Veterans have a much higher rate of infection from the hepatitis C virus, also known as HCV or Hep C, than the rest of the American population. Although HCV is a problem, particularly for Vietnam veterans, all veterans show an increased risk of infection. The virus is blood-borne, so any contact with blood, blood products, syringes, tattoo needles, or even shared razors during your service could have infected you. If you can establish that your case of Hep C was contracted while you were in service, you are eligible for VA disability payments.
Disability Rating for VA HCV Benefits
Hepatitis C infects the liver causing it to inflame. The liver is responsible for regulating metabolism and aiding digestion. As a result, you may experience symptoms related to metabolism and energy levels. Moreover, hep C can weaken the liver and make it susceptible to cirrhosis, cancer, and liver failure.
However, most cases of hep C exhibit no symptoms or only mild symptoms. As a result, many people with hep C do not even realize they are infected.
Does Hepatitis C Qualify for Disability?
Yes. Hepatitis C does qualify for VA disability benefits and, more importantly, can be granted a disability rating as high as 100% if the symptoms are near-constant and debilitating. Symptoms included in the rating schedule include nausea, vomiting, fatigue, malaise, anorexia, joint pain, and liver pain.
Hep C How Much Compensation Will I Get from the Military?
Specifically, the VA Hep C guidelines for rating HCV gives six different ratings for the virus. When the virus is non-symptomatic, the rating is 0%.
When the virus shows intermittent symptoms for more than one week, but less than two weeks during the preceding year, the rating is 10%. If symptoms are daily for between two weeks and four weeks during the preceding year, the rating is 20%. A 40% VA disability rating is assigned when symptoms appear daily for between four weeks and six weeks during the preceding year. If the symptoms appear daily for more than six weeks, but less than constantly, during the preceding year, the rating is 60%. And, as mentioned above, if the symptoms are near-constant, the rating is 100%.
Is There a Hep C Cure?
Yes, but different people react differently to the antiviral medications used. The result is that some people can be cleared of HCV while others cannot. The VA reported in 2018 that they had cured 100,000 veterans of Hep C.
Unfortunately, the antivirals used to treat hep C can be very expensive. This has led to lawsuits by Medicaid recipients and prison inmates who have the disease but cannot get their state to pay for the medications.
Since it is so difficult to cure, you might be able to apply for a Permanent and Total VA rating so that your benefits won’t be at risk every five years. It will vary on conditions, but working with a doctor who knows how VA law works can help you make your case stronger.
Residuals of Hep C
HCV can cause many symptoms that can be separately rated to attempt to get a higher overall disability rating. For example, Hep C can cause:
When calculating a residuals rating, each symptom is separately rated, and then the ratings are aggregated using a VA disability calculator. The VA’s system for aggregating residual ratings is not simple addition. Rather, VA math uses a complex formula to calculate an overall disability rating from multiple individual disabling conditions. Depending on the severity of these symptoms, the overall rating based on these residuals may be greater than a single rating for hep C.
Learn from one of our VA Disability Lawyers how to use our VA Disability Calculator. You can put your Hep C Rating in there with your estimated residual ratings.
VA Disability Rating for Liver Problems like Cirrhosis
One of the complications of hep C is cirrhosis of the liver. Cirrhosis occurs when the virus causes scar tissue to develop in the liver. As a result, veterans who suffer from HCV may eventually seek VA benefits for cirrhosis of the liver.
Some VA cirrhosis quick notes: Although you hear it often concerning alcoholism, cirrhosis can be caused by diseases like HCV as well as alcohol consumption. Cirrhosis is rated between 10% and 100% depending on the symptoms presented and whether they respond to treatment.
Other complications from hep C include liver cancer and liver failure, both of which can be assigned a VA disability rating as high as 100% if they are service-connected. If a liver transplant is required, the VA assigns a disability rating of 100%, subject to reevaluation one year after the transplant.
Although you hear it often concerning alcoholism, cirrhosis can be caused by diseases like HCV as well as alcohol consumption.
Fatty Liver VA Disability Rating
Another potential complication from HCV is fatty liver or hepatic steatosis. Fatty liver disease occurs when damage to the liver causes an accumulation of fat cells that inhibits the liver’s function. Fatty liver disease is rated as other chronic liver diseases (non-cirrhotic) with ratings ranging from 0% to 100% depending on the severity and recurrence of symptoms.
Hepatitis A and Hepatitis B
HCV is not the same as hepatitis A or hepatitis B. While all three viruses affect the liver, they have different routes of transmission and different effects. More importantly, they are handled differently by the VA for disability benefits.
- Hepatitis A: Hepatitis A is a virus that is easily transmitted from person to person. When you hear about a hepatitis outbreak from a restaurant or fast food location, the virus being passed from food handlers to customers is hepatitis A. Hep A almost always clears up without treatment. Hepatitis A is not ratable by the VA for disability benefits because it is relatively minor. However, hep A can lead to gastroparesis – a condition in which the stomach never fully empties. If Hep A is service-connected, a VA rating for gastroparesis may be obtained as a secondary service-connected disability.
- Hepatitis B: Hepatitis B is a virus that causes chronic illness. Hepatitis B can be transmitted through sexual contact or blood. Hep B is currently incurable. The hepatitis B veteran’s affairs disability benefits rating can range from 0% to 100% depending on the severity and frequency of symptoms. Hepatitis B can also cause duodenitis. Duodenitis is an inflammation of the small intestine. If Hep B is service-connected, you may be eligible for a duodenitis VA rating under the secondary service-connected disability doctrine.
Establishing a Service Connection for VA HCV Claims
To grant VA disability benefits, a claim must include a service connection. There are three ways to establish a service connection – the disability manifested during service,was worsened, or was caused by service. Because many cases of HCV are asymptomatic, you may not find out that you carry the virus until years or even decades after infection. The inability to identify when you were infected can make it difficult to establish a service connection.
If you find out that one of your buddies was diagnosed with HCV, you can use a buddy statement from them to help your case. If you were both in the same unit and subjected to the same things, a buddy statement could be indispensable in your claim.
Does the Military Test for Hep C?
No, and this creates another obstacle for establishing a service connection to HCV. Your military discharge physical can establish a baseline for your health for later VA disability claims. For example, if you have served for four years and your medical examination at discharge shows a herniated disc in your back, there is at least a logical inference that you suffered, or worsened, an intervertebral disc injury during your time in the service.
During the Vietnam War era, there was no effective hep C test. At that time, all hepatitis was viewed as a single disease. As a result, if the military routinely tested for hepatitis at discharge, it could have identified hepatitis, but would not have identified the type of hepatitis. However, the military was not even doing that.
Even now, with testing for HCV available, the military does not test for HCV at discharge. This means that it can be difficult for you to pinpoint with complete accuracy whether you acquired hep C during your time in the service unless you can identify a specific event that may have led to infection.
Any contact with blood could have increased your risk. A blood transfusion during the time that blood supplies were not tested for hep C might be enough to show a service connection. If you suffered a cut or prick during your service on an object that might have been infected with hep C, such as a syringe or knife, this might support a service connection even if you were not in the medical corps. However, if you worked as a corpsman, nurse, or doctor, you may be able to establish a service connection through your regular job duties alone without identifying a specific event.
Similarly, sharing toiletries, such as razors, can transmit hep C. This can support a service connection as well. Establishing a service connection for a virus like Hep C may require lay evidence, meaning statements from ordinary fact witnesses. For example, if you shared a razor with another service member, and she testifies that she has also contracted hep C, you may be able to establish that the infection occurred during your time in the service.
There is an open question about whether the VA can grant a service connection for hep C transmitted by tattoo needles, body piercings, and drug syringes. These can be a substantial pathway for the transmission of hep C, particularly when they are obtained in countries with substandard sanitary conditions. However, the VA has the authority to deny VA disability benefits for willful misconduct. If the VA determines that you acquired hep C through willful misconduct, you may be denied VA benefits even if the fact otherwise establishes a service connection.
Although there is no clear and consistent answer, the VA’s rules do not specifically disallow hep C claims that establish a service connection through tattoo needles and body piercings. Thus, these appear to be allowable. However, diseases acquired through chronic drug use are excluded from forming the basis of grantable VA disability benefits claims. Thus, there is a good chance that a hep C disability benefits claim based on IV drug use may be denied.
The Hep C Vietnam Veterans Connection
Hep C is particularly prevalent among Vietnam veterans. There is no single explanation for this connection. However, there are a few factors that increased the risk of Vietnam veterans to contract HCV.
- Blood transfusions: During the Vietnam War, there was no way to screen blood supplies for hep C. As a result, casualties that required blood transfusions could receive infected blood. Blood supplies are now screened for hep C, so this transmission route is rare today.
- Wounds: The casualty rate in the Vietnam War was higher than in more recent military operations. Moreover, corpsmen and medical personnel were not as conscientious about using gloves when treating patients. As a result, infected patients often infected corpsmen, doctors, and nurses, who then passed the infection on to other patients.
- Contact with local populations: Between 5% and 8% of the Vietnamese population is infected with HCV. Contact with the blood of wounded Vietnamese could infect service personnel.
- Intravenous drug use: Hep C can be transmitted through the sharing of needles used for intravenous drug use. By many estimates, around 30% of US soldiers in Vietnam used heroin at least once. Transmission through sharing of needles was and continues to be, a major pathway for HCV.
It is important to note that hep C is only rarely transmitted through sexual contact, so sexual contact with Vietnamese is generally not considered a major source of hep C infections.
Also, there is no connection between Agent Orange and hep C. Herbicides like Agent Orange can cause a myriad of health problems in exposed veterans. However, HCV is a blood-borne virus and, as such, has no relation to Agent Orange exposure. In fact, current research shows no link between Agent Orange exposure and any form of liver disease. So cases of hepatitis C are higher in Vietnam vets, but it is not because of Agent Orange.
Other Sources of Compensation for HCV
There are almost no alternate resources for veterans with hep C. Consequently, your best opportunity for hep C compensation is filing a VA disability benefits claim. Depending on your circumstances, you may want to seek out a law firm that won veterans hep C cases in California or elsewhere against the VA.
Hep C Compensation Funds
A hep C compensation fund was created for the residents of many countries, such as Canada, the UK, and Ireland. This fund was intended to compensate people who had been unknowingly infected with hep C through the blood supply even though blood could have been screened for hep C. However, as of Spring 2020, no such hep C compensation fund exists in the US.
Can I get Medicaid if I have Hep C?
Yes. However, many states do not include treatment for hep C within their scope of coverage. This has led to lawsuits by some Medicaid users. However, at this time, the coverage of hep C treatment by Medicaid varies from state to state.
In 12 states, Medicaid coverage is only available after the illness progresses to F3 and 18 states require F2 level liver damage. Many states require 6 months to a year of sobriety, even though alcohol does not affect HCV. These are rapidly changing laws, with Montana updating its HCV guidelines as recently as February 2020.
The hep C compensation fund in Canada was the result of litigation against the Canadian government, which operates hospitals in Canada. There are no lawsuits of similar scope in the US, but you can see why we are keeping an eye on HCV litigation. One benefit of working with a Certified VA Benefits Lawyer is that if we work with you and the laws change, we have a head start because we already know your case.
Social Security Disability for HCV
Hep C does qualify for disability benefits under social security. However, under social security disability insurance (SSDI), hep C must render you unable to work.
However, if your case of hep C is serious enough to qualify for SSDI, you are allowed to collect VA disability benefits and SSDI at the same time. In other words, VA disability benefits are not considered “earned income” for purposes of awarding SSDI. Thus, they will not prevent you from qualifying SSDI.
With few alternative options for compensation for HCV, establishing a clear VA disability claim with a fact-based service connection is critical. Discuss your HCV disability claim with a VA attorney regardless of where you are currently located and whether you were deployed.
Yes, because you may have been misdiagnosed with having something else that doesn’t carry as high of a VA disability rating. Since HCV is contagious through blood and you were all together through it all, it is possible that you have it too.
For a long time, the military didn’t test anybody for hepatitis of any kind, much less HCV. It would be worth letting a VA disability lawyer look over his file to see if we can find out where the VA messed up and should still pay you back pay for benefits you’ve missed.