Citation Nr: 18153901
Decision Date: 11/28/18	Archive Date: 11/28/18

DOCKET NO. 16-51 504
DATE:	November 28, 2018
REMANDED
Entitlement to service connection for elevated aspartate aminotransferase (claimed as liver condition) is remanded.
REASONS FOR REMAND
The Veteran served on active duty in the U.S. Army from September 1987 to December 1987, from November 1988 to December 1995, and from September 2000 to December 2013.  
Entitlement to service connection for elevated aspartate aminotransferase (claimed as liver condition) is remanded.
The Veteran seeks service connection for a liver condition.  Initially, the Regional Office (RO) denied the claim because the Veteran only had elevated lab results but no diagnosis.  In the September 2016 Statement of the Case, the RO denied the claim stating that although there is a diagnosis of cirrhosis within a year of service, the condition is not shown to be to a compensable degree within a year of service to qualify for presumptive service connection.  However, the RO did not also consider whether service connection is warranted on a direct basis.  
Nor is the record currently sufficient to grant the claim as there is no medical opinion of record linking the Veteran’s current diagnosis for cirrhosis to his active service.  However, the Veteran has a current diagnosis for cirrhosis of the liver.  His service treatment records also reflect elevated lab results indicated to suggest a liver disease, which are sufficient to suggest an in-service incurrence and association to his service.  As such, the Board finds that VA’s duty to assist has been triggered, and the Veteran should be afforded a VA examination to assess the nature and etiology of his liver condition.  See McClendon v. Nicholson, 20 Vet. App. 79 (2006); 38 C.F.R. § 3.159(c)(4). 
The matter is REMANDED for the following action:
1. Schedule the Veteran for a VA examination with an appropriate examiner to assess the nature and etiology of his liver condition. 
The claims file and a copy of this remand must be made available to the reviewing examiner, and the examiner should indicate in the report that the claims file was reviewed.
The examiner is also advised that the Veteran is competent to attest to observable symptoms.  If there is a medical basis to support or doubt the Veteran’s reports of symptomatology, the examiner should provide a fully reasoned explanation.
Any opinion provided must be accompanied by a rationale.   
The examiner is asked to provide an opinion as to whether it is at least as likely as not (a 50 percent or greater probability) that the Veteran’s liver condition was incurred in or is otherwise related to his active service.
2. After completing the above actions, readjudicate the claim on appeal.  If the benefits sought on appeal remain denied, the Veteran should be furnished an appropriate Supplemental Statement of the Case and be provided an opportunity to respond.  
Thereafter, the case should be returned to the Board for further appellate consideration, as appropriate.
The appellant has the right to submit additional evidence and argument on the matter the Board has remanded.  Kutscherousky v. West, 12 Vet. App. 369 (1999).

 
GAYLE STROMMEN
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	A. Smith, Associate Counsel