating for solitary plasmacytoma continues for six months after all treatment ends — including surgery, radiation (the mainstay for solitary plasmacytoma of bone or extramedullary plasmacytoma), chemotherapy, immunomodulators (lenalidomide, pomalidomide), proteasome inhibitors (bortezomib), monoclonal antibodies (daratumumab), and autologous stem-cell transplantation. At the six-month mark, VA must schedule a mandatory examination. The exam decision tree: (1) If the plasmacytoma has progressed to symptomatic multiple myeloma, the rating shifts from DC 7724 to DC 7712 (multiple myeloma), which carries its own 5-year-from-diagnosis 100% window with enhanced § 3.105(e) + § 3.344(a)(b) stabilization protection. (2) If there has been no progression and no recurrence, the cancer DC drops away and chronic residuals are rated separately under their own diagnostic codes. The regulation specifically calls out two categories of residual: (a) residuals of plasma cell dysplasia itself such as venous thromboembolism (rated under DC 7121 lymphedema, DC 7110 aneurysm, or pulmonary embolism — combine under § 4.25), pathologic fracture at the plasmacytoma site (rated under affected bone), and persistent paraprotein-related effects; (b) treatment adverse effects such as peripheral neuropathy from bortezomib or thalidomide-class drugs (DCs 8520-8540 by nerve), radiation-induced damage at the plasmacytoma site (skin under DCs 7800-7805, bowel under DC 7332 if pelvic field, marrow suppression), cardiotoxicity from anthracyclines (DC 7020), and stem-cell-transplant residuals. Residuals combine under 38 CFR § 4.25 subject to anti-pyramiding rules of § 4.14. If VA proposes to reduce the rating after the six-month exam, the protection of 38 CFR § 3.105(e) applies — VA must notify you 60 days before reduction with reasons and your right to a hearing. If the plasmacytoma recurs at any time (most commonly as multiple myeloma transformation), the higher rating resumes from the date of recurrence.