Citation Nr: 0949081 Decision Date: 12/31/09 Archive Date: 01/13/10 DOCKET NO. 08-13 629 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in St. Louis, Missouri THE ISSUE Entitlement to service connection for fatty liver. ATTORNEY FOR THE BOARD M. J. In, Associate Counsel INTRODUCTION The Veteran served on active duty from December 1986 to March 2007. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a June 2007 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in St. Louis, Missouri. FINDINGS OF FACT The evidence of record shows that the Veteran's current fatty liver is related to his active military service. CONCLUSION OF LAW Fatty liver was incurred during military service. 38 U.S.C.A. §§ 1110, 1131, 5103A, 5107 (West 2002); 38 C.F.R. § 3.303 (2009). REASONS AND BASES FOR FINDINGS AND CONCLUSION As provided for by the Veterans Claims Assistance Act of 2000 (VCAA), VA has a duty to notify and assist claimants in substantiating a claim for VA benefits. 38 U.S.C.A. §§ 5100, 5102, 5103, 5103A, 5107, 5126 (West 2002 & Supp. 2009); 38 C.F.R. §§ 3.102, 3.156(a), 3.159 and 3.326(a) (2009). In this case, the Board is granting in full the benefit sought on appeal. Accordingly, without deciding that any error was committed with respect to the duty to notify or the duty to assist, such error was harmless and need not be further considered. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active military service. 38 U.S.C.A. §§ 1110, 1131 (West 2002); 38 C.F.R. § 3.303(a) (2009). Service connection may also be granted for any disease initially diagnosed after service, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 U.S.C.A. § 1113(b) (West 2002); 38 C.F.R. § 3.303(d) (2009); Cosman v. Principi, 3 Vet. App. 503, 505 (1992). In order to prevail on the issue of service connection there must be (1) medical evidence of a current disability; (2) medical evidence, or in certain circumstances, lay evidence of in-service occurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between an in- service injury or disease and the current disability. See Hickson v. West, 12 Vet. App. 247, 253 (1999); see also Pond v. West, 12 Vet App. 341, 346 (1999). Historically, the Veteran served in the Army from December 1986 to March 2007. The Veteran's October 1986 entrance examination report is silent for any complaints, findings, or diagnoses of fatty liver or any other liver disease. A May 2006 service treatment record noted elevated serum enzyme levels and an assessment of fatty liver was given. Subsequent service treatment reports in June 2006 and in October 2006 concluded with assessments of fatty liver and pancreas, with normal liver function tests. The Veteran's November 2006 retirement examination report noted the Veteran's history of fatty liver and pancreas and that he was treated with a medication for high cholesterol. In preparing for his separation from military service, the Veteran filed a claim in November 2006 seeking entitlement to service connection for a fatty liver. Following his discharge from military service, the Veteran underwent a VA examination in March 2008. After reviewing the Veteran's claims file, the VA examiner noted the onset of the Veteran's liver problem in November 2005, at which time a finding of fatty liver was made based on blood work. The report also noted that ultrasound testing of liver revealed fatty liver and pancreas. Since then, the report noted that the condition had improved, that his current liver enzymes were no longer elevated, and that no current symptoms existed. Nevertheless, the report concluded with a diagnosis of fatty liver, and that this condition caused significant effects on usual occupational activities. Specifically, the Veteran reported that he declined jobs involving potential exposure to chemicals to avoid further damage to liver even though such jobs were much higher-paying than his current job. After reviewing the evidence of record, the Board finds that the Veteran's current fatty liver can not be reasonably disassociated from his military service. The Veteran's service treatment records revealed multiple assessments of fatty liver. Moreover, despite the April 2008 VA examination's finding that there were no current symptoms, the report clearly indicated a diagnosis of fatty liver. A fatty liver, also called "hepatic steatosis", is "yellow discoloration of the liver due to fatty degeneration of parenchymal cells". See Stedman's Medical Dictionary, p. 1583, 27th Edition (2000). The medical evidence of record shows that the Veteran had fatty liver both during and very soon after his discharge from service. Thus, continuity of symptomatology of this condition is also established in this case. Based on the totality of the evidence, and with application of the benefit of the doubt rule of 38 U.S.C.A. § 5107(b), the Board finds that the Veteran currently has fatty liver which was incurred during his active military service. Accordingly, service connection for fatty liver is warranted. ORDER Service connection for fatty liver is granted. ____________________________________________ JOY A. MCDONALD Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs