38 CFR Part 4 — 38 CFR § 4.114
Cirrhosis Of The Liver
dc-7312-cirrhosis-of-the-liver
Digestive
Diagnostic code
7312
Why your DC matters: DC 7312 is the exact code the VA uses to rate this condition. It determines which symptoms unlock which percentage, what evidence the rater looks for, and which secondaries are most likely to be approved.
Last verified against 38 CFR (eCFR Part 4):
Rating criteria (38 CFR Part 4)
Diagnostic code 7312 — Cirrhosis Of The Liver — is listed under 38 CFR § 4.114 in 38 CFR Part 4. The paragraphs below summarize how this code is used; the official schedule text controls exact percentages, formulas, and notes.
Schedule summary (educational, not a substitute for the regulation): Educational index row from the rating schedule naming convention; confirm exact diagnostic code, effective date, and criteria in the current eCFR Part 4.
Exact rating criteria: Open Part 4 in the eCFR (link under “Official source” below). Locate your diagnostic code number (7312) in the correct body-system subpart, or use Find in Page (Ctrl+F / ⌘F) for “7312”. Copy the verbatim rating table, including any parenthetical notes, exceptions, and cross-references, for the version of Part 4 that applies to your effective date.
Effective dates & which schedule version applies
Which diagnostic code, percentage, and effective date apply depends on the facts of your claim and the version of the rating schedule in force for the period being decided. Generally, VA applies the schedule in effect at the specified time under 38 U.S.C. § 5110 and implementing rules, subject to exceptions (e.g., protected ratings, liberalizing law changes—see regulation and VA manual policy as applicable).
For older claims, the **current** eCFR may not match the text that applied years ago. If your decision references a prior percentage or code, compare against the Part 4 text **as of** your claim’s relevant dates; historical Federal Register / CFR snapshots may be needed for precise comparison.
The “Last verified” date on this page is when we last checked this educational summary against the electronic CFR—not the date of any VA policy or your personal claim decision.
Notes for your claim
Evidence: Show that your diagnosis and severity match the factors the schedule names for DC 7312 (e.g., measurements, frequency, treatment, functional loss), with medical and lay evidence as appropriate.
C&P exams: Results should reflect the schedule’s requirements (correct joints measured, correct formulas). If the exam omits required findings, consider submitting records or requesting clarification.
If you disagree with the DC, percentage, or effective date, review the Part 4 text for your period and consider a supplemental claim or appeal with a VA-accredited representative.
This site does not provide legal advice.
Official source
38 CFR Part 4 (eCFR) — locate diagnostic code 7312 in the subpart for your body system (use Find in Page if needed).
DC 7312 is the highest-ceiling liver disease code — 100% on MELD score ≥ 15 alone, before any symptom burden. The post-May-2024 § 4.114 restructure tied the schedule to objective MELD scores plus a symptom track, making this one of the cleaner ratings in the section. Veterans whose chronic liver disease (DC 7345) or Hepatitis C (DC 7354) progresses to cirrhosis should file an increase under DC 7312 immediately — the ceiling is significantly higher. Cirrhosis at 100% combined with another 60% rating triggers SMC-S (housebound) consideration.
Rating Tiers — What Each Percentage Requires
| Rating | What It Takes | Evidence That Supports It |
|---|---|---|
| 100% | MELD ≥ 15, OR continuous daily debilitating symptoms (such as fatigue, malaise, nausea, vomiting, anorexia, arthralgia, and right upper quadrant pain). | MELD score calculation from labs (creatinine, bilirubin, INR, sodium) ≥ 15; or chart-documented continuous daily debilitating symptoms across multiple visits. |
| 60% | MELD score > 11 but < 15, OR daily fatigue + at least one episode of complication (ascites, encephalopathy, hemorrhage, hepatorenal/hepatopulmonary syndrome). | MELD 12-14; or chart documentation of daily fatigue + a complication episode in the past 12 months. |
| 30% | MELD score of 10 or 11, OR signs of portal hypertension such as splenomegaly or ascites. | MELD 10-11; or imaging/exam findings of portal hypertension (splenomegaly, ascites, varices on endoscopy). |
| 10% | MELD score > 6 but < 10, OR evidence of anorexia, weakness, abdominal pain, or malaise. | MELD 7-9; or chart notes of any one listed symptom. |
| 0% | Asymptomatic, but with a history of liver disease. | Confirmed cirrhosis diagnosis on imaging or biopsy with no current symptoms or MELD elevation. |
What Qualifies Under DC 7312?
Confirmed cirrhosis
Imaging (ultrasound, CT, MRI), biopsy, or FibroScan F4 fibrosis stage. Cirrhosis = scarring with architectural distortion.
MELD or symptom-driven tier
DC 7312 dual-track schedule:
- • 0% — Asymptomatic history only
- • 10% — MELD 7-9 OR anorexia/weakness/pain/malaise
- • 30% — MELD 10-11 OR portal hypertension signs (splenomegaly, ascites)
- • 60% — MELD 12-14 OR daily fatigue + one complication episode (ascites/HE/bleed/HRS/HPS)
- • 100% — MELD ≥ 15 OR continuous daily debilitating symptoms
Language Your Rater Needs to See
These are the exact (or near-exact) regulatory phrases that unlock specific tiers. If your DBQ or C&P report doesn't use this vocabulary, the rater may default to a lower percentage even when symptoms qualify.
“MELD score greater than or equal to 15”
100% gate. MELD ≥ 15 is the objective trigger — no symptom burden required. Calculate MELD-Na from creatinine, bilirubin, INR, and sodium. Track the highest recent value.
“Continuous daily debilitating symptoms”
Alternate 100% path if MELD < 15 but symptoms are constant. Requires multi-visit documentation of daily fatigue, nausea, malaise, RUQ pain affecting function.
“Episode of ascites, hepatic encephalopathy, GI hemorrhage, or hepatorenal/hepatopulmonary syndrome”
Each complication episode is its own 60% qualifier under the alternate path (with daily fatigue). Document hospital records, paracentesis records, lactulose Rx for HE.
Evidence Checklist — Specific to This Condition
Cirrhosis diagnosis (imaging, biopsy, or FibroScan F4)
CRITICALEstablishes the cirrhosis vs. chronic liver disease distinction. Critical for code switch from DC 7345/7354 to DC 7312.
MELD-Na score from labs
CRITICALCreatinine + bilirubin + INR + sodium. Calculate the current MELD-Na and track over time. Drives every tier.
Complication history (ascites, HE, varices, GI bleed, HRS, HPS)
CRITICALEach documented episode supports 60% under the alternate path. Pull hospital records.
Portal hypertension imaging
IMPORTANTSplenomegaly on ultrasound; varices on endoscopy; ascites volume. Supports 30% under the portal-hypertension track.
Symptom + daily-fatigue diary
IMPORTANTDaily vs. intermittent symptoms drive 60% vs. 100% alternate path.
Hepatology consult notes
SUPPORTINGTreatment plan, transplant evaluation status, and trajectory. Supports severity narrative.
C&P Exam Tips
Bring MELD calculation from recent labs
Calculate yourself or have your hepatologist note it in chart. ≥ 15 = automatic 100%.
Bring records of every complication episode
Paracentesis records (ascites), lactulose Rx + HE episodes, endoscopy reports (varices), hospitalizations for GI bleed. Each episode anchors 60%.
Describe daily symptom impact concretely
'I sleep 12+ hours and still can't function past noon' beats 'I'm tired.' Daily fatigue is a tier gate.
Don't say 'My cirrhosis is compensated'
Even compensated cirrhosis rates ≥ 10% if any symptom present. Describe the symptoms you do have rather than minimizing.
Common Mistakes That Cost Veterans Points
Staying under DC 7345 / 7354 after cirrhosis develops
When fibrosis stage hits F4, file an increase under DC 7312. The ceiling is significantly higher — 100% on MELD alone.
Not calculating MELD-Na
MELD score is the objective tier gate. Don't rely on subjective symptoms when an objective score may already qualify you for 100%.
Missing SMC-S after 100% cirrhosis
100% cirrhosis + another 60% rating triggers SMC-S (housebound) per § 3.350(i). Many veterans miss this stacking play.
Not pursuing transplant-list status as evidence
Being on the transplant list inherently supports MELD ≥ 15 and continuous debilitating symptoms. Pull UNOS/OPTN records.
Tactical Plays
⚡ MELD ≥ 15 = automatic 100% — calculate yours
MELD-Na is the cleanest path to 100% under DC 7312. Pull recent labs (creatinine, bilirubin, INR, sodium), calculate MELD, file for increase if ≥ 15. No symptom burden required.
⚡ 100% cirrhosis + 60% other rating = SMC-S
Per § 3.350(i), a single 100% rating plus another disability rated 60% or more triggers SMC-S (housebound). Many cirrhotic veterans already have MH or other ratings that complete the stack. Pursue the SMC-S claim explicitly.
⚡ Track transplant-list status as 100% evidence
Being listed for liver transplant inherently confirms MELD ≥ 15 and continuous debilitating symptoms. Pull UNOS records and submit with the increase claim.
Secondary Conditions to File With This One
Hepatocellular carcinoma
STRONGDC 7343
Cirrhosis is the leading risk factor for HCC. Active HCC = 100% under DC 7343, plus separate SMC considerations.
Hepatic encephalopathy (cognitive secondary)
MODERATERecurrent HE can cause persistent cognitive impairment ratable under DC 8045 (TBI residuals) or MH codes by analogy.
Type 2 diabetes (cirrhosis-associated)
MODERATEDC 7913
Cirrhosis disrupts glucose metabolism; new-onset DM in cirrhotic patients can rate separately.
Depression / fatigue-related MH
STRONGDC 9434
Chronic cirrhosis with fatigue and life impact drives well-documented MH secondaries.
Esophageal varices / GI bleed history
SITUATIONALVariceal bleeds may have separately ratable residuals (anemia, esophageal stricture). Pursue if documented.
Compensation Scenarios
2026 rates (effective Dec 1, 2025, per va.gov)
0% — single, no dependents
TOTAL
$0.00/mo
Asymptomatic confirmed cirrhosis.
10% — single, no dependents
Base rating
$180.42
TOTAL
$180.42/mo
MELD 7-9 or any one listed symptom.
30% — single, no dependents
Base rating
$552.47
TOTAL
$552.47/mo
MELD 10-11 or portal hypertension signs.
60% — single, no dependents
Base rating
$1,435.02
TOTAL
$1,435.02/mo
MELD 12-14 or daily fatigue + complication episode.
100% — single, no dependents
Base rating
$3,938.58
TOTAL
$3,938.58/mo
MELD ≥ 15 or continuous daily debilitating symptoms.
100% cirrhosis + 60% other → SMC-S (housebound)
Base rating
$3,938.58
SMC-S monthly
+$425.94
TOTAL
$4,364.52/mo
Per § 3.350(i), 100% schedular + 60% separate = SMC-S. Pursue explicitly.
Note: Amounts are approximations rounded to nearest dollar. Actual comp varies with effective date, dependents (spouse, children, parents — each adds), Aid & Attendance, and additional disabilities. Combined ratings use VA Math (§ 4.25), not simple addition.
Key Definitions
📊What is the MELD score?
Model for End-Stage Liver Disease — a 6-40 score calculated from serum creatinine, bilirubin, INR, and (in MELD-Na) sodium. Originally developed for transplant listing; now also used in VA cirrhosis rating. Higher = worse liver function.
🩸What's 'Portal Hypertension'?
Elevated pressure in the portal venous system from cirrhotic liver scarring. Signs include splenomegaly, ascites, esophageal/gastric varices, and caput medusae. Supports 30% under the alternate path.
⚠️What complications qualify for 60%?
Ascites, hepatic encephalopathy (confusion from buildup of ammonia/toxins), variceal hemorrhage, hepatorenal syndrome (kidney failure from cirrhosis), hepatopulmonary syndrome (low O2 from cirrhosis-induced lung shunts). Any one episode + daily fatigue = 60%.
🏠How does SMC-S apply to 100% cirrhosis?
Per § 3.350(i), a 100% schedular rating plus a separate disability rated 60% or higher triggers SMC-S (housebound) entitlement — an additional monthly payment. Many cirrhotic veterans have MH or other ratings that complete this stack.
How to File Your Claim
Confirm cirrhosis diagnosis (imaging/biopsy/FibroScan)
Establishes the code switch from DC 7345/7354 to DC 7312.
Calculate MELD-Na from recent labs
Creatinine, bilirubin, INR, sodium. Use any standard MELD calculator. Track the highest recent value.
Pull complication records (ascites/HE/bleed/HRS/HPS)
Each documented episode supports 60% under the alternate path.
File 21-526EZ specifying 'cirrhosis of liver (DC 7312)' — as increase from prior 7345/7354
Reference the prior code + the progression to cirrhosis.
Stack SMC-S if 100% + other 60%
§ 3.350(i) housebound trigger. Pursue explicitly in the claim narrative.
Typical Claim Timeline
File initial claim
Day 0–7: Submit VA Form 21-526EZ with all medical evidence on file
VA acknowledges claim
Week 1–2: Receive confirmation letter and claim tracking number
C&P examination scheduled
Month 1–3: VA contracts an exam vendor and sends you appointment notice
Attend C&P exam
Bring your full evidence package; describe symptoms on your worst days, not your best
Decision & rating notice
Month 3–6: Decision letter with rating percentage and effective date
First payment & retro back pay
Within 15 days of decision; retroactive to claim date (or effective date if earlier)
Timeline varies by case complexity and VA regional office workload. Some claims resolve faster; others take longer.
Important Considerations
MELD ≥ 15 = automatic 100%
Objective tier gate. Calculate MELD-Na from recent labs and file for increase if you qualify.
File DC 7312 increase ASAP after cirrhosis confirmation
Don't stay under DC 7345 or 7354 — DC 7312 has a higher ceiling and dual-track schedule.
100% + 60% = SMC-S housebound
Many cirrhotic veterans already have MH or other ratings that complete the SMC-S stack. Pursue explicitly per § 3.350(i).
Transplant list status = 100% evidence
UNOS listing inherently confirms MELD ≥ 15 and continuous debilitating symptoms.
Related Tools & Resources
Frequently Asked Questions
Do I have to be symptomatic to get 100% under DC 7312?
No. MELD ≥ 15 alone triggers 100% — no symptom burden required. This is the cleanest 100% path in § 4.114.
Can I switch from DC 7354 to DC 7312 if my HCV progressed?
Yes. When HCV (DC 7354) progresses to cirrhosis (F4 fibrosis), file an increase under DC 7312. DC 7312 has a higher ceiling — pursue the switch.
What is MELD-Na and how is it calculated?
MELD-Na is the Model for End-Stage Liver Disease score incorporating serum sodium. Calculated from creatinine, bilirubin, INR, and sodium. Standard online calculators (MDCalc, Mayo Clinic) compute it from lab values.
Does cirrhosis qualify for SMC?
100% cirrhosis combined with another disability rated 60% or higher triggers SMC-S (housebound) per § 3.350(i). HCC complications (DC 7343) may trigger higher SMC tiers.
What happens to my rating after a liver transplant?
Post-transplant, the rating typically continues at 100% for the post-op recovery period, then transitions to a residuals-based rating. Specific schedule for transplants is in § 4.114; track immunosuppression, rejection episodes, and renal residuals as ongoing rating support.
Official Regulatory Source
Cirrhosis is rated under 38 CFR § 4.114, DC 7312 — MELD-driven schedule reaches 100% on MELD ≥ 15 alone.
38 CFR § 4.114 — Digestive System (eCFR) →Scroll to DC 7312. § 4.114 was substantially restructured effective May 19, 2024 — current criteria tie tiers to MELD score.
⚠️ Verify with a VSO
§ 4.114 was restructured effective May 19, 2024. DC 7312 criteria explicitly tied to MELD score in the post-restructure language — verify current text on eCFR.
Next Steps
If your rating decision lists DC 7312, compare your current symptoms and documentation against the criteria above. Consider:
- Requesting a copy of your rating decision and C&P exam report from the VA
- Gathering all relevant medical records (VA and private providers)
- Documenting functional limitations and how they impact work and daily activities
- Obtaining a nexus letter if needed to establish or strengthen service connection
- Filing for secondary conditions that may be related to this primary condition
- Contacting a VA-accredited VSO, claims agent, or attorney to review your file
This is general educational information only — not legal or medical advice.
Also: DC code lookup (tools) lists the same index in a compact layout.
Source: 38 CFR Part 4, Diagnostic Code 7312 • va.gov
⚠️ Important Disclaimer
This page provides general educational information only based on public VA regulations (38 CFR) and va.gov resources. It is not legal, medical, or claims assistance. Ratings and service connections are decided case-by-case by the VA based on the individual veteran’s evidence. We do not prepare claims, generate documents, or provide personalized advice. Always consult a VA-accredited Veterans Service Organization (VSO), attorney, or your physician for help with your specific situation. Verify the latest rules on va.gov.