Evidence Checklist: Hepatitis B

Nexus opinion linking hepatitis B to service ("at least as likely as not")Critical

A medical opinion connecting HBV to service-related blood exposure, jet gun inoculations (pre-1997), sexual transmission during deployment, or other service-related exposure events.

Liver biopsy or FibroScan for fibrosis staging

Liver biopsy or FibroScan results staging the degree of hepatic fibrosis (F0–F4) and necroinflammatory activity — critical for establishing hepatitis B disease severity.

Hepatitis B viral markers (HBsAg, HBeAg, HBV DNA, anti-HBc)Critical

Comprehensive hepatitis B serologic panel documenting surface antigen status, e-antigen, HBV DNA viral load, and core antibody — establishing active infection, chronic carrier state, or resolved infection.

Serial liver function tests (ALT, AST, bilirubin, albumin, INR)Critical

Longitudinal liver panel results documenting disease activity, inflammatory flares (ALT spikes), and hepatic synthetic function — key indicators of chronic disease severity.

Antiviral treatment records (tenofovir, entecavir)

Records documenting antiviral therapy with tenofovir alafenamide, tenofovir disoproxil, or entecavir, including duration, viral suppression, and resistance testing.

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.

Personal statement describing symptoms and functional impact

Your own written account of how this condition affects your daily activities, work, and relationships. Describe your worst days.

Completed DBQ Liver ConditionsCritical

Standardized form capturing HBV marker status, fibrosis stage, liver function results, treatment, and functional impact.

Service treatment records (STRs)Critical

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