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7354
§ 4.114 Schedule of ratings—digestive system.

Hepatitis C

A viral infection causing liver inflammation, transmitted through blood contact and potentially leading to chronic liver disease.

What the rating means

Hepatitis C is tracked under diagnostic code 7354 but rated using the criteria for chronic liver disease without cirrhosis (diagnostic code 7345). Five rating levels are possible: 0%, 20%, 40%, 60%, and 100%.

A 0% rating applies when you have a previous history of liver disease but currently have no symptoms. A 20% rating applies when you have chronic liver disease with at least one of the following: intermittent fatigue, malaise, anorexia, hepatomegaly, or pruritus. A 40% rating applies when the disease is progressive, requires continuous medication, causes minor weight loss, and produces at least two symptoms from this list: daily fatigue, malaise, anorexia, hepatomegaly, pruritus, or arthralgia. A 60% rating applies when the same conditions are met but with substantial weight loss instead of minor weight loss. A 100% rating applies when the disease is progressive and requires use of both parenteral antiviral therapy and parenteral immunomodulatory therapy; this rating continues for six months after treatment ends, after which VA must conduct a mandatory exam to determine the appropriate rating going forward. If those treatments are recommended but medically contraindicated, rating is done under the criteria for cirrhosis of the liver.

Evidence that helps

Medical records documenting your diagnosis of Hepatitis C through confirmed laboratory or serologic testing form the foundation of your claim. To support higher rating levels, records should show whether your disease is described as progressive and whether a physician has prescribed continuous medication or parenteral antiviral and immunomodulatory therapies. Documentation of treatment dates and any discontinuance of those therapies matters for the 100% level and the mandatory exam requirement.

Physical exam findings and clinical notes that record hepatomegaly (enlarged liver), pruritus, arthralgia, or other listed symptoms help establish the 20%, 40%, and 60% levels. For the 40% and 60% levels specifically, records showing measured or documented weight loss — and whether it was minor or substantial — are relevant, along with evidence of at least two qualifying symptoms. Your own statements, and statements from people who know you, describing daily fatigue, malaise, or loss of appetite and how those symptoms affect your work and daily activities can help show the frequency and severity of your symptoms. If you have developed sequelae such as cirrhosis, those are evaluated separately under their own diagnostic codes.

Secondary conditions

Conditions that are often caused or made worse by this one. If you have any of these, they may be claimable as secondary service connection.