New Hepatitis B Rating Guidelines in 2024

U Hepatitis B Rating Guidelines in 2024

In 2019, the Clinical Gastroenterology and Hepatology Journal published an article that spoke about the prevalence of the Hepatitis B virus among Veterans and suggested that there may be a link between this fact and service-related factors. However, back then, the authors still claimed that it was unclear whether service-connected exposures or some other risk factors and behaviors were responsible for this trend.

In March 2024, WHO published new guidelines regarding this liver infection and the Hepatitis B virus that causes it. These new guidelines included revised HBV diagnostics and testing methods, as well as treatment eligibility recommendations.

Hepatitis B is responsible for 2000–4000 deaths in the U.S. every year. Studies show that the prevalence of exposure to HBV is highest among people with “traditional” risk factors such as alcoholismsubstance abuse, and homelessness. Unfortunately, many Veterans are familiar with those challenges. Veterans Health Administration also points out that HBV exposure is often associated with combat and other service-connected injuries.

Starting May 19, 2024, the Hepatitis B disability ratings have been updated in the Schedule for Rating Disabilities under the diagnostic code 7345.

Being informed is the key to securing all the VA benefits you and your family may be entitled to. We’ll cover VA rates for Hepatitis B, the latest updates to the rating system, and what they mean for you if you already have a VA disability for Hepatitis B.

What is Hepatitis B?

Center for Disease Control and Prevention (CDC) defines Hepatitis B as “a liver infection caused by the hepatitis B virus (HBV). Hepatitis B is spread when blood, semen, or other body fluids from a person infected with the virus enter the body of someone who is not infected.”

Another commonly known strain of the hepatitis virus is Hepatitis C. Both infections have a lot in common, however, there are some key differences between Hepatitis B and Hepatitis C.

First, Hepatitis C is more likely to turn into a chronic condition than Hepatitis B. Also, while Hepatitis B can be transmitted through all kinds of bodily fluids, Hepatitis C is typically passed through blood. And, due to their many similarities, VA offers almost the same rating standards for Hepatitis B and C. 

HBV is believed to be more infectious and resilient than HIV (Human Immunodeficiency Virus). It can survive outside the body for about 7 days and still be able to infect someone who was not vaccinated against it before.

One of the biggest problems with this virus is that it is a so-called “silent infection.” Most infected people don’t have any symptoms until it starts to affect the liver. As a result, newly infected people can unknowingly pass the virus on to others. 

Those who develop acute illness may have symptoms like:

  • Yellowing of the skin and eyes (jaundice)
  • Dark urine
  • Extreme fatigue
  • Nausea
  • Vomiting
  • Abdominal pain

If the disease progresses into a chronic form, it may cause:

  • Cirrhosis (scarring) of the liver
  • Liver cancer
  • Liver failure

Blood testing is the only way to know for sure if a person is infected with or vaccinated against HBV.

The good news is that, statistically, 9 out of 10 adults who get hepatitis B recover. However, in about 1 of 20 cases, Hepatitis B takes a chronic form. In this case, the disease is treatable but not curable. It means that an infected person will likely have to take antiviral medications such as Entecavir (Baraclude), Tenofovir (Viread), Lamivudine (Epivir), or Adefovir (Hepsera) for the rest of their life. These medications help to control the infection and its symptoms and prevent them from destroying the liver.

Hepatitis B Risk Factors and Military Service

Approximately 850,000 to 2.2 million people in the U.S. suffer from chronic hepatitis B virus (HBV) infection. However, taking a closer look at the risk factors and considerations regarding the virus, you may see a clear link between them and the lifestyle and conditions usually associated with military service.

Hepatitis B risk factors include:

  • Contact With Blood
    Service members, especially those with combat experience, are at severe risk of exposure to HBV. However, all sorts of accidents and injuries associated with military service may make you vulnerable to the virus. 
  • Visiting “high-risk” Locations
    Africa, Eastern Europe, and Asia are known as regions with increased prevalence of HBV. Veterans who were deployed in these regions face an extremely high risk of getting infected, not only through direct contact with blood but even through routine interactions with locals and personal hygiene procedures.
  • Medical Procedures
    While in most countries the use of disposable needles and syringes for medical procedures is required by law, some Veterans have experience being treated in conditions and settings where sterilization is questionable. It is also a pressing issue among Veterans who suffer from substance abuse. The use of shared needles and syringes is another significant risk factor for HBV infection.

VA Disability Rates for Hepatitis B

From now on, Hepatitis B is rated under the diagnostic code 7345, Chronic Liver Disease Without Cirrhosis, with rates of 0%, 20%, 40%, 60%, and 100%.

Your rate will depend on the severity of your symptoms and their effect on your everyday life, as well as the duration of your condition.

Here is a closer look at the new VA rating principles for Hepatitis B under DC 7345.

0% Rate 

A Veteran gets 0% VA rate under DC 7345 if you have:

  • A History of Liver Disease
    There is a history of liver disease caused by HBV in the past
  • No Symptoms Now
    At the moment of filing the claim, you did not experience symptoms of Hepatitis B. 

In other words, even if you had inflammation or some sort of damage to your liver caused by the Hepatitis B virus, but underwent treatment, and now your condition remains in a dormant state, causing no symptoms of effect on your life, you are most likely to receive a 0% VA disability rate.

20% Rate

Veterans who develop a chronic form of liver disease due to Hepatitis B infection can receive a 20% VA disability rate if they suffer from at least one of the following symptoms:

  • Anorexia
    Pathological decrease of appetite, which leads to losing more weight than is healthy for a person’s age and height
  • Hepatomegaly
    Enlargement of liver. It is often seen as a sign of an underlying problem, such as liver damage, inflammation, or cancer
  • Intermittent Fatigue
    Periods of unexplained, persistent, and relapsing exhaustion, often associated with bacterial or viral infection in the body and liver disease
  • Malaise
    The so-called “general ill feeling” is when you feel uneasiness and discomfort without any obvious cause
  • Pruritus
    Severe itching, of visibly undamaged area on your skin. It can be irritating and even painful, localized in one area or spread all over your body. It is one of the most common symptoms of chronic liver disease

40% Rate

To qualify for 40% VA disability rate for Hepatitis B, you need to have:

  • Chronic Liver Disease
    A medical diagnosis that indicates that the HBV has developed into a chronic liver disease which is causing liver damage in progress
  • Weight Loss
    Chronic liver disease causes not critical but notable weight loss
  • Medication
    Your condition requires continuous medication to maintain the symptoms and prevent complications that may occur due to progressing Hepatitis B

In addition, you need to have at least 2 of the following symptoms:

  • Anorexia
  • Pruritus
  • Malaise
  • Hepatomegaly
  • Arthralgia
  • Joint stiffness and pain, which may be side effects of Hepatitis B medication
  • Daily Fatigue, a constant and limiting lingering tiredness, a sense of unexplained, persistent, and relapsing exhaustion.

60% Rate

60% VA rate for Hepatitis B generally has the same qualifying criteria as 40%. You need to have a chronic form of liver disease caused by HBV and require continuous medication to maintain the disease and its symptoms. 

However, in this case, you also need to show significant weight loss. It is often caused by such common symptoms of chronic liver disease as:

  • Liver dysfunction
  • Decreased appetite
  • Malabsorption of nutrients

In addition, you should also indicate at least 2 symptoms from the same group mentioned for the 40% rate.

100% Rate

Veterans who have progressive chronic liver disease and suffer from near-constant debilitating symptoms (such as fatigue, malaise, nausea, vomiting, anorexia, arthralgia, and right upper quadrant pain) can be entitled to a 100% VA disability rating for Hepatitis B.

The 100% rating criteria also include:

  • Immunomodulatory Therapy
    Taking immunomodulators, medications that change your immune system so it works more effectively. They include treatments that increase or decrease your immune response. The most common one is interferon, a protein, which is essential to fighting viruses.
  • Antiviral Therapy
    Taking medications which target the virus and suppress its ability to replicate in your body

It is important to note that both medication treatment programs need to be parenteral (i.e. taken not orally, but through injections or intravenous (IV) infusions.)

You should also remember that the 100% VA disability rate will continue for at least 6 months after you finish the parenteral medication course. It implies that the chronic liver condition that may qualify you for a 100% rate may persist and show its symptoms even after finishing the treatment course. 

After 6 months you will be re-examined and assigned a new VA disability rate based on your condition and symptoms.

News for Veterans Who Already Have VA Disability for Hepatitis B

If you have already been rated for Hepatitis B, you may have noticed some significant differences between the old and new rating criteria.

For example, before the update, Veterans who suffered from asymptomatic liver conditions could still qualify for the 10% VA disability rate.

So, what happens to your VA disability rate and complications today? Absolutely nothing. Veterans who have already filed for VA disability and received their rate are being “grandfathered,” which means you will not be requalified.

In case you applied for the VA Disability Benefits for Hepatitis B before May 2024, when the update came into effect, and haven`t received the answer yet, your case will be considered under both “old” and “new” criteria, and you will receive the more favorable rate.

It means that even if you have an asymptomatic form of liver condition, caused by HBV, you may still receive a 10% VA disability rate.


Knowledge is power. And when it comes to dealing with the bureaucratic machine seeking and claiming your benefits, it is the only power you need to succeed.

VCU knows how confusing and overwhelming the procedure can be, and how often new updates in the rating system lead to misconceptions and missing one’s rightfully earned compensation.

Book your free 30-minute call with one of our Veteran Specialists right now, and you will have a loyal associate in your quest. Together, we will go through your case, find its strong and weak spots, and make sure that you will use all the existing opportunities to claim and increase your VA disability rate.

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