Citation Nr: 0810338 Decision Date: 03/28/08 Archive Date: 04/09/08 DOCKET NO. 06-20 267 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Atlanta, Georgia THE ISSUES 1. Entitlement to service connection for hepatitis C. 2. Entitlement to service connection for post-traumatic stress disorder (PTSD). REPRESENTATION Appellant represented by: Georgia Department of Veterans Services ATTORNEY FOR THE BOARD Nicole Klassen, Associate Counsel INTRODUCTION The veteran served on active duty from June 1965 to June 1978. He also had active service from June 1978 to February 1981, which in a November 1981 administrative decision, the RO determined to have been under dishonorable conditions for VA purposes; VA benefits based on any disability incurred in or aggravated during this period are therefore prohibited. In March 2006, the veteran's representative asked that a claim for service connection for a left knee disability be adjudicated. The RO issued a VCAA letter regarding this matter in March 2006; however, there is no indication in the claims older that the claim was adjudicated. This matter is referred to the RO for appropriate action. The appeal is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. VA will notify the appellant if further action is required. REMAND Unfortunately, a remand is required in this case. Although the Board sincerely regrets the additional delay, it is necessary to ensure that there is a complete record upon which to decide the veteran's claim so that he is afforded every possible consideration. In regard to the claim for service connection for hepatitis C, the veteran tested positive for hepatitis C in November 2003 and began treatment with the VA Medical Center for this disease. He underwent a liver biopsy in February 2004, which confirmed the diagnosis of hepatitis C, genotype 1A. The veteran contends that this disease is a result of in-service risk factors. Specifically, he contends that as a casualty clerk with the 14th Infantry in Vietnam, he had daily exposure to blood when dealing with dead and wounded men. The claims file also indicates non-service related hepatitis C risk factors recognized by VA, including in-service and post-service intravenous drug use and intranasal cocaine use. Although attempts were made in September 2003 to obtain the veteran's complete service medical records, such records were never obtained. To date, the only service records associated with the veteran's claims file are his dental records and personnel records. Further efforts at obtaining the veteran's service medical records should be taken before the Board renders a decision in this case. In regard to the claim for service connection for PTSD, service connection requires a veteran to provide 1) medical evidence diagnosing PTSD; 2) a link, established by medical evidence, between current symptoms of PTSD and an in-service stressor; and 3) credible supporting evidence that the claimed in-service stressor occurred. 38 C.F.R. § 3.304(f) (2007). This case turns on the first and second required elements listed above, namely medical evidence diagnosing PTSD and a medical nexus opinion linking current symptoms to the veteran's in-service stressors. The third element was established in April 2006, when the Center for Units Records Research (CURR) verified the veteran's reported in-service stressors of rocket and mortar attacks on his battalion in February 1968 and April 1968 while stationed at the Long Binh Post. It is unclear, however, whether the veteran has been diagnosed with PTSD. Although VA doctors have made numerous references to the veteran having PTSD during treatment, he has never been formally diagnosed with PTSD and a medical opinion as to the etiology of such condition, if present, has never been provided. See VA treatment records from September 2000, August 2002, May 2003, July 2003, and November 2003. A VA examination determining whether the veteran in fact has PTSD, and if so, whether such condition is related to or caused by exposure to rocket and mortar fire during service, is necessary in this case before the Board renders a decision. Accordingly, the case is REMANDED for the following action: 1. Make arrangements to obtain the veteran's complete service medical records, including clinical records, from the National Personnel Records Center (NPRC) and/or any other appropriate source. 2. Thereafter, schedule the veteran for a VA psychiatric examination. The claims file and a copy of this remand must be made available to and reviewed by the examiner in conjunction with the examination. All necessary tests should be conducted. The examiner must express an opinion as to whether the veteran meets the criteria for PTSD contained in DSM-IV, and if he meets such criteria, whether PTSD can be related to the stressor or stressors reported by the veteran and established as having occurred during active service (i.e., the in-service stressors of rocket and mortar attacks on his battalion). The examiner must provide a comprehensive report including complete rationales for all opinions and conclusions reached, citing the objective medical findings leading to the conclusions. 3. Finally, readjudicate the claims on appeal. If the claims remain denied, provide the veteran and his representative with a supplemental statement of the case and allow an appropriate time for response. The appellant has the right to submit additional evidence and argument on the matters the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). This claim must be afforded expeditious treatment. The law requires that all claims remanded by the Board of Veterans' Appeals or by the United States Court of Appeals for Veterans Claims for additional development or other appropriate action must be handled in an expeditious manner. See 38 U.S.C.A. §§ 5109B, 7112 (West Supp. 2007). _________________________________________________ P.M. DILORENZO Veterans Law Judge, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 2002), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Appeals for Veterans Claims. This remand is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (2007).