Effective May 19, 2024, under the new DC 7354 for Hepatitis C or non-A or non-B hepatitis, veterans can get a Hepatitis C VA disability rating between 0% and 100% with breaks at 20%, 40%, and 60%.
Your final VA rating for Hepatitis C depends on the frequency (how often), severity (how bad), and duration (how long) of symptoms and how those symptoms negatively impact your work, life, and social functioning.
➡️ Learn more about the VA digestive system rating changes here.
Summary of Key Points
- Hepatitis C or non-A or non-B hepatitis now have their own VA ratings with the recent addition of DC 7354 under CFR Title 38, Part 4, the Schedule for Rating Disabilities. Note that DC 7354 instructs the VA to rate Hepatitis C, non-A, and non-B hepatitis under DC 7345, chronic liver disease without cirrhosis. The VA disability ratings for Hepatitis C are 0%, 20%, 40%, 60%, or 100%.
- DC 7354 includes Hepatitis B, primary biliary cirrhosis (PBC), primary sclerosing cholangitis (PSC), autoimmune liver disease, Wilson’s disease, Alpha-1-antitrypsin deficiency, hemochromatosis, drug-induced hepatitis, and non-alcoholic steatohepatitis (NASH).
- If you already have a VA rating for Hepatitis C, there will be no change to your current VA rating—you are “grandfathered” in under the old rating criteria.
What is Hepatitis C?
Hepatitis C is a viral infection that primarily affects the liver.
It is caused by the hepatitis C virus (HCV), which is transmitted through contact with infected blood.
Hepatitis C can lead to both acute and chronic forms of liver disease.
- Transmission: Hepatitis C is most commonly spread through contact with infected blood. This can occur through sharing needles or other drug injection equipment, receiving blood transfusions or organ transplants from infected donors (though this is rare in countries with stringent screening procedures), or through needlestick injuries in healthcare settings. It can also be transmitted through sexual contact with an infected person, though this mode of transmission is less common.
- Symptoms: Many people with hepatitis C do not experience symptoms, especially in the early stages of the infection. When symptoms do occur, they can include fatigue, fever, joint pain, nausea, loss of appetite, abdominal pain, dark urine, and jaundice (yellowing of the skin and eyes).
- Acute vs. Chronic Hepatitis C: Hepatitis C can be acute or chronic. Acute hepatitis C occurs within the first six months after exposure to the virus. Many people with acute hepatitis C do not experience symptoms, and the infection may resolve on its own without treatment. However, some individuals may develop chronic hepatitis C, where the virus persists in the body for a prolonged period, often leading to liver damage and other complications.
- Complications: Chronic hepatitis C can lead to serious liver complications, including liver cirrhosis (scarring of the liver), liver failure, and liver cancer. It is one of the leading causes of liver transplantation in many countries.
- Diagnosis: Hepatitis C is diagnosed through blood tests that detect the presence of HCV antibodies and/or viral RNA. Additional tests, such as liver function tests and imaging studies, may be performed to assess liver health and determine the extent of liver damage.
- Treatment: Treatment for hepatitis C has evolved significantly in recent years with the development of direct-acting antiviral medications (DAAs). These drugs target specific steps in the HCV lifecycle and can cure the infection in the majority of cases. Treatment regimens may vary depending on factors such as the genotype of the virus, the extent of liver damage, and the presence of other medical conditions.
- Prevention: Prevention measures for hepatitis C include avoiding behaviors that can lead to exposure to infected blood, such as needle sharing, practicing safe sex, avoiding sharing personal items such as toothbrushes or razors that may come into contact with blood, and ensuring proper sterilization of medical equipment in healthcare settings. Additionally, screening of blood donations and implementation of harm reduction strategies among at-risk populations (such as people who inject drugs) can help reduce the transmission of hepatitis C.
Hepatitis C Risk Factors and Considerations for Veterans
Veterans may face unique risk factors and considerations regarding hepatitis C due to a variety of factors related to their military service and experiences.
- Exposure to Blood: Military service members may be at increased risk of exposure to blood and blood-borne pathogens, including hepatitis C, due to combat injuries, medical procedures, or other occupational hazards. This exposure can occur through blood transfusions, needlestick injuries, or contact with contaminated medical equipment.
- Injecting Drug Use: Substance abuse, including injecting drug use, is a risk factor for hepatitis C transmission. Some veterans may develop substance use disorders, including opioid addiction, as a result of physical or psychological trauma experienced during military service. Injection drug use, particularly when sharing needles or other equipment, can increase the risk of hepatitis C transmission.
- Sexual Risk Factors: Certain sexual behaviors, such as having multiple sexual partners or engaging in unprotected sex, can increase the risk of hepatitis C transmission. Veterans may face challenges in maintaining stable relationships or accessing sexual health services due to the demands of military service, deployments, or post-deployment readjustment.
- Mental Health Issues: Veterans may experience mental health issues such as post-traumatic stress disorder (PTSD), depression, or substance abuse disorders, which can impact their risk behaviors and healthcare-seeking behaviors. Mental health conditions may also affect adherence to hepatitis C treatment regimens.
- Homelessness and Housing Insecurity: Some veterans may face challenges related to homelessness or housing instability, which can exacerbate their risk of hepatitis C transmission and complicate access to healthcare services, including screening, diagnosis, and treatment.
- Healthcare Access and Utilization: Veterans may encounter barriers to accessing healthcare services within the VA healthcare system or in the civilian healthcare system, including long wait times, geographic distance to VA facilities, and limited availability of specialty care services.
- Military Exposures: Certain military exposures, such as deployment to areas with high rates of hepatitis C prevalence, may increase the risk of infection. Additionally, exposure to environmental hazards, such as contaminated water or chemicals, could potentially impact liver health and increase susceptibility to hepatitis C infection.
- Age: Older veterans may be at increased risk of hepatitis C due to exposures that occurred earlier in their lives, before the implementation of universal precautions and screening practices.
Given these risk factors and considerations, it is important for veterans to be aware of the risk of hepatitis C infection and to seek appropriate healthcare services, including screening, testing, and treatment.
What is the Hepatitis C VA Disability Rating?
The VA rates Hepatitis C under the new DC 7354 with ratings from 0% to 100% with breaks at 20%, 40%, and 60%.
However, DC 7354 instructs the VA to rate Hepatitis C, non-A, and non-B hepatitis under DC 7345, chronic liver disease without cirrhosis, as follows:
100% VA Rating for Hepatitis C
Progressive chronic liver disease requiring use of both parenteral antiviral therapy (direct antiviral agents), and parenteral immunomodulatory therapy (interferon and other); and for six months following discontinuance of treatment.
Explanation of the 100 Percent VA Rating Criteria
This is the highest disability rating for Hepatitis C, indicating the most severe impact on the veteran’s health and daily life. The condition requires the use of both parenteral antiviral therapy (direct antiviral agents, which are administered through non-oral means to directly fight the hepatitis C virus) and parenteral immunomodulatory therapy (such as interferon, which helps modulate the immune system’s response to the virus). Treatment discontinuance effects are considered for six months following the end of treatment, recognizing the ongoing impact on the veteran’s health.
60% VA Rating for Hepatitis C
Progressive chronic liver disease requiring continuous medication and causing substantial weight loss and at least two of the following: (1) daily fatigue, (2) malaise, (3) anorexia, (4) hepatomegaly, (5) pruritus, and (6) arthralgia.
Explanation of the 60 Percent VA Rating Criteria
This rating is given for less severe but still significant disease impact, requiring continuous medication. The veteran experiences substantial weight loss and at least two of the following symptoms:
- Daily fatigue: Persistent tiredness not relieved by rest.
- Malaise: A general feeling of discomfort or unease.
- Anorexia: Loss of appetite leading to weight loss.
- Hepatomegaly: Enlargement of the liver.
- Pruritus: Itchy skin.
- Arthralgia: Joint pain.
40% VA Rating for Hepatitis C
Progressive chronic liver disease requiring continuous medication and causing minor weight loss and at least two of the following: (1) daily fatigue, (2) malaise, (3) anorexia, (4) hepatomegaly, (5) pruritus, and (6) arthralgia.
Explanation of the 40 Percent VA Rating Criteria
This rating applies when the disease requires ongoing medication and causes minor weight loss and at least two of the above-mentioned symptoms (fatigue, malaise, anorexia, hepatomegaly, pruritus, arthralgia), indicating a moderate impact on health and well-being.
20% VA Rating for Hepatitis C
Chronic liver disease with at least one of the following: (1) intermittent fatigue, (2) malaise, (3) anorexia, (4) hepatomegaly, or (5) pruritus.
Explanation of the 20 Percent VA Rating Criteria
This rating is for chronic liver disease with milder symptoms compared to the higher ratings. The veteran must have at least one of the following symptoms: intermittent fatigue, malaise, anorexia, hepatomegaly, or pruritus, indicating a lower impact on daily life.
0% VA Rating for Hepatitis C
Previous history of liver disease, currently asymptomatic rate at 0%
Explanation of the 0 Percent Non-Compensable VA Rating Criteria
This rating signifies that the veteran has a history of liver disease but is currently asymptomatic, meaning they do not present any symptoms. Although there’s no current impact on the veteran’s health, the recognition of the disease’s history is important for future healthcare considerations and benefits.
Important Notes
Note (#1): 100% evaluation shall continue for six months following discontinuance of parenteral antiviral therapy and administration of parenteral immunomodulatory drugs. Six months after discontinuance of parenteral antiviral therapy and parenteral immunomodulatory drugs, determine the appropriate disability rating by mandatory VA exam. Apply the provisions of § 3.105(e) of this chapter to any change in evaluation based upon that or any subsequent examination.
Note (#2): For individuals for whom physicians recommend both parenteral antiviral therapy and parenteral immunomodulatory drugs, but for whom treatment is medically contraindicated, rate according to DC 7312 (Cirrhosis of the liver).
Note (#3): This diagnostic code includes Hepatitis B (confirmed by serologic testing), primary biliary cirrhosis (PBC), primary sclerosing cholangitis (PSC), autoimmune liver disease, Wilson’s disease, Alpha-1-antitrypsin deficiency, hemochromatosis, drug-induced hepatitis, and non-alcoholic steatohepatitis (NASH). Track Hepatitis C (or non-A, non-B hepatitis) under DC 7354 but evaluate it using the criteria in this entry.
Note (#4): Evaluate sequelae, such as cirrhosis or malignancy of the liver, under an appropriate diagnostic code, but do not use the same signs and symptoms as the basis for evaluation under DC 7354 and under a diagnostic code for sequelae. (See § 4.14)
What If I Already Have VA Disability for Hepatitis C?
If you already have VA disability for Hepatitis C, there will be no change to your current VA disability rating; you are “grandfathered” in under the old rating criteria.
A reduction in your rating will only occur if there is improvement in a disability sufficient to warrant a reduction under the old criteria.
All VA claims related to these digestive systems that were submitted and in “pending” status as of May 19, 2024, will be considered under both the old and new rating criteria, and whichever criteria is more favorable to the veteran will be applied.
In summary, get your VA claim submitted ASAP!
Why?
Because the VA rater must consider both the old and new criteria and select the rating that’s most favorable to you.
About the Author
Brian Reese
Brian Reese is one of the top VA disability benefits experts in the world and bestselling author of You Deserve It: The Definitive Guide to Getting the Veteran Benefits You’ve Earned (Second Edition).
Brian’s frustration with the VA claim process led him to create VA Claims Insider, which provides disabled veterans with tips, strategies, and lessons learned to win their VA disability compensation claim, faster, even if they’ve already filed, been denied, gave up, or don’t know where to start.
As the founder of VA Claims Insider and CEO of Military Disability Made Easy, he has helped serve more than 10 million military members and veterans since 2013 through free online educational resources.
He is a former active duty Air Force officer with extensive experience leading hundreds of individuals and multi-functional teams in challenging international environments, including a combat tour to Afghanistan in 2011 supporting Operation ENDURING FREEDOM.
Brian is a Distinguished Graduate of Management from the United States Air Force Academy, Colorado Springs, CO, and he holds an MBA from Oklahoma State University’s Spears School of Business, Stillwater, OK, where he was a National Honor Scholar (Top 1% of Graduate School class).
