Citation Nr: 1104363 Decision Date: 02/03/11 Archive Date: 02/14/11 DOCKET NO. 07-32 661 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Waco, Texas THE ISSUE Entitlement to service connection for hepatitis C. REPRESENTATION Veteran represented by: Veterans of Foreign Wars of the United States WITNESSES AT HEARING ON APPEAL The Veteran and B. M. ATTORNEY FOR THE BOARD P. Childers, Counsel INTRODUCTION The Veteran, who is the appellant, served on active duty from April 1969 to October 1970. This matter is before the Board of Veterans' Appeals (Board) on appeal of a rating decision in January 2006 of a Department of Veterans Affairs (VA) Regional Office (RO). In November 2010, the Veteran appeared at hearing before the undersigned Veterans Law Judge. A transcript of the hearing is in the Veteran's claims file. The appeal is REMANDED to the RO via the Appeals Management Center in Washington, D.C. REMAND On VA examination in April 2010, the VA examiner stated that in the absence of symptomatology prior to 2003, a nexus between the Veteran's hepatitis C and service was not medically possible, but as the conclusion does not provide sufficient analysis that the Board can consider and weigh, the examination was inadequate. Accordingly, the case is REMANDED for the following action: 1. Request the VA records from 2003 to May 2007, including any consultation reports, before the Veteran's liver transplant in June 2007 from the Portland, Oregon, VA Medical Center. 2. After completion of the above, afford the Veteran a VA examination by a physician to determine whether it is more likely than not (probability greater than 50 percent), at least as likely as not (probability of 50 percent), less likely than not (probability less than 50 percent), or an opinion is not possible without resort to speculation that the hepatitis C, first documented after service in 2003, is related to a potential risk factor, namely, the Veteran's skin exposure to blood in Vietnam. In formulating the opinion, the VA examiner is asked to consider that the Veteran stated that he had skin exposure to blood several times in Vietnam, including when he carried casualties after his shelter was hit by enemy fire. Also, after service, the Veteran had donated blood into the 1990s before he learned that he had hepatitis C in 2003. The VA examiner is asked to support the opinion by addressing the Veteran's potential risk factors. If however after a review of the record, a determination of the risk factor is not possible without resort to speculation, the examiner is asked to clarify whether the risk factor cannot be determined because there are multiple potential causes, when the potential skin exposure to blood in service is not more likely than any other the cause of the Veteran's hepatitis C and that an opinion on a risk factor is beyond what may be reasonably concluded based on the evidence of record and current medical knowledge. The Veteran's file must be made available to the examiner for review. 3. After the development has been completed, adjudicate the claim. If the benefit sought remains denied, furnish the Veteran and his representative a supplemental statement of the case and return the case to the Board. The Veteran has the right to submit additional evidence and argument on the matter 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 that are 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. 2010). _________________________________________________ George E. Guido Jr. 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) (2010).