Citation Nr: 18146281 Decision Date: 10/31/18 Archive Date: 10/30/18 DOCKET NO. 16-34 115 DATE: October 31, 2018 ORDER Entitlement to service connection for hepatitis C is denied. FINDING OF FACT Hepatitis C virus was not manifest during active service; and, the preponderance of the evidence fails to establish that it is etiologically related to service. CONCLUSION OF LAW The criteria for entitlement to service connection for hepatitis C have not been met. 38 U.S.C. §§ 1110, 1131 (2012); 38 C.F.R. § 3.303 (2018). (CONTINUED NEXT PAGE) REASONS AND BASES FOR FINDING AND CONCLUSION The appellant is a Veteran who served on active duty from January 1974 to January 1977. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an April 2013 rating decision by the Cheyenne, Wyoming, Regional Office (RO) of the Department of Veterans Affairs (VA). Appellate jurisdiction was subsequently transferred to the RO in Oakland, California. 1. Entitlement to service connection for hepatitis C. Under the relevant laws and regulations, service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131 (2012). Service connection connotes many factors but basically it means that the facts, shown by evidence, establish that a particular injury or disease resulting in disability was incurred coincident with service in the Armed Forces, or if preexisting such service, was aggravated therein. 38 C.F.R. § 3.303(a) (2018). Generally, the evidence must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). The Board has the authority to discount the weight and probity of evidence in light of its own inherent characteristics and its relationship to other evidence. Madden v. Gober, 125 F.3d 1477 (Fed. Cir. 1997). VA may favor one medical opinion over another, provided an adequate basis is provided. Owens v. Brown, 7 Vet. App. 429 (1995). It is the policy of VA to administer the law under a broad interpretation, consistent with the facts in each case, with all reasonable doubt to be resolved in favor of the claimant. 38 C.F.R. § 3.102 (2018). The Veteran contends that he has hepatitis C as a result of active service. He states he contracted the virus due to tattoos he received in service. He provided copies of internet-source medical literature in support of his claim. Service treatment records note no tattoos upon enlistment examination and show tattoos to the right and left arms upon separation examination. VA treatment records dated in December 2006 included a hepatitis C risk assessment noting a history of multiple sexual partners. A February 2011 surgery report noted poor intravenous (IV) access secondary to a history of IV drug abuse. A February 2012 report noted a history including intranasal cocaine use a blood transfusion in 1992. VA examination in April 2016 included a diagnosis of hepatitis C. It was noted the Veteran has risk factors including transfusions of blood or blood products before 1992, intravenous drug use or intranasal cocaine use, high risk sexual activity, and other direct percutaneous exposure to blood (identified as two tattoos). The examiner found it was less likely that hepatitis C was incurred in or caused by the claimed in-service injury, event, or illness. The rationale for the opinion noted that, in view of the fact that the Veteran had so many risk factors for acquiring hepatitis C other than having been tattooed while in active service, it was impossible to implicate that as the most likely cause of his acquiring the disease. Based upon the evidence of record, the Board finds the Veteran’s hepatitis C was not manifest during active service and that the evidence fails to establish that any it developed as a result of service. The opinion of the April 2016 VA examiner is persuasive. The examiner is shown to have reviewed the evidence of record and to have adequately considered the lay statements and reported symptom manifestations history of record. See Dalton v. Nicholson, 21 Vet. App. 23 (2007). There is no competent medical to the contrary. Consideration must be given to the Veteran’s personal assertion that he has a present disability as a result of service. Lay persons are competent to provide opinions on some medical issues. See Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011). The specific issue in this case, however, falls outside the realm of common knowledge of a lay person. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007). The claimed disability at issue is not a condition that is readily amenable to lay diagnosis or probative comment regarding etiology. See Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). The Board acknowledges that the Veteran is competent to report observable symptoms, but there is no indication that he is competent to etiologically link any such symptoms to a current diagnosis. He is not shown to possess the requisite medical training, expertise, or credentials needed to render a diagnosis or a competent opinion as to medical causation. Nothing in the record demonstrates that he received any special training or acquired any medical expertise in as to such disorders. See King v. Shinseki, 700 F.3d 1339, 1345 (Fed. Cir. 2012). Accordingly, the lay evidence does not constitute competent medical evidence and lacks probative value. When all the evidence is assembled VA is then responsible for determining whether the evidence supports the claim or is in relative equipoise, with the claimant prevailing in either event, or whether a preponderance of the evidence is against the claim in which case the claim is denied. Ortiz v. Principi, 274 F.3d 1361 (Fed. Cir. 2001). The preponderance of the evidence in this case is against the Veteran’s claim. MICHAEL A. HERMAN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD T. Douglas, Counsel