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Evidence checklist

Fatty Liver Disease

DC 734538 CFR § 4.114Digestive

Evidence strength

Mark what you already have below and your evidence strength appears here.

Target
Saved locally
01

Specialist opinion

Highest value0 of 4 collected
Hepatic ultrasound or CT/MRI showing hepatic steatosisCritical

Imaging documenting increased echogenicity on ultrasound, or decreased attenuation on CT, or signal loss on MRI consistent with hepatic steatosis. MRI-PDFF provides quantitative fat fraction.

Private provider · independent opinion
FibroScan (CAP + stiffness) for fibrosis and steatosis stagingCritical

FibroScan results providing controlled attenuation parameter (CAP) for steatosis grading and liver stiffness measurement for fibrosis staging — critical for determining NAFLD vs. NASH with fibrosis.

Private provider · independent opinion
Nexus opinion linking fatty liver disease to service ("at least as likely as not")Critical

A medical opinion connecting NAFLD/NASH to service-connected diabetes, obesity, hypertriglyceridemia, or metabolic syndrome conditions that arose or worsened during service.

Private provider · independent opinion
Liver biopsy (if performed) staging NASH and fibrosis

Pathology report from liver biopsy documenting NAS (NAFLD activity score), hepatocyte ballooning, lobular inflammation, and fibrosis stage (F0–F4) — the gold standard for NASH diagnosis.

Private provider · independent opinion
02

Treatment records

0 of 2 collected
Liver function tests and metabolic labs (ALT, AST, lipid panel, A1C, glucose)

Serial liver panels showing ALT/AST elevation patterns, and metabolic labs documenting associated conditions (dyslipidemia, insulin resistance) that support the NAFLD diagnosis.

VA or private records · written request
Treatment and specialist follow-up records

Hepatology or gastroenterology records documenting weight management efforts, dietary counseling, management of metabolic risk factors, and any clinical trial participation.

VA or private records · written request
03

Lay statements

0 of 1 collected
Buddy statement from spouse, family, or fellow service member

A written statement from someone who can describe observable symptoms and how your condition affects daily life.

You or a witness · VA Form 21-4138 or 21-10210How to get this →
04

Benefits questionnaire

0 of 1 collected
Completed DBQ Liver ConditionsCritical

Standardized form capturing steatosis and fibrosis staging, liver function results, complications, and functional impact.

Provider-completed · VA DBQ formHow to get this →
05

Service records

0 of 1 collected
Service treatment records (STRs)Critical

Military medical records showing in-service treatment, complaints, or injuries related to this condition.

NPRC / milConnect · SF-180
Condition guideRating criteria and what VA looks forC&P exam prepWhat the examiner will askBuddy statement builderGuided VA Form 21-10210

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