Hepatitis C
Hepatitis C is rated under DC 7354 using the chronic liver disease without cirrhosis schedule (DC 7345). You must identify the risk factor(s) from service that could have led to the infection. If your only risk factor is drug use during service, service connection cannot be granted. Hepatitis C must be confirmed by serologic (blood) testing. Important rater guidance: if there are any symptoms at all, even mild, the minimum rating should be 20%. A 0% rating should not be assigned if symptoms are present or liver function tests show damage.
VA Rating Levels
No symptoms and no evidence of liver damage on testing.
At least one of the following: intermittent fatigue, malaise, anorexia (loss of appetite), hepatomegaly (enlarged liver), or pruritus (itching).
Continuous medication with minor weight loss, plus at least two of the following: daily fatigue, malaise, anorexia, hepatomegaly, pruritus, or arthralgia (joint pain).
Continuous medication with substantial weight loss, plus at least two of the following: daily fatigue, malaise, anorexia, hepatomegaly, pruritus, or arthralgia.
During use of both antiviral therapy and immunomodulatory therapy, continued for six months after treatment ends. Then re-evaluated on residual symptoms.
Exam Tips & Key Evidence
- →You must identify your in-service risk factors. Common ones include jet air gun immunizations (1940s-1990s), tattoos or piercings during service, blood transfusions before 1975, and exposure to blood in healthcare roles.
- →If you have any symptoms at all, even mild fatigue or itching, the minimum rating should be 20%. A 0% rating should only apply if you truly have no symptoms and no liver damage on tests.
- →If your only risk factor was drug use during service, the VA cannot grant service connection. However, if you have other risk factors in addition to that, list them all.
- →Hepatitis B (DC 7345) uses the same rating criteria. The same risk factor and diagnosis rules apply.
- →If your hepatitis progresses to cirrhosis, it would be re-evaluated under the cirrhosis schedule (DC 7312), which has different and potentially higher rating criteria.
Commonly Related Conditions
38 CFR Reference
38 CFR 4.114, DC 7354