Hepatitis C

Hepatitis C is a virus that inflames the liver and, over years, can lead to scarring (cirrhosis) or liver cancer. The VA does not treat hepatitis C as automatically connected to service — there is no presumptive rule for it. Instead it applies the usual three-part test: a current diagnosis, something that happened during service, and a medical link between the two (38 CFR § 3.303).

The VA's own hepatitis program recognizes specific risk factors — most strongly a blood transfusion before the blood supply began being screened in 1992, and also intravenous drug use, tattoos, and other exposures to blood. The VA has studied whether the air-gun "jet injectors" once used for mass vaccinations could spread the virus; its guidance notes transmission is biologically possible but that no case of a veteran infected by a military jet injector has been confirmed. Which documented risk factor the record supports is often the central question in these appeals.

When hepatitis C is service-connected, the VA rates it under the digestive-system schedule (38 CFR § 4.114). Under the rules in effect since 2024, Diagnostic Code 7354 (hepatitis C) is evaluated using the chronic-liver-disease criteria of Diagnostic Code 7345, on a 0 to 100 percent scale. The rating rises with the severity of progressive liver disease — for example, needing continuous medication along with weight loss and symptoms such as daily fatigue, malaise, or poor appetite at the lower-but-compensable levels (such as 20 percent), up through the most severe level, which reflects progressive disease requiring intensive antiviral and immune-modulating treatment. Because the rating tracks current liver disease and symptoms, successful treatment that clears the virus can change what later examinations find.

This is general educational information about how the VA's rules work — not legal advice, not a VA decision, and not a prediction about any individual claim. Outcomes depend on your own facts and evidence; a denial can be appealed.