For thousands of veterans, hepatitis is more than just a medical diagnosis—it’s a condition that can directly affect their quality of life, work, and long-term health. Hepatitis B (HBV) and hepatitis C (HCV) are especially common among veterans who served before the early 1990s, when medical procedures, vaccinations, and safety protocols were not as strictly regulated as they are today.
Understanding how hepatitis can be service-connected is vital for veterans seeking compensation and health care benefits through the Department of Veterans Affairs (VA). Leah breaks down what hepatitis is, how it relates to military service, what the VA considers in claims, and the steps veterans can take to strengthen their cases.
Table of Contents
What Is Hepatitis?
Hepatitis is an inflammation of the liver, most commonly caused by viral infections. The two most prevalent types are:
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Hepatitis B (HBV): Often spread through blood and bodily fluids.
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Hepatitis C (HCV): Primarily transmitted through blood exposure.
Both conditions can lead to long-term complications such as cirrhosis, liver cancer, and chronic liver damage. In many cases, symptoms do not appear until years or even decades after exposure.
How Hepatitis Is Transmitted
Veterans may have been exposed to hepatitis during or after their service in several ways:
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Air gun injections: These were commonly used to administer vaccines. Poor sterilization practices placed many service members at risk.
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Blood transfusions before 1992: Before widespread screening began, transfusions could transmit hepatitis.
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Combat trauma and emergency surgery: Exposure to infected blood in high-risk situations.
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Unsterile medical equipment or poor sanitation: Especially for those serving overseas in less regulated environments.
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Sexual contact or sharing razors: Less common but still possible routes of transmission.
Because symptoms can take years to appear, many veterans may not realize they were infected during their time in service.
Direct Service Connection for Hepatitis
To qualify for direct service connection, a veteran must generally establish three things:
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A current diagnosis of hepatitis B or C.
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Evidence of exposure or symptoms during service.
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A medical nexus—a doctor’s opinion linking the current condition to service.
Examples of Direct Service Connection:
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A veteran received a blood transfusion during active duty in the 1980s and later developed hepatitis.
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Records show exposure to blood while serving as a combat medic.
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Documentation confirms vaccinations administered with air gun injectors.
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Service in an area with poor sanitation and unsafe medical practices.
Although hepatitis from air gun injections is not presumptive, the VA acknowledges the risks. If strong evidence supports a claim, it may still be granted.
Secondary Service Connection for Hepatitis
Not all cases are directly related to service. In some situations, hepatitis may qualify as a secondary service-connected condition. This means the hepatitis was caused or aggravated by another service-connected disability or its treatment.
Examples of Secondary Service Connection:
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PTSD and substance use disorder: A veteran develops substance dependency linked to PTSD and contracts hepatitis through IV drug use.
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Immunosuppressive medications: Prescribed for a service-connected autoimmune condition, these can reactivate dormant hepatitis B.
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Contaminated VA medical treatment: Blood products or equipment used in treatment after service later found to be unsafe.
Secondary claims can be complex but are possible with strong medical documentation and a supportive nexus opinion.
What the Medical Literature Says
Research supports the link between military service and hepatitis exposure. Studies show:
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Veterans who received air gun injections face increased risk of hepatitis C.
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The VA’s own fast letter (211B, issued in 2012) advises evaluators to consider exposure from air gun immunizations when reviewing claims.
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Hepatitis C can remain dormant for decades, meaning veterans may only receive a diagnosis long after their service.
This evidence can strengthen claims, especially if referenced by a treating physician in a nexus letter.
How VA Rates Hepatitis
The VA evaluates hepatitis under 38 CFR §4.114 using specific diagnostic codes:
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7354 for Hepatitis C
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7345 for Hepatitis B
The rating depends on both lab results and symptoms. Factors include:
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Abnormal liver function tests (ALT, AST, bilirubin).
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Fatigue, malaise, anorexia, jaundice, or weight loss.
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Frequency and severity of incapacitating episodes requiring physician-prescribed bed rest.
Example Ratings:
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10%: Intermittent fatigue or malaise.
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30%: More persistent symptoms with weight loss or dietary restrictions.
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60–100%: Severe or near-constant symptoms, liver damage, hospitalization, or complications such as cirrhosis or liver cancer.
In advanced cases, secondary ratings may apply for complications like hepatic encephalopathy or liver cancer.
What to Expect at a C&P Exam
If you file a claim for hepatitis, you’ll likely be scheduled for a Compensation & Pension (C&P) exam. These exams may be conducted by a physician, nurse practitioner, or physician assistant.
During the exam, the VA examiner will review:
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Your medical diagnosis and lab results.
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Symptoms such as fatigue, jaundice, or abdominal pain.
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Treatment history and flare-ups.
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Documented exposure scenarios during service.
How to Prepare:
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Bring copies of your medical records and lab results.
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Provide a detailed history of potential exposures during service.
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Be honest about how your symptoms affect daily life.
Preparation can help ensure your exam accurately reflects your condition.
Considerations for Supporting Your Claim
Hepatitis claims can be denied if evidence is incomplete or unclear. To increase your chances of approval:
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Work with a VA-accredited representative such as a Veterans Service Officer (VSO), claims agent, or attorney.
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Confirm your diagnosis with up-to-date lab results.
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Provide detailed evidence of in-service exposure scenarios.
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Obtain a nexus letter from a doctor using “at least as likely as not” language to connect your hepatitis to service when applicable.
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Reference peer-reviewed studies or VA fast letters that support your case.
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Consider appealing if denied. Many claims are initially rejected but later approved on appeal.
Why It Matters
Hepatitis can be an invisible illness, progressing quietly until serious complications appear. For veterans, the disease is often directly tied to service experiences—sometimes without their knowledge. If hepatitis is connected to your military service, you deserve both recognition and compensation.
Whether it stems from a transfusion, an air gun injection, combat trauma, or secondary conditions like PTSD, your claim matters. With the right documentation, medical support, and representation, many veterans successfully obtain service connection and the benefits they’ve earned.
Final Thoughts
Hepatitis may not always show visible signs, but its effects on a veteran’s life can be significant. The VA recognizes the risks service members faced, and multiple paths exist to establish service connection. If your claim has been denied, don’t give up—seek guidance, gather evidence, and consider an appeal.
Your service and sacrifice deserve to be honored with the benefits that can help you manage this challenging condition.
Also read: VA Disability for Medication Side Effects
At Prestige Veteran Medical Consulting, a veteran-owned company, we specialize in Independent Medical Opinions (IMOs) known as Nexus letters.
Our purpose is to empower YOU, the veteran, to take charge of your medical evidence and provide you with valuable educational tools and research to guide you on your journey.
Understanding the unique challenges veterans face, our commitment lies in delivering exceptional service and support.
Leveraging an extensive network of licensed independent medical professionals, all well-versed in the medical professional aspects of the VA claims process, we review the necessary medical evidence to incorporate in our reports related to your VA Disability Claim.
Prestige Veteran Medical Consulting is not a law firm, accredited claims agent, or affiliated with the Veterans Administration or Veterans Services Organizations. However, we are happy to discuss your case with your accredited VA legal professional.
