The Department of Veterans Affairs (VA) sets a hepatitis C VA rating from 0% to 100% using the chronic liver disease criteria in its rating schedule. At Rank and Pay, we publish plain-language guides to VA disability ratings.
VA tracks hepatitis C under Diagnostic Code (DC) 7354, but the [VA Schedule for Rating Disabilities at 38 CFR 4.114](https://www.ecfr.gov/current/title-38/chapter-I/part-4/subpart-B/subject-group-ECFR3ba0d2cf9ebb9d7/section-4.114) tells raters to evaluate it with the criteria in DC 7345. If hepatitis C has caused cirrhosis, VA rates the cirrhosis separately under DC 7312, and the same symptoms cannot be counted under both codes.
How VA Rates Hepatitis C Under DC 7354 and DC 7345
VA rates hepatitis C by applying the DC 7345 criteria for chronic liver disease without cirrhosis to a condition filed under DC 7354. DC 7354 covers hepatitis C, also listed as non-A, non-B hepatitis, and it directs raters to DC 7345 for the rating criteria.
Four factors set the percentage under DC 7345. They are the symptoms you have and how often they happen, whether the disease needs continuous medication, how much weight you have lost, and whether you are being treated with two specific therapies.
For hepatitis C, several rules that change a rating sit in the notes printed under DC 7345. Those notes cover the six months after treatment, the follow-up exam, contraindicated treatment and cirrhosis.
The DC 7345 Hepatitis C VA Rating Table
DC 7345 has five levels for hepatitis C: 0%, 20%, 40%, 60% and 100%. The levels are paraphrased here, and the regulation text controls if the wording differs.
| Rating | What DC 7345 requires (paraphrased) |
|---|
| 0% | A previous history of liver disease, with no current symptoms |
| 20% | Chronic liver disease with at least one of these: intermittent fatigue, malaise, anorexia, hepatomegaly (enlarged liver) or pruritus (itching) |
| 40% | Progressive chronic liver disease that requires continuous medication and causes minor weight loss, with at least two of these: daily fatigue, malaise, anorexia, hepatomegaly, pruritus and arthralgia (joint pain) |
| 60% | The same as 40%, but with substantial weight loss |
| 100% | Progressive chronic liver disease that requires both parenteral antiviral therapy (direct antiviral agents) and parenteral immunomodulatory therapy (interferon and other), and for six months after that treatment stops |
How to Read the Steps Between 20%, 40% and 60%
The 20% and 40% levels differ in four ways you can compare against your own medical records.
- Fatigue: 20% lists intermittent fatigue, and 40% lists daily fatigue.
- Symptom count: 20% needs at least one listed symptom, and 40% needs at least two.
- Medication: 40% requires progressive disease that needs continuous medication. The 20% level has no medication requirement.
- Weight loss: 40% requires minor weight loss, and 60% requires substantial weight loss. The 20% level has no weight-loss requirement.
If your medical records mention weight loss, ask your doctor to note the amount and the time period.
Hepatitis C VA Rating After Treatment Ends
The 100% rating under DC 7345 continues for six months after antiviral and immunomodulatory treatment is discontinued, and then a mandatory VA exam decides the next rating. Note 1 under DC 7345 sets this order.
- During treatment: DC 7345 assigns 100% when progressive chronic liver disease requires both parenteral antiviral therapy and parenteral immunomodulatory therapy.
- Treatment stops: the 100% evaluation continues for six months after the treatment is discontinued.
- Six months after treatment stops: VA determines the appropriate rating through a mandatory VA examination.
- After the exam: the regulation says any change in the evaluation based on that exam, or on any later exam, follows 38 CFR 3.105(e).
- Lasting damage: residuals such as cirrhosis are evaluated under their own diagnostic code, rated under DC 7312.
If you are treated with both therapies, then before the six-month exam write down which DC 7345 symptoms you have, how often each one happens and any change in your weight. Our [Compensation and Pension (C&P) exam tips](/va-claims/c-and-p-exam-tips/) cover how to prepare for the appointment.
What the Schedule Says If Hepatitis C Is Cured
Once treatment ends, Note 1 under DC 7345 leaves the new rating to the mandatory VA exam held six months after treatment stops. The schedule rates residuals, such as cirrhosis or liver cancer, separately under their own codes.
For comparison, DC 7345 describes its 0% level as a previous history of liver disease with no current symptoms. The exam findings, measured against the DC 7345 levels and any code for residuals, decide where the rating lands.
VA offers a
supplemental claim, a
higher-level review and a
Board appeal if you disagree with the rating.
When Treatment Is Medically Contraindicated
If physicians recommend both antiviral and immunomodulatory therapy but the treatment is medically contraindicated, Note 2 under DC 7345 directs VA to rate under DC 7312, the code for cirrhosis of the liver. The DC 7312 cirrhosis criteria then set the percentage.
Ask the treating physician to state in your records that both therapies were recommended and that treatment is medically contraindicated.
Hepatitis C Cirrhosis VA Rating Under DC 7312
VA rates cirrhosis caused by hepatitis C under DC 7312, with five levels from 0% to 100% based on either a Model for End-Stage Liver Disease (MELD) score or symptoms. If the evidence has no MELD score, Note 3 under DC 7312 says VA rates on symptoms.
| Rating | MELD score path | Symptom path (paraphrased) |
|---|
| 0% | No MELD threshold | Asymptomatic, with a history of liver disease |
| 10% | Greater than 6 and less than 10 | Anorexia, weakness, abdominal pain or malaise |
| 30% | 10 or 11 | Signs of portal hypertension, such as splenomegaly or ascites, with weakness, anorexia, abdominal pain or malaise |
| 60% | Greater than 11 and less than 15 | Daily fatigue plus at least one episode in the past year of variceal hemorrhage, portal gastropathy or hepatic encephalopathy |
| 100% | 15 or more | Continuous daily debilitating symptoms and generalized weakness, plus at least one of these: ascites, a history of spontaneous bacterial peritonitis, hepatic encephalopathy, variceal hemorrhage, coagulopathy, portal gastropathy, or hepatopulmonary or hepatorenal syndrome |
The MELD column and the symptom column are alternatives at each level. A level can be met through the score or through the listed symptoms.
If you have had a MELD score calculated, compare it with the MELD column in the table. Include the lab results behind that score in any claim you file.
Rating Cirrhosis and Hepatitis C Without Counting Symptoms Twice
VA can rate hepatitis C and its cirrhosis under separate codes, but Note 4 under DC 7345 bars using the same signs and symptoms as the basis for both ratings. The schedule treats cirrhosis and liver malignancy as sequelae, and each is evaluated under an appropriate diagnostic code.
For example, if daily fatigue supports the cirrhosis rating under DC 7312, that same daily fatigue cannot also support the hepatitis C rating under DC 7354. Each rating has to rest on its own set of findings.
If you hold more than one rating, our [combined rating explainer](/explainers/va-disability-rating-explained/) shows how VA's combined rating formula works. The [VA disability rating calculator](/tools/va-disability-rating-calculator) runs the math for you.
Liver Cancer Occurring with Cirrhosis
Hepatocellular carcinoma that occurs with cirrhosis is rated under DC 7343, malignant neoplasms of the digestive system, instead of DC 7312. Our [VA cancer rating guide](/explainers/va-disability-rating-cancer/) covers how cancer ratings work.
DC 7345 vs DC 7312 for Hepatitis C
DC 7345 rates chronic liver disease without cirrhosis, and DC 7312 rates cirrhosis of the liver.
| Criterion | DC 7345 (used for DC 7354) | DC 7312 |
|---|
| What it covers | Chronic liver disease without cirrhosis, including hepatitis C | Cirrhosis of the liver |
| Rating levels | 0%, 20%, 40%, 60%, 100% | 0%, 10%, 30%, 60%, 100% |
| What sets the level | Symptoms, continuous medication, weight loss and treatment | MELD score or symptoms |
| How 100% is reached | Both parenteral therapies, plus six months after treatment stops | MELD score of 15 or more, or continuous daily debilitating symptoms with a listed complication |
| Used for | Rates the hepatitis C itself | Rates cirrhosis, or replaces DC 7345 when recommended treatment is contraindicated |
DC 7345 is the starting point for hepatitis C without cirrhosis. DC 7312 applies once cirrhosis is diagnosed, or under Note 2 when recommended treatment is medically contraindicated. With cirrhosis, the two ratings can sit side by side as long as different symptoms support each one.
How to Get Hepatitis C Service Connected
Hepatitis C is not on the Agent Orange presumptive list in 38 CFR 3.309(e), so a claim has to establish service connection through the usual elements. VA looks for three of them.
- A current diagnosis of hepatitis C.
- An in-service event, injury or illness.
- A medical link, called a nexus, between the diagnosis and the in-service event, injury or illness.
The nexus has to be supported by evidence. Our [
nexus letter explainer](/explainers/what-is-a-nexus-letter/) covers what a
nexus letter is, and the [nexus letter guide](/va-claims/nexus-letter-guide/) walks through getting one.
An accredited representative can help you build the evidence for the link, and free help is available from accredited Veterans Service Officers (VSOs). VA's [how to file a disability claim page](https://www.va.gov/disability/how-to-file-claim/) lists the filing steps.
A Checklist for a Hepatitis C Claim
Gather these items before you file or before the post-treatment exam.
- The hepatitis C diagnosis in your medical records.
- Evidence of the in-service event, injury or illness.
- Medical evidence linking the two, such as a nexus letter.
- A written list of the DC 7345 symptoms you have, how often each happens and any weight loss.
- Records of continuous medication, if you take any for the liver disease.
- Start and stop dates for antiviral and immunomodulatory therapy, so the six-month period can be tracked.
- Any cirrhosis diagnosis, MELD score or record of the complications listed under DC 7312.
- A physician statement if both therapies were recommended but medically contraindicated.
Review Options If You Disagree with a Decision
A veteran who disagrees with a VA decision has three review options: a supplemental claim, a higher-level review or a Board appeal. VA's [decision reviews page](https://www.va.gov/decision-reviews/) explains each option, and our [VA Form 20-0995 page](/va-forms/20-0995/) covers the supplemental claim form.
Who This Page Is Not For
- If you want a monthly payment amount, this page does not state one. Start at the [VA disability hub](/va-disability/) instead.
- If you have hepatocellular carcinoma with cirrhosis, that rating falls under DC 7343, and the VA cancer rating guide is the better starting point.
- If you want someone to tell you whether you qualify, this page describes criteria only. Free help with your own records is available from an accredited VSO.
What Would Change This Answer
- VA amends the rating schedule. The rating criteria can change, so confirm the current text of 38 CFR 4.114 at the [Electronic Code of Federal Regulations (eCFR)](https://www.ecfr.gov/current/title-38/chapter-I/part-4/subpart-B/subject-group-ECFR3ba0d2cf9ebb9d7/section-4.114).
- Recommended treatment is medically contraindicated. Note 2 moves the rating to DC 7312.
- Cirrhosis develops. It gets its own rating under DC 7312, based on symptoms other than those behind the DC 7354 rating.
- Liver cancer occurs with cirrhosis. DC 7343 replaces DC 7312.
- Treatment ends. The 100% level runs for six more months, and then the mandatory exam decides the new rating.
Match your medical records to the DC 7345 levels, then start your claim for a hepatitis C VA rating on VA's [filing page](https://www.va.gov/disability/how-to-file-claim/).
This page is general information only and is not medical or legal advice. Rank and Pay is not affiliated with the VA. The rating criteria can change, so confirm the current text of 38 CFR 4.114 at the [eCFR](https://www.ecfr.gov/current/title-38/chapter-I/part-4/subpart-B/subject-group-ECFR3ba0d2cf9ebb9d7/section-4.114) before you rely on it, and talk to an accredited VSO about your own claim.