JAK2 c.1849G>T (p.Val617Phe) is the canonical activating mutation in myeloproliferative neoplasms, identified in >80% of polycythemia vera cases and a substantial proportion of essential thrombocythemia and primary myelofibrosis cases.1 Well-established functional studies across multiple independent laboratories demonstrate that V617F disrupts JH2 pseudokinase domain autoinhibition, resulting in constitutive JAK2 kinase activity, STAT-mediated transcriptional activation, cytokine-independent cell growth, and erythrocytosis in murine models.2 The variant is located in the JH2 pseudokinase domain, a critical regulatory region and established mutational hotspot for gain-of-function variants in myeloproliferative neoplasms.3 Population databases show the variant at very low frequency (gnomAD v2.1: 0.034%; v4.1: 0.029%), well below the 0.1% PM2 threshold. Observed homozygotes are consistent with somatic clonal hematopoiesis rather than germline events.4 REVEL in silico prediction score of 0.881 supports a deleterious effect on protein function.5 ClinVar reports the variant as Pathogenic by 14 clinical diagnostic laboratories and Likely pathogenic by 5, with variation ID 14662.6 Two strong pathogenic criteria (PS3 + PS4) satisfy the '2 Strong' pathogenic combination rule under the generic ACMG/AMP 2015 framework. Additional moderate (PM1) and supporting criteria (PM2, PP3, PP5) provide further confirmatory evidence.7