Digestive System§ 4.114Updated
Rating criteria

VA Diagnostic Code 7312Cirrhosis of the liver

Rated from 0% to 100% under § 4.114. Here is what the VA requires at each level.

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What each rating requires

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  1. 100%

    Liver disease with Model for End-Stage Liver Disease score greater than or equal to 15; or with continuous daily debilitating symptoms, generalized weakness and at least one of the following: (1) ascites (fluid in the abdomen), or (2) a history of spontaneous bacterial peritonitis, or (3) hepatic encephalopathy, or (4) variceal hemorrhage, or (5) coagulopathy, or (6) portal gastropathy, or (7) hepatopulmonary or hepatorenal syndrome

  2. 60%

    Liver disease with Model for End-Stage Liver Disease score greater than 11 but less than 15; or with daily fatigue and at least one episode in the last year of either (1) variceal hemorrhage, or (2) portal gastropathy or hepatic encephalopathy

  3. 30%

    Liver disease with Model for End-Stage Liver Disease score of 10 or 11; or with signs of portal hypertension such as splenomegaly or ascites (fluid in the abdomen) and either weakness, anorexia, abdominal pain, or malaise

  4. 10%

    Liver disease with Model for End-Stage Liver Disease score greater than 6 but less than 10; or with evidence of either anorexia, weakness, abdominal pain or malaise

  5. 0%

    Asymptomatic, but with a history of liver disease

From the schedule

Notes on this code

These notes are part of the regulation. They change how the levels above are applied.

  • Note (1): Rate hepatocellular carcinoma occurring with cirrhosis under DC 7343 (Malignant neoplasms of the digestive system, exclusive of skin growths) in lieu of DC 7312.
  • Note (2): Biochemical studies, imaging studies, or biopsy must confirm liver dysfunction (including hyponatremia, thrombocytopenia, and/or coagulopathy).
  • Note (3): Rate condition based on symptomatology where the evidence does not contain a Model for End-Stage Liver Disease score.

Cirrhosis of the Liver — VA Disability Rating (Diagnostic Code 7312)

Understanding Cirrhosis of the Liver

Cirrhosis of the liver is a condition of the digestive system, rated by the VA under Diagnostic Code 7312 in § 4.114 of the VA rating schedule.

When rating this condition, the VA relies heavily on the Model for End-Stage Liver Disease (MELD) score as well as your documented symptoms. According to the rating notes, biochemical studies, imaging studies, or biopsy must confirm liver dysfunction — including findings such as hyponatremia, thrombocytopenia, and/or coagulopathy. When the evidence does not contain a MELD score, the VA rates the condition based on your symptomatology.

Please note: If hepatocellular carcinoma occurs with cirrhosis, the VA rates it under DC 7343 (Malignant neoplasms of the digestive system, exclusive of skin growths) instead of DC 7312.

Available Rating Levels

The VA assigns one of the following disability ratings based on your MELD score and/or symptoms:

100%

Liver disease with a MELD score of 15 or greater; or with continuous daily debilitating symptoms, generalized weakness, and at least one of the following:

  • Ascites (fluid in the abdomen)
  • A history of spontaneous bacterial peritonitis
  • Hepatic encephalopathy
  • Variceal hemorrhage
  • Coagulopathy
  • Portal gastropathy
  • Hepatopulmonary or hepatorenal syndrome

60%

Liver disease with a MELD score greater than 11 but less than 15; or with daily fatigue and at least one episode in the last year of either:

  • Variceal hemorrhage, or
  • Portal gastropathy or hepatic encephalopathy

30%

Liver disease with a MELD score of 10 or 11; or with signs of portal hypertension such as splenomegaly or ascites (fluid in the abdomen), along with either weakness, anorexia, abdominal pain, or malaise.

10%

Liver disease with a MELD score greater than 6 but less than 10; or with evidence of either anorexia, weakness, abdominal pain, or malaise.

0%

Asymptomatic, but with a history of liver disease.

What the VA Looks For

  • MELD Score: The Model for End-Stage Liver Disease score is a central factor in determining your rating level. Where the evidence does not contain a MELD score, the VA rates the condition based on your symptoms.
  • Confirmed Liver Dysfunction: Biochemical studies, imaging studies, or biopsy must confirm liver dysfunction — including hyponatremia, thrombocytopenia, and/or coagulopathy.
  • Symptoms and Complications: Documentation of symptoms such as fatigue, weakness, anorexia, abdominal pain, malaise, ascites, and portal hypertension, as well as complications like variceal hemorrhage, hepatic encephalopathy, and portal gastropathy.
  • Frequency and Severity: Whether symptoms are daily, debilitating, or continuous, and whether specific complications have occurred within the last year.

These criteria are a rendering of § 4.114, diagnostic code 7312. The official version is the one that governs your rating.

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What next

How to claim this

Knowing the criteria is the first half. Getting your file to show them is the second.

  1. Find your level in the stack

    Read each rung against what your medical records already say. The level your records document today is the one the VA can support today.

  2. Name the gap

    Look at the rung above yours and write down exactly what it asks for that your file does not show yet — a diagnosis, a measurement, a prescribed brace, a doctor’s opinion linking it to service.

  3. Claim it by code

    File under diagnostic code 7312 and attach the evidence for the level you are asking for. Other Digestive System codes may cover your secondary conditions.

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