Chronic Hepatic Encephalopathy

DC 7312Digestive38 CFR 4.114, DC 7312

Brain function problems caused by a damaged liver that cannot filter toxins from the blood. Symptoms include confusion, forgetfulness, poor concentration, personality changes, and in severe cases, coma. The VA rates it based on how much it affects your thinking and how often you have episodes.

How the VA rates this condition

The VA rates this condition based on how much it affects your ability to work and carry out daily activities. The examiner will focus on the functional limitations your condition causes, not just the diagnosis itself.

Diagnostic code

DC 7312

Rating range

10% – 100%

Rating levels

Rating criteria are defined in 38 CFR 4.114, DC 7312. This guide presents a plain-language summary and is not a substitute for the full regulatory text. Always consult a VSO or VA-accredited attorney for case-specific advice.

Rating Levels

You have persistent or near-constant cognitive impairment from hepatic encephalopathy. You cannot work or manage your own affairs. You may need a caregiver for daily tasks or have had hepatic coma.

What the VA looks for

Persistent cognitive impairment requiring caregiver
Hepatic coma episodes documented
Refractory encephalopathy despite maximum treatment
Inability to work or manage personal affairs
Generalized weakness and substantial weight loss
Persistent jaundice

Common Pitfalls

⚠Not getting neuropsychological testing — the VA needs objective evidence of cognitive impairment, not just a report of feeling confused. Formal testing documents the severity.
⚠Not tracking ammonia levels over time — serial blood ammonia measurements show the pattern of your condition and correlate with symptom severity.
⚠Not documenting how the cognitive impairment affects your work — describe specific examples of mistakes, forgotten tasks, or inability to concentrate that affect your job performance.
⚠Not connecting the liver disease to service — hepatic encephalopathy is a complication of liver disease, so the underlying liver condition (hepatitis C from service, alcohol-related liver disease secondary to PTSD) must be service-connected first.
⚠Not reporting all hospitalizations for encephalopathy episodes — each hospitalization supports a higher rating. Keep records of every ER visit and admission.

Related DBQ Forms

DBQ Liver Conditions

View evidence checklist →See secondary conditions →

Condition Rating Guides

Understand what the VA looks for at each rating level — loading conditions…

Chronic Hepatic Encephalopathy

How the VA rates this condition

Diagnostic code

DC 7312

Rating range

10% – 100%

Rating levels

Rating Levels

You have persistent or near-constant cognitive impairment from hepatic encephalopathy. You cannot work or manage your own affairs. You may need a caregiver for daily tasks or have had hepatic coma.

What the VA looks for

Persistent cognitive impairment requiring caregiver
Hepatic coma episodes documented
Refractory encephalopathy despite maximum treatment
Inability to work or manage personal affairs
Generalized weakness and substantial weight loss
Persistent jaundice

Common Pitfalls

⚠Not getting neuropsychological testing — the VA needs objective evidence of cognitive impairment, not just a report of feeling confused. Formal testing documents the severity.

⚠Not tracking ammonia levels over time — serial blood ammonia measurements show the pattern of your condition and correlate with symptom severity.

⚠Not documenting how the cognitive impairment affects your work — describe specific examples of mistakes, forgotten tasks, or inability to concentrate that affect your job performance.

⚠Not connecting the liver disease to service — hepatic encephalopathy is a complication of liver disease, so the underlying liver condition (hepatitis C from service, alcohol-related liver disease secondary to PTSD) must be service-connected first.

⚠Not reporting all hospitalizations for encephalopathy episodes — each hospitalization supports a higher rating. Keep records of every ER visit and admission.