Chronic Cholangitis — VA Disability Rating (DC 7314)

Diagnostic Code 7314 · 38 CFR §4.114

What Is It?

DC 7316 no longer exists. VA rewrote the digestive schedule effective May 19, 2024 (89 FR 19743). It removed DC 7316 and moved chronic cholangitis into DC 7314, now titled "Chronic biliary tract disease," whose Note names cholangitis first: the code "includes cholangitis, biliary strictures, Sphincter of Oddi dysfunction, bile duct injury, and choledochal cyst." Primary sclerosing cholangitis is the exception — the same Note routes it to chronic liver disease without cirrhosis, DC 7345. VA said so itself in the rulemaking, code by code: the removal "would not, in and of itself, alter existing evaluations or grants of service connection. Rather, VA would modify the individual’s record to reflect the grant of service connection under" the current code. 38 CFR § 3.951(a) says the same thing as a rule of general application — a readjustment to the rating schedule is not grounds for reducing an evaluation already in effect unless medical evidence establishes that the disability has actually improved. The old code still appears in this page’s web address because the address has not changed; the code the page teaches has. Cholangitis is inflammation of the bile ducts. It produces right upper quadrant pain, nausea and vomiting, often with fever and jaundice in an acute attack, and over years it can scar the ducts, disturb fat absorption and damage the liver.

Rating Criteria

Evidence Needed

MRCP (magnetic resonance cholangiopancreatography) or ERCP imaging that shows duct narrowing, beading, or strictures is the strongest objective evidence. Liver enzyme panels showing elevated alkaline phosphatase and GGT during flares document active inflammation. A liver biopsy, if performed, characterizes the histology. Blood work for primary sclerosing cholangitis (autoantibodies, IgG4) is relevant when that is the underlying cause. Records from each acute flare — labs, imaging, treatment — establish the recurrence pattern that drives the rating. Service records or post-deployment infectious-disease workups that document a parasitic or bacterial trigger support the nexus when relevant.

C&P Exam Tips

Bring the imaging report and the liver enzyme trend. Describe the pattern of your flares — how often they occur, whether jaundice or fever accompanies them, how long each lasts, and how they resolve. Mention fatigue and itching, which are sometimes the dominant symptoms between acute flares. If you have had ERCP procedures, biliary stents, or balloon dilations, list them — these document the chronicity. Distinguish chronic cholangitis from acute cholangitis episodes that may have happened previously, since the rating is for the chronic ongoing disease state.

How to File

File VA Form 21-526EZ naming cholangitis or biliary tract disease; the rater assigns DC 7314. The criteria count clinically documented attacks of right upper quadrant pain with nausea and vomiting in the past 12 months, so what you need is the record of those attacks — ER notes, urgent care visits, imaging on the day of the attack — plus any ERCP or dilatation procedures. One documented dilatation of a biliary stricture in the past 12 months reaches 30 percent on its own.

Common Mistakes

Filing without MRCP imaging, leaving no objective documentation of duct disease Assuming the neighbouring biliary conditions are separate ladders. Chronic cholecystitis is rated under this same code, DC 7314, and chronic cholelithiasis (DC 7315) routes into it, so all three are decided on the same count of documented attacks; only complications of cholecystectomy (DC 7318) carries criteria of its own, and 38 CFR 4.114 bars combining any of them with each other in any event Not documenting flare frequency carefully, which is the variable that distinguishes the 10% and 30% tiers Missing the secondary-claim window for hepatic fibrosis when biopsy data show it

Frequently Asked Questions

Why does my paperwork say DC 7316?

DC 7316 was removed effective May 19, 2024. VA’s stated position is that the removal "would not, in and of itself, alter existing evaluations or grants of service connection" and that it would "modify the individual’s record to reflect the grant of service connection under DC 7314 instead of DC 7316."

I have primary sclerosing cholangitis. Is that DC 7314?

No. DC 7314’s own Note directs that primary sclerosing cholangitis be rated under chronic liver disease without cirrhosis, DC 7345. That code runs 100 / 60 / 40 / 20 / 0 and is keyed to treatment and findings rather than to counted biliary attacks: 100 percent for progressive disease requiring both parenteral antiviral and parenteral immunomodulatory therapy, and for six months after treatment stops; 60 and 40 percent for continuous medication with substantial or minor weight loss as 38 CFR 4.112 defines them, plus at least two of daily fatigue, malaise, anorexia, hepatomegaly, pruritus and arthralgia; 20 percent for at least one of intermittent fatigue, malaise, anorexia, hepatomegaly or pruritus; 0 percent for a previous history of liver disease, currently asymptomatic. There is no 10 percent row on that code, and it reaches higher percentages than DC 7314.

What counts as a "clinically documented attack"?

An episode of right upper quadrant pain with nausea and vomiting that appears in the medical record — seen and written down by a clinician. Episodes you managed at home without contacting anyone are the most commonly lost evidence in these claims. Call the nurse line, send a portal message, or be seen, so the attack exists on paper.