Primary Biliary Cholangitis

DC 7312Digestive38 CFR 4.114, DC 7312

A chronic autoimmune disease where the bile ducts in the liver are slowly destroyed, leading to bile buildup and progressive liver damage. The VA rates primary biliary cholangitis based on symptom severity, liver function impairment, and the impact on your daily life.

How the VA rates this condition

The VA rates this condition based on the type and intensity of treatment you require. Higher ratings correspond to more aggressive treatment regimens, such as daily medication, insulin dependence, or the need for ongoing medical management.

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 primary biliary cholangitis with near-constant debilitating symptoms, advanced cirrhosis, or liver failure requiring consideration for transplant.

What the VA looks for

Near-constant debilitating symptoms
Advanced cirrhosis or liver failure
Liver transplant evaluation or listing
Inability to maintain employment
Severe portal hypertension or variceal bleeding

Common Pitfalls

⚠Not getting anti-mitochondrial antibody (AMA) testing — this is the hallmark diagnostic test for primary biliary cholangitis and is essential for establishing the diagnosis.
⚠Not documenting the severity of pruritus (itching) — this debilitating symptom often disrupts sleep and daily activities, and should be reported at every medical visit.
⚠Not tracking liver function tests over time — progressive elevation of alkaline phosphatase and bilirubin levels demonstrates the worsening nature of the condition.
⚠Not filing for secondary conditions such as osteoporosis, sicca syndrome (dry eyes/mouth), or thyroid disease that commonly co-occur with primary biliary cholangitis.

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…

Primary Biliary Cholangitis

How the VA rates this condition

Diagnostic code

DC 7312

Rating range

10% – 100%

Rating levels

Rating Levels

You have primary biliary cholangitis with near-constant debilitating symptoms, advanced cirrhosis, or liver failure requiring consideration for transplant.

What the VA looks for

Near-constant debilitating symptoms
Advanced cirrhosis or liver failure
Liver transplant evaluation or listing
Inability to maintain employment
Severe portal hypertension or variceal bleeding

Common Pitfalls

⚠Not getting anti-mitochondrial antibody (AMA) testing — this is the hallmark diagnostic test for primary biliary cholangitis and is essential for establishing the diagnosis.

⚠Not documenting the severity of pruritus (itching) — this debilitating symptom often disrupts sleep and daily activities, and should be reported at every medical visit.

⚠Not tracking liver function tests over time — progressive elevation of alkaline phosphatase and bilirubin levels demonstrates the worsening nature of the condition.

⚠Not filing for secondary conditions such as osteoporosis, sicca syndrome (dry eyes/mouth), or thyroid disease that commonly co-occur with primary biliary cholangitis.