Chronic Liver Disease (Cirrhosis) — VA Disability Rating Criteria (DC 7312)
Diagnostic Code 7312 · 38 CFR §4.114
What Is It?
Chronic liver disease encompasses ongoing damage to the liver from various causes including hepatitis infections, toxic exposure, alcohol use, or autoimmune conditions. As damage progresses, it can lead to cirrhosis — scarring that replaces healthy liver tissue and impairs the liver's ability to function. Symptoms range from fatigue and mild abdominal discomfort in early stages to jaundice, fluid buildup in the abdomen, confusion, and bleeding problems in advanced disease. Veterans may develop liver disease from hepatitis contracted during service, toxic exposures (including Agent Orange), or medications used for other service-connected conditions.
Rating Criteria
| Rating | Criteria |
|---|---|
| 100% | Near-constant debilitating symptoms with one or more of the following: persistent ascites not controlled by treatment, hepatic encephalopathy (confusion from liver failure), bleeding from enlarged veins in the esophagus or stomach, or meeting criteria for a liver transplant. |
| 70% | You have documented liver damage with symptoms including persistent jaundice, fluid accumulation requiring treatment, markedly abnormal liver function tests, and significant weight loss. Hospitalization for liver-related complications has occurred. |
| 50% | You have disturbance of liver function with signs of portal hypertension such as an enlarged spleen or abdominal fluid. Lab tests show more significant impairment. Fatigue, weakness, nausea, and dietary limitations substantially affect your daily life. |
| 30% | Your liver disease causes persistent fatigue, right upper abdominal discomfort, nausea, and loss of appetite requiring dietary adjustment. You may have mild hepatomegaly (enlarged liver). Some weight loss is present. |
| 10% | Your liver condition causes intermittent fatigue, general discomfort, and some loss of appetite. Liver function tests show mild abnormalities but you do not have signs of advanced disease. Dietary restriction may be necessary. |
Evidence Needed
Liver function tests (AST, ALT, bilirubin, albumin, PT/INR) over time showing the pattern and severity of impairment. Imaging studies (ultrasound, CT, or MRI) showing liver size, texture, and signs of cirrhosis or portal hypertension. Liver biopsy results if available. Records of hospitalizations for complications like ascites, variceal bleeding, or encephalopathy. Documentation of the underlying cause (hepatitis serology, exposure records).
C&P Exam Tips
Have your most recent lab results and imaging available for the examiner. Describe your daily symptoms — fatigue level, appetite, nausea, any confusion or memory issues, bruising tendency. If you have been hospitalized for liver-related problems, provide those records. Mention all medications you take for the liver condition and any dietary restrictions your doctor has imposed.
How to File
File under DC 7312 for chronic liver disease or cirrhosis. Include hepatology or GI specialist records, lab trends, imaging results, and documentation of any complications. If liver disease resulted from service-connected hepatitis C or toxic exposure, file as secondary with appropriate nexus documentation.
Common Mistakes
Not submitting serial lab results is a frequent error. A single set of labs may catch you on a good day. Submitting six to twelve months of labs shows the trend and typical level of impairment. Another mistake is not documenting complications separately — if liver disease causes encephalopathy, variceal bleeding, or ascites, each episode should be thoroughly documented as they can push the rating to the highest levels.
Frequently Asked Questions
Is liver disease from hepatitis C ratable?
Yes. If you contracted hepatitis C during military service (from blood transfusions, jet injectors, or other in-service exposures) and it caused liver damage, both the hepatitis and the resulting liver disease are ratable. They may be rated under separate codes.
Can I get rated for liver disease if I also drank alcohol?
The VA considers all contributing factors. If military service contributed to your liver disease (through hepatitis, toxic exposure, or medications), service connection may be established even if other factors like alcohol also played a role. However, the VA generally does not grant service connection for conditions solely caused by willful misconduct.
What if I need a liver transplant?
A liver transplant itself can warrant a 100 percent rating for at least one year following surgery. After that, the VA re-evaluates based on your residual symptoms and liver function.