Citation Nr: 1318203 Decision Date: 06/05/13 Archive Date: 06/11/13 DOCKET NO. 09-03 111 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Montgomery, Alabama THE ISSUES 1. Entitlement to a compensable evaluation for hepatitis C, prior to April 18, 2012. 2. Entitlement to service connection for systemic hypertension. 3. Entitlement to service connection for bilateral hearing loss. REPRESENTATION Appellant represented by: Disabled American Veterans WITNESSES AT HEARING ON APPEAL Appellant and his spouse ATTORNEY FOR THE BOARD E. I. Velez, Counsel INTRODUCTION The appellant had active service from April 1969 to November 1970. This matter came before the Board of Veterans' Appeals (Board) on appeal from decisions of September 2008 and December 2008 by the Department of Veterans Affairs (VA) Regional Office (RO) in Detroit, Michigan. Jurisdiction has since been transferred to the RO in Montgomery, Alabama. RO hearings were held in May 2009 and May 2011. Transcripts of the hearings have been associated with the claim file. With regards to the issue of the evaluation of hepatitis C, the Board notes that in a rating decision of January 2013, the RO granted a 100 percent disability rating effective April 18, 2012. Accordingly, the period on appeal is the period prior to April 18, 2012. With regards to the issue of entitlement to service connection for hypertension, the Board notes that the Veteran has been diagnosed with essential hypertension and portal hypertension. Service connection is in effect for cirrhosis of the liver with an evaluation of 100 percent. Portal hypertension is one of the symptoms associated with cirrhosis of the liver. Therefore, in essence, service connection is already in effect for portal hypertension as a symptom of cirrhosis of the liver. Accordingly, the issue on appeal has been recharacterized to more accurately reflect the claim has entitlement to service connection for systemic hypertension. 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 The Veteran seeks service connection for systemic hypertension and bilateral hearing loss, and an increased evaluation for hepatitis C prior to April 18, 2012. After a careful review of the evidence of record, the board notes that additional development is needed prior to deciding the claim. The Veterans Claims Assistance Act of 2000 (VCAA) describes VA's duty to notify and assist claimants in substantiating a claim for VA benefits. 38 U.S.C.A. §§ 5100, 5102, 5103(a), 5103A, 5107, 5126 (West 2002); 38 C.F.R. §§ 3.102, 3.156(a), 3.159 and 3.326(a) (2012). Upon receipt of a complete or substantially complete application for benefits, VA is required to notify the claimant and his or her representative, if any, of any information, and any medical or lay evidence, that is necessary to substantiate the claim. 38 U.S.C.A. § 5103(a) (West 2002); 38 C.F.R. § 3.159(b) (2012); Quartuccio v. Principi, 16 Vet. App. 183 (2002). Additionally, the VCAA provides that VA shall make reasonable efforts to assist a claimant in obtaining evidence necessary to substantiate the claimant's claim, unless no reasonable possibility exists that such assistance would aid in substantiating the claim. A review of the claim file shows that VA outpatient treatment records dated from September 2007 to July 2011 have been associated with the claim file. The Veteran's Virtual VA file contains five pages of treatment records dated between September and October 2011. However, a supplemental statement of the case notes that the RO considered VA outpatient treatment records from March 2008 to October 2011; a discharge summary for the period from November 12-17, 2011; and, treatment records from December 2011 to January 2013. It was noted most of these records were reviewed electronically. The Board has reviewed the paper and Virtual VA claim files and notes that neither file contains any VA outpatient treatment records beyond October 2011. These records must be obtained. The Board notes that it is unclear as to whether all of the relevant records after July 2011 were obtained as there are only five pages of records starting in September 2011. The Bord finds that it is entirely possible that there are outstanding relevant treatment records dated between July 2011 and September 2011. The outstanding records are particularly important as the RO has assigned a 100 percent disability rating for hepatitis C and assigned an effective date of April 18, 2012 for the rating. Without the treatment records, it is not possible for the Board to properly assess the severity of the Veteran's disability. Moreover, the Board finds that the single VA examination conducted relating the issue of entitlement to service connection for bilateral hearing loss is inadequate for appellate review and a new VA examination is needed. The Veteran was afforded a VA audiological examination in March 2008. At the time, the Veteran was diagnosed with bilateral hearing loss disability. The examiner opined that hearing loss disability was not likely related to military service. While acknowledging the noise exposure in service, the examiner noted the normal hearing at entrance and separation examinations. A review of the examination report shows that the examiner did not indicate whether the claim file had been reviewed. Moreover, there is no reported history of the disability noted in the examination report. Significantly, the Veteran has asserted he experienced diminished hearing in service, but this does not appear to have been considered by the examiner. Accordingly, the Board finds that a new VA examination is needed prior to deciding the claim. Accordingly, the case is REMANDED for the following action: 1. The RO/AMC should obtain and associate with the claim file all VA outpatient and inpatient treatment records for the treatment of hepatitis C, hearing loss and hypertension from February 14, 2011 to the present. 2. After the development above has been completed, the RO/AMC should schedule the Veteran for an audiological examination to determine the nature and etiology of the current bilateral hearing loss disability. The claim file should be made available to the examiner. The examiner should also be granted access to the Veteran's Virtual VA file. The examiner should note in the examination report that the claim file, both paper and Virtual, have been reviewed. The examiner should be made aware that acoustic trauma in service has been conceded. The examiner should also elicit a full history from the Veteran as to the approximate date of onset of his symptoms. After an examination of the Veteran, the examiner should provide an opinion as to whether the bilateral hearing loss disability is at least as likely as not due to the acoustic trauma in service or whether such a relationship is unlikely. The examiner should consider the Veteran's reports of symptoms, including his reports of diminished hearing while in service. A complete rationale for any opinion rendered must be provided. 3. Following completion of the above, readjudicate the issues on appeal. If the decisions remain adverse to the appellant, he and his representative should be provided with a supplemental statement of the case. An appropriate period of time should be allowed for response. The appellant has the right to submit additional evidence and argument on the matter or 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 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. 2012). _________________________________________________ MICHAEL LANE 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) (2012).