Get Hepatitis

Completing the HEPATITIS form is essential for individuals seeking disability benefits for liver conditions from the U.S. Department of Veterans Affairs. This guide provides clear, step-by-step instructions to help users fill out the form accurately and efficiently, ensuring all required information is gathered.

Follow the steps to ensure a complete submission of the HEPATITIS form.

1. Press the ‘Get Form’ button to retrieve the HEPATITIS form and open it in your preferred document editor.
2. Begin by entering the name of the patient or veteran at the top of the form. This identifies who the form pertains to.
3. Input the patient or veteran's Social Security number in the designated field to ensure proper tracking and identification.
4. In Section I, diagnose the patient's liver condition by indicating whether the veteran currently has or has ever been diagnosed with a liver condition. Select 'Yes' or 'No.' If 'Yes,' provide details by selecting applicable conditions and entering associated ICD codes and dates of diagnosis.
5. Proceed to Section II, where you will summarize the veteran's medical history concerning their liver conditions. Include any relevant information about causes, onset, and the course of the conditions.
6. In Section III, state if there are currently any signs or symptoms of chronic or infectious liver diseases. Check all relevant symptoms and provide additional details where required, including the frequency and severity.
7. Continue to Section IV, which focuses on cirrhosis. Indicate any signs or symptoms the veteran may be experiencing related to cirrhosis, checking all that apply and noting frequencies and severities.
8. In Section V, determine if the veteran is a candidate for a liver transplant. Provide details if applicable, including any hospitalizations or past transplant surgeries.
9. Section VI asks about any pertinent physical findings or complications. If there are related scars or other conditions, detail them accordingly.
10. In Section VII, indicate whether diagnostic testing has been carried out. List various imaging and laboratory studies performed, providing dates and results as necessary.
11. Specify in Section VIII how the liver condition affects the veteran's ability to work, including examples to illustrate the impact.
12. Complete Section IX with any additional remarks or information that could support the claim.
13. Finally, ensure Section X is filled out by a physician, who should sign and provide necessary contact information. Their certification of the information is crucial for submission.
14. Review the completed form for accuracy. Save your changes, and choose to download or print the form for submission.

Start completing your HEPATITIS form online today to ensure your claim for disability benefits is processed smoothly.