Hepatitis B and Hepatitis C — VA Disability Rating Criteria (DC 7345 and DC 7354)

Diagnostic Code 7345 · 38 CFR §4.114

What Is It?

Hepatitis B and hepatitis C are different viruses with different code numbers and one shared set of rating criteria, and knowing which number goes where is the first thing to get right on the claim form. 38 CFR 4.114 lists DC 7345 as "Chronic liver disease without cirrhosis," and Note (3) to that entry states that the code includes hepatitis B confirmed by serologic testing. So hepatitis B is rated under DC 7345 directly. Hepatitis C has its own number — DC 7354, "Hepatitis C (or non-A, non-B hepatitis)" — but that entry carries no criteria of its own. It reads "Rate under DC 7345," and Note (3) to DC 7345 says the same thing from the other direction: track hepatitis C under DC 7354, but evaluate it using the criteria in the DC 7345 entry. The practical result is one ladder for both viruses — 100, 60, 40, 20 and 0 percent — with the code of record differing by which virus you have. The ladder is written around treatment and symptoms rather than viral load or liver enzymes: the 100 percent row requires both parenteral antiviral therapy and parenteral immunomodulatory therapy, the 60 and 40 percent rows require continuous medication plus weight loss plus at least two of six named symptoms, and the 20 percent row needs only one of five. This page also answers for DC 7344: an earlier version of this site rated hepatitis under that number, but 38 CFR 4.114 lists DC 7344 as "Benign neoplasms, exclusive of skin growths" — a routing entry with no percentages, whose Note names lipoma, leiomyoma, colon polyps and villous adenoma. It has nothing to do with viral hepatitis.

Rating Criteria

Evidence Needed

Start with the serology, because it decides the code: hepatitis B surface antigen and the rest of the B panel, or the hepatitis C antibody plus a confirmatory RNA/PCR result. Add the treatment record in the specific terms the criteria use — whether therapy was parenteral (injected or infused) or oral, whether it was antiviral, immunomodulatory, or both, and the start and stop dates, since the 100 percent evaluation continues for six months after parenteral therapy is discontinued. Then build the symptom record: fatigue, malaise, anorexia, hepatomegaly, pruritus and arthralgia are the six named findings, and the middle rows require at least two of them, so a treatment note that records only "tired" will not carry a 40 percent evaluation. Weight has to be documented over time, not estimated — 38 CFR 4.112 defines substantial weight loss as involuntary loss of more than 20 percent of baseline sustained for three months and minor weight loss as 10 to 20 percent, measured against the clinically documented two-year average before onset or the weight at the discharge physical. Finally, the service evidence for exposure: jet-injector inoculation, blood transfusion before screening, combat medical care, shared equipment, or occupational needlestick.

C&P Exam Tips

Say which virus you have and let the examiner write down the confirmatory test, because the code of record follows the serology. Describe the six named symptoms by name and by frequency — daily fatigue is a different criterion from intermittent fatigue, and the difference is a rating step. Bring the weight history rather than a number from memory. If you have completed treatment and cleared the virus, do not assume the claim is over: the 100 percent evaluation runs for six months past the end of parenteral therapy, and a cleared virus that leaves symptoms behind is still rated, while a cleared virus with no symptoms is the 0 percent row, which keeps service connection alive. If both parenteral antiviral and parenteral immunomodulatory drugs were recommended but treatment was medically contraindicated, say so: Note (2) to DC 7345 directs that those veterans be rated under DC 7312 for cirrhosis of the liver instead.

How to File

File on VA Form 21-526EZ under DC 7345 for hepatitis B and under DC 7354 for hepatitis C, attaching the serology, the treatment record with dates and route of administration, and the symptom and weight history. The rating criteria are identical either way. One structural rule shapes the strategy: the opening paragraph of 38 CFR 4.114 provides that ratings under DC 7301 through 7329, 7331, 7342, 7345 through 7350, 7352 and 7355 through 7357 will not be combined with each other, and both DC 7345 and DC 7354 fall inside it. A veteran with hepatitis and another listed digestive condition receives a single evaluation under the code reflecting the predominant disability picture, elevated one step if the overall severity warrants. Sequelae outside the digestive schedule — diabetes, neuropathy, a mental-health condition — are combined normally under 38 CFR 4.25.

Common Mistakes

Filing under DC 7344, which is the benign-neoplasm entry and carries no rating criteria at all. Assuming hepatitis B and hepatitis C are rated differently — they share one criteria set; only the code of record differs. Claiming a rating from viral load or liver enzyme numbers, which appear nowhere in the criteria. Reporting one symptom when the middle rows require two of the six named findings. Estimating weight loss instead of documenting it against the baseline 38 CFR 4.112 defines. Treating a sustained virologic response as the end of the claim, when the entry has a 0 percent row precisely for a previous history of liver disease that is currently asymptomatic. And overlooking Note (2), which routes veterans for whom both parenteral therapies are contraindicated to DC 7312 instead.

Frequently Asked Questions

Which diagnostic code should I put on my claim — 7345 or 7354?

Hepatitis B goes under DC 7345, which Note (3) says includes hepatitis B confirmed by serologic testing. Hepatitis C goes under DC 7354. Either way the evaluation comes from the DC 7345 criteria, so the choice of number does not change the percentage you can reach.

What is DC 7344?

38 CFR 4.114 lists DC 7344 as "Benign neoplasms, exclusive of skin growths." It has no percentage column — it directs evaluation under a code appropriate to the predominant disability or the specific residuals after treatment, and its Note names lipoma, leiomyoma, colon polyps and villous adenoma. It is not a hepatitis code.

I was cured by the new antivirals. Can I still be rated?

Yes, in two ways. A 100 percent evaluation continues for six months after parenteral antiviral and immunomodulatory therapy is discontinued, after which a mandatory VA examination sets the rating, with 38 CFR 3.105(e) governing any reduction. And the 0 percent row exists for a previous history of liver disease that is currently asymptomatic, which keeps service connection in place if symptoms return.

Does the 100 percent row cover oral direct-acting antivirals?

As written, the row requires both parenteral antiviral therapy and parenteral immunomodulatory therapy — that is, injected or infused. Modern hepatitis C treatment is usually oral tablets alone, which does not meet the row on its face. Most current claims are therefore decided on the 60, 40 and 20 percent rows, which turn on continuous medication, weight loss and the six named symptoms.

What are the six symptoms the criteria name?

Daily fatigue, malaise, anorexia, hepatomegaly, pruritus and arthralgia. The 60 and 40 percent rows require at least two of them alongside continuous medication and weight loss; the 20 percent row requires only one of the first five, and it accepts intermittent rather than daily fatigue.

Can I be rated for hepatitis and cirrhosis at the same time?

Not on the same findings. Note (4) to DC 7345 directs that sequelae such as cirrhosis or malignancy be evaluated under an appropriate code, but the same signs and symptoms cannot support both — that is the pyramiding bar in 38 CFR 4.14. Both codes also sit inside the 38 CFR 4.114 non-combination group, so VA assigns one evaluation under the predominant code.