38 CFR Part 4 — 38 CFR § 4.114
Hepatitis C Or Non A Non B Hepatitis
dc-7354-hepatitis-c-or-non-a-non-b-hepatitis
Digestive
Diagnostic code
7354
Why your DC matters: DC 7354 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 7354 — Hepatitis C Or Non A Non B Hepatitis — 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 (7354) in the correct body-system subpart, or use Find in Page (Ctrl+F / ⌘F) for “7354”. 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 7354 (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 7354 in the subpart for your body system (use Find in Page if needed).
Hepatitis C rates under DC 7354 — distinct from DC 7345 (chronic liver disease without cirrhosis, general). DC 7354 has a unique 6-tier schedule based on symptom severity, daily fatigue, incapacitation episodes, and weight loss/dehydration. Veterans with chronic HCV from in-service jet injectors, blood transfusions, or shared field equipment have strong direct SC pathways. Camp Lejeune water contamination veterans get presumptive service connection. Critically: even SVR (sustained virologic response after DAA treatment) doesn't automatically reduce ratings if residual symptoms persist — VA must evaluate current symptoms, not virologic clearance.
Rating Tiers — What Each Percentage Requires
| Rating | What It Takes | Evidence That Supports It |
|---|---|---|
| 100% | Near-constant debilitating symptoms (such as fatigue, malaise, nausea, vomiting, anorexia, arthralgia, and right upper quadrant pain). | Chart documentation of constant or near-constant symptom burden across multiple visits; functional incapacitation; weight loss; hospitalization records. |
| 60% | Daily fatigue, malaise, and anorexia, with substantial weight loss (or other indication of malnutrition), and hepatomegaly, OR incapacitating episodes (with symptoms such as fatigue, malaise, nausea, vomiting, anorexia, arthralgia, and right upper quadrant pain) having a total duration of at least 6 weeks during the past 12-month period, but not occurring constantly. | Weight loss + albumin documentation; hepatomegaly on exam/imaging; 6+ weeks of incapacitation tracked. |
| 40% | Daily fatigue, malaise, and anorexia, with minor weight loss and hepatomegaly, OR incapacitating episodes of at least 4 weeks but less than 6 weeks total during past 12 months. | Chart-documented daily fatigue + 4-6 weeks of incapacitation. |
| 20% | Daily fatigue, malaise, and anorexia (without weight loss or hepatomegaly), requiring dietary restriction or continuous medication, OR incapacitating episodes having a total duration of at least 2 weeks but less than 4 weeks during the past 12-month period. | Daily symptom log + ongoing Rx or 2-4 weeks/year incapacitation. |
| 10% | Intermittent fatigue, malaise, and anorexia, OR incapacitating episodes (with symptoms such as fatigue, malaise, nausea, vomiting, anorexia, arthralgia, and right upper quadrant pain) having a total duration of at least 1 week but less than 2 weeks during past 12 months. | Intermittent symptom log; 1-2 weeks/year incapacitation. |
| 0% | Nonsymptomatic. | HCV positive serology but no current symptoms or functional impact. |
What Qualifies Under DC 7354?
Confirmed chronic HCV infection
Positive HCV antibody + detectable HCV RNA persisting > 6 months. Or established history of chronic HCV with treatment course.
Symptom-driven tier escalation
DC 7354 tiers:
- • 0% — Nonsymptomatic
- • 10% — Intermittent symptoms OR 1-2 wks/yr incapacitation
- • 20% — Daily symptoms requiring Rx OR 2-4 wks/yr incapacitation
- • 40% — Daily symptoms + minor weight loss + hepatomegaly OR 4-6 wks/yr incapacitation
- • 60% — Daily symptoms + substantial weight loss + hepatomegaly OR 6+ wks/yr incapacitation
- • 100% — Near-constant 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.
“Substantial weight loss + hepatomegaly”
60% conjunctive criteria — both required. 'Substantial' weight loss = documented unintentional ≥ 10% loss over 6 months. Hepatomegaly on physical exam or imaging.
“Incapacitating episodes totaling X weeks/year”
Cumulative weeks of incapacitation drive tier. Each tier has a specific week range. Track and sum carefully.
“Near-constant debilitating symptoms”
100% gate. Most days of most weeks affected. Multi-visit documentation required.
Evidence Checklist — Specific to This Condition
HCV serology + RNA quantitation
CRITICALPositive antibody + detectable RNA confirms chronic HCV. Pre-treatment baseline + any current viral load.
Treatment history (interferon, DAAs)
CRITICALSofosbuvir/ledipasvir, glecaprevir/pibrentasvir, etc. Document SVR status BUT remember — residual symptoms post-SVR still rate.
Symptom diary (daily fatigue, malaise, anorexia, RUQ pain)
CRITICALDaily vs. intermittent + severity. Drives 10/20/40% tiers.
Weight + albumin trends
CRITICALDocuments substantial weight loss + malnutrition for 60%/100%.
Liver imaging + biopsy (if available)
IMPORTANTUltrasound, CT, FibroScan. Documents hepatomegaly, fibrosis stage, cirrhosis development.
In-service exposure documentation
IMPORTANTJet injector use (pre-1997), blood transfusions, combat exposure, tattoos in service, Camp Lejeune service.
C&P Exam Tips
Bring a symptom diary (daily fatigue, malaise, anorexia ratings)
Tier gates differentiate 'daily' vs. 'intermittent.' Provide concrete diary data.
Bring incapacitation log (weeks/year)
Each tier specifies a weeks-range. Track and sum the weeks you were too symptomatic to function.
Bring weight history
Pre-illness vs. current; unintentional loss > 10% over 6 months supports substantial weight loss criterion.
Don't say 'I'm cured because I had SVR'
VA must rate current symptoms. SVR (virologic cure) doesn't eliminate residual hepatitis symptoms — describe ongoing fatigue, malaise, RUQ pain, etc.
Common Mistakes That Cost Veterans Points
Accepting 0% post-SVR despite ongoing symptoms
Residual fatigue, malaise, joint pain post-SVR are well-documented. File supplemental with symptom diary.
Filing under DC 7345 instead of DC 7354
DC 7345 = chronic liver disease without cirrhosis (general). DC 7354 = Hepatitis C specifically. Different rating schedule. Use the specific code.
Missing Camp Lejeune presumptive path
Camp Lejeune service Aug 1953 - Dec 1987 triggers presumptive SC for several conditions including HCV-associated chronic liver issues.
Not documenting in-service risk factors
Jet injectors (pre-1997), combat blood exposure, military transfusions — all are recognized risk factors. Document in claim narrative.
Tactical Plays
⚡ SVR ≠ resolved condition — residual symptoms still rate
Achieving sustained virologic response with direct-acting antivirals doesn't reduce your rating if you still have fatigue, malaise, RUQ pain, or arthralgia. VA must rate current symptoms, not virologic status. File supplemental if you got reduced post-SVR.
⚡ Establish in-service exposure for direct SC
Jet injectors (pre-1997 military use), combat blood exposure, military transfusions, in-service tattoos — all are recognized HCV risk factors. Camp Lejeune water contamination is a separate presumptive path.
⚡ Track cirrhosis progression — rate separately if it develops
HCV → cirrhosis is well-documented progression. If FibroScan or imaging shows cirrhosis, file DC 7312 separately. DC 7312 reaches 100%.
Secondary Conditions to File With This One
Cirrhosis of liver
STRONGDC 7312
HCV → cirrhosis is well-documented progression. If cirrhosis develops, rate separately under DC 7312 (which reaches 100%).
Hepatocellular carcinoma
MODERATEDC 7343
HCV is a primary cause of liver cancer; rate separately if diagnosed.
Cryoglobulinemia (vasculitis)
MODERATEHCV-associated cryoglobulinemia causes vasculitic skin, joint, and renal manifestations; rate separately.
Type 2 diabetes (HCV-associated)
MODERATEDC 7913
HCV is a recognized contributor to insulin resistance and Type 2 diabetes; secondary pathway.
Depression / fatigue-related MH
STRONGDC 9434
Chronic HCV with fatigue + life impact drives well-documented MH secondaries.
Compensation Scenarios
2026 rates (effective Dec 1, 2025, per va.gov)
0% — single, no dependents
TOTAL
$0.00/mo
Nonsymptomatic chronic HCV (often post-SVR with no residuals).
10% — single, no dependents
Base rating
$180.42
TOTAL
$180.42/mo
Intermittent symptoms OR 1-2 wks/yr incapacitation.
20% — single, no dependents
Base rating
$356.66
TOTAL
$356.66/mo
Daily symptoms requiring continuous Rx.
40% — single, no dependents
Base rating
$795.84
TOTAL
$795.84/mo
Daily symptoms + minor weight loss + hepatomegaly.
60% — single, no dependents
Base rating
$1,435.02
TOTAL
$1,435.02/mo
Daily symptoms + substantial weight loss + hepatomegaly.
100% — single, no dependents
Base rating
$3,938.58
TOTAL
$3,938.58/mo
Near-constant debilitating symptoms.
60% HCV + 100% cirrhosis (post-progression)
Base rating
$3,938.58
TOTAL
$3,938.58/mo
If cirrhosis develops, DC 7312 can reach 100% on its own — replacing or stacking with DC 7354 depending on the rating sheet.
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 SVR (Sustained Virologic Response)?
Undetectable HCV RNA 12 weeks after completing direct-acting antiviral treatment. Equivalent to virologic cure. But VA must rate ongoing symptoms — SVR doesn't auto-reduce ratings.
⚖️What's 'Substantial Weight Loss'?
Unintentional loss of ≥ 10% of baseline body weight over a 6-month period. Documented in chart with serial weights. The 60%/100% gate.
🫀What is Hepatomegaly?
Enlarged liver detected on physical exam or imaging. Liver edge palpable below costal margin > 2 cm, or imaging-confirmed enlargement. Required for 40%/60%.
📋What's the difference between DC 7354 and DC 7345?
DC 7354 = chronic Hepatitis C specifically. DC 7345 = chronic liver disease without cirrhosis (general, non-HCV). Different rating schedules. Use the specific code that matches diagnosis.
How to File Your Claim
Pull HCV serology + RNA quant + treatment history
Establishes diagnosis + treatment course + current status.
Build symptom + incapacitation diary
Daily vs. intermittent symptoms + cumulative incapacitation weeks/year.
Document in-service exposure
Jet injectors, combat blood exposure, transfusions, Camp Lejeune service. Each is a recognized risk factor.
File 21-526EZ specifying 'chronic Hepatitis C (DC 7354)'
Add Camp Lejeune presumption if applicable.
Stack secondaries: cirrhosis, MH, cryoglobulinemia, DM
Each rates separately. Cirrhosis (DC 7312) reaches 100% independently.
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
SVR doesn't end your rating
Even with virologic cure from DAA treatment, residual symptoms (fatigue, malaise, RUQ pain) still rate. File supplemental if VA reduced post-SVR.
Use DC 7354, not DC 7345
DC 7354 = HCV specifically. DC 7345 = chronic liver disease (general). Different schedules — use the right code.
Camp Lejeune service = presumptive
Service at Camp Lejeune Aug 1953 - Dec 1987 triggers presumptive SC for several conditions.
Track cirrhosis progression
If cirrhosis develops, DC 7312 rates separately and reaches 100% on its own.
Related Tools & Resources
Frequently Asked Questions
Can I get a rating if I've already been cured (SVR)?
Yes if residual symptoms persist. SVR (virologic cure) doesn't end VA rating — VA must rate current symptoms. Many veterans have post-SVR fatigue, joint pain, and brain fog that continue to rate.
What's the difference between DC 7354 and DC 7345?
DC 7354 = chronic Hepatitis C specifically. DC 7345 = chronic liver disease without cirrhosis (general, non-HCV causes — autoimmune, NAFLD, etc.). They have different rating schedules; file under the diagnosis-matching code.
Is HCV presumptive for any veterans?
Camp Lejeune service (Aug 1953 - Dec 1987) triggers presumptive SC for several conditions associated with contaminated water exposure. HCV-related chronic liver issues fall in this presumptive pathway. Verify your specific service period and condition.
Can I file for HCV if I was exposed via jet injector in service?
Yes — jet injectors (pre-1997 military use) are recognized HCV transmission vectors. Document in-service jet injector use + current HCV diagnosis + nexus opinion for direct SC pathway.
Does HCV qualify for SMC or special benefits?
Cirrhosis at 100% may qualify for SMC-S (housebound) or other SMC tiers if combined with other 60%+ ratings. Hepatocellular carcinoma triggers 100% during active treatment under DC 7343.
Official Regulatory Source
Hepatitis C is rated under 38 CFR § 4.114, DC 7354. Distinct from DC 7345 (chronic liver disease without cirrhosis, general).
38 CFR § 4.114 — Digestive System (eCFR) →Scroll to DC 7354. § 4.114 was substantially restructured effective May 19, 2024 — verify current criteria.
⚠️ Verify with a VSO
§ 4.114 was restructured effective May 19, 2024. DC 7354 was retained for Hepatitis C but criteria language may have been updated — verify current text on eCFR before filing.
Next Steps
If your rating decision lists DC 7354, 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 7354 • 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.