Hepatitis C VA Claim and Rating: How DC 7354 Works in 2026
Quick answer: VA lists hepatitis C under DC 7354 but rates it with the chronic liver disease criteria in DC 7345 (38 CFR 4.114): 0%, 20%, 40%, 60% or 100%. To be service connected you generally need a current diagnosis, an in-service event or exposure, and a medical opinion linking the two. Cirrhosis and liver cancer are rated separately.
Hepatitis C is a liver infection that can stay quiet for years. Many veterans only learn they have it from a routine blood test long after discharge. That raises a hard question for a VA claim: how do you connect a diagnosis today to something that happened in service? This guide covers how VA rates the condition, what the 2024 rating changes mean, which risk factors matter, and how a medical opinion fits in.
If your claim involves cirrhosis, fatty liver or another liver condition, start with our nexus letter for liver disease guide and the related liver disease secondary claim article.
How does VA rate hepatitis C?
Under 38 CFR 4.114, DC 7354 reads "Hepatitis C (or non-A, non-B hepatitis): Rate under DC 7345 (Chronic liver disease without cirrhosis)." So the DC 7345 criteria control. The text below is from the eCFR, current as of October 29, 2026.
| Rating | DC 7345 criteria (used for DC 7354) | 2026 monthly pay (veteran alone) |
|---|---|---|
| 100% | Progressive chronic liver disease requiring both parenteral antiviral therapy (direct antiviral agents) and parenteral immunomodulatory therapy (interferon and other), and for six months after treatment ends | $3,938.58 |
| 60% | Progressive chronic liver disease requiring continuous medication and causing substantial weight loss and at least two of: daily fatigue, malaise, anorexia, hepatomegaly, pruritus, arthralgia | $1,435.02 |
| 40% | Progressive chronic liver disease requiring continuous medication and causing minor weight loss and at least two of the same six symptoms | $795.84 |
| 20% | Chronic liver disease with at least one of: intermittent fatigue, malaise, anorexia, hepatomegaly or pruritus | $356.66 |
| 0% | Previous history of liver disease, currently asymptomatic | $0 |
Two notes in the regulation matter in practice:
- Treatment period. The 100% rating continues for six months after parenteral antiviral and immunomodulatory therapy stops. After that, VA sets the rating using a mandatory exam (Note 1).
- Treatment not possible. If a physician recommends both therapies but treatment is medically contraindicated, VA rates under DC 7312, the cirrhosis code (Note 2).
Ratings are based on the evidence of your symptoms and treatment, so records from your own clinicians matter. Our nexus letter guide explains how medical opinions are used in claims.
What changed in the digestive rating schedule?
VA published a final rule revising the digestive system section of the rating schedule, effective May 19, 2024. The Federal Register notice says the update was meant to use current medical terminology and give detailed, updated criteria for digestive conditions (Federal Register, March 20, 2024). The current DC 7345 text above is the revised version, which uses the 0/20/40/60/100 scale. If you have an older decision, ask your representative whether the current criteria could matter for you.
How much does VA pay for hepatitis C?
VA pays based on your combined disability rating, not on the diagnosis. VA's rates effective December 1, 2025 list these amounts for a veteran with no dependents: 20% is $356.66, 40% is $795.84, 60% is $1,435.02 and 100% is $3,938.58 per month. The table above shows them next to each rating. Rates for veterans with spouses, children or parents are higher; see VA's compensation rates page or our pay rates chart. If hepatitis C is one of several conditions, VA combines ratings with its own formula, so use our disability calculator to see how they stack.
What risk factors does VA recognize for hepatitis C?
VA's examiners look at how you may have contracted the virus, because hepatitis C is spread through blood. The CDC says injection drug use and transfusion or transplant before July 1992 are established risk factors, and that the virus spreads through sharing or reusing needles or items that contact infected blood (CDC clinical overview). A Board of Veterans' Appeals decision summarizing VBA Fast Letter 04-13 says most infections are accounted for by transfusion before 1992 and injection drug use (BVA Citation Nr 0531165).
This matters because an examiner will usually ask about every possible route. If you have a nonservice risk factor, a medical opinion should explain why service is still at least as likely as not the cause. If you have none, say so clearly and make sure your records show it.
Can air gun (jet injector) vaccinations support a hepatitis C claim?
Many veterans who served in the Vietnam era recall mass vaccinations with jet injector "air guns." VA addressed this in VBA Fast Letter 04-13, dated June 29, 2004. According to a Board decision quoting it, the letter concluded there was no scientific evidence documenting hepatitis C transmission by air gun injection, but called it "biologically plausible." It also said the examiner's report should include a full discussion of all modes of transmission and a rationale for why the air gun was the source in that veteran's case (BVA Citation Nr 0531165; a similar summary appears in Citation Nr 0815807).
In plain terms: air gun exposure is not an automatic basis for service connection, and it is not ruled out either. The medical opinion carries the weight. Board decisions are specific to their facts and do not set a result for your claim. We could not retrieve the Fast Letter itself from an official VA page, so we describe it only through those Board decisions.
How do I get service connection for hepatitis C?
VA says compensation is available if you have a current condition and served on active duty, active duty for training or inactive duty training, and the condition can be linked to service (VA eligibility). For hepatitis C, the practical steps are:
- Confirm the diagnosis. Get lab-based records (for example, antibody and viral load tests) from your clinician or VA.
- Pull your service treatment records. Look for immunizations, transfusions, surgery, dental work, combat injuries or other blood exposure.
- Document your history. Write a clear timeline of exposures in service and any risk factors outside service, including when you were first tested.
- Gather a medical opinion. Ask a qualified clinician to review your records and address the link to service and other risk factors.
- File the claim. Our how to file guide walks through the process. You can also work with an accredited representative; search VA's accreditation database and compare options in VSO vs. claims agent vs. attorney.
- Prepare for the C&P exam. See how to prepare for the exam.
Do I need a nexus letter for a hepatitis C claim?
A nexus letter is a medical opinion connecting your condition to service. Hepatitis C claims often turn on it, because the diagnosis usually comes years after service and VA examiners look at every risk factor. A useful opinion reviews your records, discusses other routes of infection and explains its reasoning. Read the full walkthrough in our nexus letter for liver disease guide, and compare options in IMO vs. nexus letter and free vs. paid nexus letters.
Cirrhosis, liver cancer and other secondary conditions
Chronic hepatitis C can lead to other liver problems. The CDC says untreated chronic hepatitis C can cause liver damage, cirrhosis, liver cancer and liver failure (CDC). If a clinician links these to service-connected hepatitis C, they can be claimed as secondary conditions. See our secondary conditions guide and how secondary service connection works.
- Cirrhosis (DC 7312): rated 0%, 10%, 30%, 60% or 100%, based on MELD score or symptoms.
- Liver cancer: Note 1 under DC 7312 says to rate hepatocellular carcinoma occurring with cirrhosis under DC 7343 instead. DC 7343 lists 100%, with rating based on residuals if there is no recurrence or metastasis after treatment and a VA exam six months later.
- No double counting: Note 4 under DC 7345 says to evaluate cirrhosis or liver malignancy under their own codes but not to use the same signs and symptoms for both (38 CFR 4.14).
| Rating | Cirrhosis criteria (DC 7312) | 2026 monthly pay (veteran alone) |
|---|---|---|
| 100% | MELD score 15 or higher; or continuous daily debilitating symptoms, generalized weakness and at least one of: ascites, history of spontaneous bacterial peritonitis, hepatic encephalopathy, variceal hemorrhage, coagulopathy, portal gastropathy, hepatopulmonary or hepatorenal syndrome | $3,938.58 |
| 60% | MELD score above 11 but below 15; or daily fatigue and at least one episode in the last year of variceal hemorrhage, portal gastropathy or hepatic encephalopathy | $1,435.02 |
| 30% | MELD score of 10 or 11; or signs of portal hypertension such as splenomegaly or ascites and either weakness, anorexia, abdominal pain or malaise | $552.47 |
| 10% | MELD score above 6 but below 10; or evidence of anorexia, weakness, abdominal pain or malaise | $180.42 |
| 0% | Asymptomatic, but with a history of liver disease | $0 |
Note 2 in DC 7312 adds that biochemical studies, imaging or biopsy must confirm liver dysfunction, and where there is no MELD score, VA rates on symptoms.
What if my hepatitis C claim is denied?
Read the decision to see why. Common reasons are no confirmed link to service, a nonservice risk factor, or an exam that did not discuss the evidence. Our denied claim guide covers review options, and the denial analyzer can help you sort the reasons. An accredited VSO, agent or attorney can advise on the best path for your case.
Talk to a VA-Accredited Attorney
Hepatitis C claims often depend on medical evidence and how it is presented. An accredited attorney can review your records and explain your options.
Get a Free Case Review →Sources
- 38 CFR 4.114, Schedule of ratings: digestive system (eCFR)
- Federal Register: Schedule for Rating Disabilities: The Digestive System
- VA compensation rates, effective December 1, 2025
- VA: eligibility for disability benefits
- BVA Citation Nr 0531165 (describing VBA Fast Letter 04-13)
- CDC: About hepatitis C
- CDC: Hepatitis C clinical overview
Frequently Asked Questions
VA lists hepatitis C under DC 7354 but rates it using the criteria for chronic liver disease without cirrhosis (DC 7345) in 38 CFR 4.114. The available ratings are 0%, 20%, 40%, 60% and 100%, depending on symptoms, weight loss, medication use and treatment.
VA's eligibility page says presumptive conditions are those where VA assumes service caused the condition, such as certain chronic illnesses within one year of discharge or illnesses tied to toxic exposures. This guide did not find hepatitis C on an official presumptive list, so most hepatitis C claims need direct service connection with a medical opinion linking the infection to service.
VBA Fast Letter 04-13 (June 29, 2004) is described in Board of Veterans' Appeals decisions as saying there was no scientific evidence documenting hepatitis C transmission by air gun injectors, but that transmission was biologically plausible. It also said the examiner's report should discuss all modes of transmission and explain why the air gun was the source in that veteran's case.
Useful evidence includes a current diagnosis from lab testing, service treatment records showing the exposure or event, a statement describing the exposure, a record of other risk factors and why they do not apply, and a medical opinion that addresses the link to service and the likelihood standard VA uses.
Yes, they can be claimed as secondary conditions if a medical opinion links them to service-connected hepatitis C. Under 38 CFR 4.114, sequelae such as cirrhosis or liver malignancy are evaluated under their own diagnostic codes, but the same signs and symptoms cannot be used twice.
Payment depends on the combined rating, not the diagnosis. For a veteran with no dependents, VA's rates effective December 1, 2025 are $356.66 a month at 20%, $795.84 at 40%, $1,435.02 at 60% and $3,938.58 at 100%. Check VA's page for dependent rates and any newer table.
Under DC 7345, a 100% rating applies for progressive chronic liver disease requiring both parenteral antiviral therapy and parenteral immunomodulatory therapy, and for six months after treatment stops. After that, VA schedules a mandatory exam to set the rating. Ask your clinician how the criteria apply to your treatment.
A nexus letter is not required by name, but a clear medical opinion tying the infection to an in-service cause is often the key missing piece. Read our nexus letter guide for liver disease and talk with an accredited representative about the right evidence for your situation.