Hepatitis and VA Disability | All You Need to Know

Leah provides a focused breakdown of how hepatitis B and C can be service-connected for VA disability claims. She explains the basics of hepatitis, common ways veterans may have been exposed during service (such as air gun injections or pre-1992 blood transfusions), and the criteria needed for direct or secondary service connection, including the importance of a medical nexus. Leah also highlights VA rating criteria, C&P exam expectations, and useful strategies like gathering strong medical documentation, requesting nexus letters, and referencing VA fast letters. 

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At Prestige Veteran Medical Consulting, a veteran-owned company, we specialize in Independent Medical Opinions (IMOs) known as Nexus letters.

The purpose of this channel 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.

⚠️ DISCLAIMER
This video is not medical or legal advice and should not be substituted for advisement from your VSO, accredited agent, or Attorney.

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Episode Transcript

Leah Bucholz (00:05):
Hey guys, it's Leah B from Prestige Veteran
Medical Consulting. I am a U. S.Army veteran, physician
assistant, and formercompensation and pension
examiner. Welcome back to ourchannel where we break down VA
disability benefits in plainlanguage and help veterans take
charge of their claims.
So I'm Leah for those of youguys who don't know me. As I
mentioned I'm a PA and former Cand P examiner and today we're

(00:27):
going to dig into a conditionthat affects thousands of
veterans and that is hepatitis,especially hepatitis B and C and
how veterans can get serviceconnected for this. So this
episode is going to cover thingslike what hepatitis is and how
it affects veterans, how it canbe directly or secondarily
related to your service orlinked to your service, what the

(00:48):
VA looks at for those types ofclaims, and what steps you can
take to help support your casefrom a medical perspective. So
if you've been diagnosed withhepatitis or you even think you
might have been exposed thisepisode is definitely for you.
So what is hepatitis?
So let's start with the basics.Hepatitis is an inflammation of

(01:08):
the liver usually caused by avirus. The two types, there's
many types, but the mostprevalent types are going to be
hepatitis B, often referenced inyour medical records as HBV or
hepatitis B virus and hepatitisC or HCV, hepatitis C virus.
Both can lead to chronic liverdamage, cirrhosis, liver cancer,

(01:31):
and serious complications ifleft untreated. So how is
hepatitis transmitted?
Exposure to infected blood orbody fluids, unsterile needles
or air gun injections. A lot ofair guns were used to do
vaccines at one point. I've seena lot of cases like that. Blood
transfusions before 1992, combattrauma or emergency surgeries,

(01:56):
in some cases sexual contact orsharing razors. Many veterans
especially those who servedbefore the early 90s may have
been exposed without evenknowing and their symptoms can
take years to show up.
So direct service connection forhepatitis. So what is that? How
do you get hepatitis and how canit be directly service
connected? So three things aregoing to be relevant to any type

(02:19):
of claim right and that's goingto be that you have a current
diagnosis in this case a currentdiagnosis of hepatitis B or C,
evidence of exposure or symptomsduring service, and a medical
nexus or essentially a doctor'sopinion linking those two.
Examples of direct serviceconnection could be things like
receiving a blood transfusionduring the military before 1992.

(02:43):
You could have been injectedwith a gun with a air gun for
immunizations which were notalways properly sterilized. You
might have been a combat medicand your records show that you
were exposed to blood when youwere treating patients. So you
served in an area with unsafewater or unsafe medical
sanitation standards. The VA hasacknowledged that air gun

(03:04):
injector risks in hepatitiscases especially for hep C.
While not automaticallypresumptive it can support your
claim if you have pretty strongevidence that supports it.
So secondary service connection.Let's talk about secondary
service connection forhepatitis. So this is when your
hepatitis is caused or worsenedby another condition that's

(03:25):
already service connected. Soagain some real world examples
could be if you're serviceconnected for PTSD and you
develop substance use disorder,you contracted hep C through IV
drug use but your alcohol ordrug use is medically linked to
your PTSD. You could be onimmunosuppressive medications
for a service connectedautoimmune condition and those

(03:46):
meds caused a reactivation of adormant hepatitis B virus.
That could be like anaggravation case. You were
treated with VA prescribed bloodproducts or equipment after
service that later turned out tobe contaminated. These can be
kind of tricky but with medicaldocumentation and a solid nexus
either from your C and Pexaminer, your treating

(04:08):
provider, whoever, many havebeen granted. So what does the
medical literature say abouthepatitis? So medical research
is definitely on your side, ifsome of these circumstances
apply to you.
So studies show that veteranswho received airgun injections
in the military were atincreased risk for hepatitis C
transmission especially beforestandard sterilization protocols

(04:30):
were enforced. So the VA itselfhas published guidance on this
issue VA Fast Letter 211B thatwas in 2012 and it even mentions
that the need to evaluatehepatitis C claims based on
likely exposure during airgunimmunization. So hep C can
remain dormant for decades as Imentioned meaning that you could

(04:51):
have been infected in serviceand not even diagnosed until
many years later. So this typeof evidence can support your
claim. You can ask your doctorto reference it.
It might make a differenceespecially if you've been done
been denied in the past. So howdoes VA rate hepatitis? So VA
rates chronic hepatitis under 38CFR 4.114, diagnostic code seven

(05:16):
thousand three and fifty fourfor hepatitis C and seven
thousand three hundred and fortyfive for hepatitis B. The rating
depends on things like labresults that show maybe your AST
or your ALT or your bilirubinabnormalities, symptoms like
fatigue, malaise, anorexia,jaundice, or weight loss. The
number and severity ofincapacitating episodes

(05:40):
requiring bed rest prescribed bya physician.
So some example ratings would belike ten percent for
intermittent fatigue or malaise,thirty percent for more
persistent symptoms with weightloss, sixty to one hundred
percent for near constantfatigue, severe symptoms, liver
damage, or hospitalization. Inadvanced cases, people might

(06:02):
also qualify for secondaryratings for things like
cirrhosis, liver cancer, hepaticencephalopathy. So what can you
expect at a C and P exam? So ifyou file a claim for hepatitis
you're likely going to go to acompensation and pension exam
with somebody who has trainingabout the liver. So it doesn't
have to be a GI doctor orhepatologist.

(06:24):
It could be a nurse practitioneror a PA. It's within their scope
of training or a generalphysician. The examiner will
look at things like yourdiagnosis and labs, symptoms
like fatigue, jaundice or pain,history of treatment or flare
ups, possible exposurescenarios. So you may wanna
bring your own medical recordsespecially if you haven't

(06:45):
submitted them, any lab results,any documentation of in service
exposures. Be honest, bespecific about how your symptoms
affect you daily.
So before we wrap up, I wannaalways touch base on tips that
can help you strengthen yourposition and that's to work with
a VA accredited representativelike a VSO or a claims agent or

(07:05):
an attorney. They can help youstrategize and navigate the
system. You wanna make sure youhave that confirmed diagnosis
because they wanna see thatobjective evidence. You can
provide that detailed history ofin cervix exposure. You can ask
your doctor for a nexus letterif they're willing to write you
one if they believe that it'srelated to service using that at

(07:26):
least as likely as not language.
They might want to include peerreviewed studies if possible or
that VA FAST letter that wetalked about. So also if it's
secondarily related to your PTSDor other medication that that
may want to be referenced. Sohepatitis may not always be
visible you guys. There's a lotof invisible diseases that we

(07:47):
suffer from, but it can changeyour life. If it's connected to
your time and service, youdeserve compensation, whether
it's from that transfusion thatyou had, a medical procedure,
like an air gun injection, thereare several paths to service
connection.
So if your claim has beendenied, don't give up. Get help
from that VSO or accredited repor a VA attorney, and don't be

(08:09):
afraid to appeal things. Don'tjust give up. So thanks again
for watching as always. Hope youguys enjoyed today's episode and
please like and subscribe anddrop some comments.
I always love to hear you guys'stories of how you overcame
things and continued to persist.Let me know if there's any other
videos that you'd like to hearabout or have me do videos on

(08:32):
and I'll add them to the list.Okay thanks guys.