Citation Nr: 18112893 Decision Date: 06/20/18 Archive Date: 06/20/18 DOCKET NO. 15-16 325 DATE: June 20, 2018 REMANDED Entitlement to service connection for hepatitis C is remanded. Entitlement to service connection for an acquired psychiatric disorder is remanded. REMAND Introduction The Veteran served on active duty in the United States Marine Corps from November 1974 to November 1978. This matter comes before the Board of Veterans’ Appeals (Board) on appeal of a November 2012 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Montgomery, Alabama. In his May 2015 substantive appeal, the Veteran requested a hearing before the Board. In a January 2017 letter, VA notified the Veteran of the date, time, and location of his scheduled hearing. The Veteran did not appear for the hearing, and he has not provided a reason for his absence or requested the hearing be rescheduled. Under these circumstances, the Board considers the hearing request to have been withdrawn. The scope of a mental health disability claim includes any mental disability that may reasonably be encompassed by the claimant’s description of the claim, reported symptoms, and other information of record. Clemons v. Shinseki, 23 Vet. App. 1, 5 (2009). The record shows the Veteran’s psychiatric symptoms have been variously diagnosed. As such, the Board refers to the Veteran’s psychiatric condition broadly, as an acquired psychiatric disorder, herein. REASONS FOR REMAND At the outset, the Board notes that VA must provide a medical examination or obtain a medical opinion when there is (1) competent evidence of a current disability or persistent or recurrent symptoms of a disability, (2) evidence establishing that an event, injury, or disease occurred in service, or establishing that certain diseases manifested during an applicable presumptive period for which the claimant qualifies, and (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the veteran’s service or with another service-connected disability, but (4) there is insufficient competent medical evidence on file for the Secretary to make a decision on the claim. McLendon v. Nicholson, 20 Vet. App. 79 (2006); see also 38 U.S.C. § 5103A(d)(2) (2012); 38 C.F.R. § 3.159(c)(4)(i) (2017). The third prong, which requires that the evidence of record “indicate” that the claimed disability or symptoms “may be” associated with the established event, disease or injury is a low threshold. McLendon, 20 Vet. App. at 83. The Veteran has not been afforded any VA examinations to address the etiology of his hepatitis C and acquired psychiatric disorder. In this case, the record shows the Veteran has been diagnosed with hepatitis C. The Veteran has contended he contracted hepatitis C while undergoing two surgeries during service. The record shows in May 1976, the Veteran underwent an “incision and drainage” related to a cyst on the left buttocks. In July 1977, he underwent a fistulectomy. Under these circumstances, the Board finds a remand is warranted for a VA examination and opinion regarding the etiology of the Veteran’s hepatitis C. The record also shows the Veteran has received treatment at VA for psychiatric symptoms, which have been variously diagnosed. The Veteran has contended his symptoms had their onset while he was placed on an “international legal hold” due to a false accusation of drug trafficking while stationed in Japan. He has asserted that, among other symptoms, he suffered from nightmares, was suicidal, and feared for his life during this time, and that these symptoms have persisted to the present. Under these circumstances, the Board finds a remand is warranted for a VA examination and opinion regarding the etiology of the all acquired psychiatric disorders present during the period of the claim. The Board also notes it does not appear the Veteran’s entire official military personnel file (OMPF), including any documentation of the legal proceedings referenced by the Veteran, has been associated with the record. As such, efforts to obtain this material must be undertaken on remand. Accordingly, the matters are REMANDED for the following actions: 1. Undertake appropriate development to obtain any outstanding records pertinent to the Veteran’s claims, to include his entire official military personnel file (OMPF). If any requested records are not available, the record should be annotated to reflect such and the Veteran notified in accordance with 38 C.F.R. § 3.159(e). 2. Thereafter, afford the Veteran a VA examination to determine the nature and etiology of his hepatitis C. All pertinent evidence of record must be made available to and reviewed by the examiner. Any indicated tests and studies should be performed. Following the examination and a review of the relevant records and lay statements, the examiner should state whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s hepatitis C originated during or is otherwise etiologically related to his military service. In providing this opinion, the examiner must address the Veteran’s service treatment records (STRs) showing he underwent an “incision and drainage,” a fistulectomy, and other treatment related to a cyst on the left buttocks during service, and the Veteran’s statements asserting he contracted hepatitis C during these procedures. The examiner must provide a rationale for any proffered opinion. If the examiner is unable to provide any required opinion, he or she should explain why. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation as to why this is so. If the inability to provide a more definitive opinion is the result of a need for additional information, the examiner should identify the additional information that is needed. 3. Following completion of step 1, above, afford the Veteran a VA examination to determine the nature and etiology of all acquired psychiatric disorders present during the period of the claim. All pertinent evidence of record must be made available to and reviewed by the examiner. Any indicated tests and studies should be performed. Following the examination and a review of the relevant records and lay statements, the examiner should identify all acquired psychiatric disorders present during the period of the claim. With respect to each identified acquired psychiatric disorder, the examiner should state whether it is at least as likely as not (50 percent probability or greater) that the disorder originated during or is otherwise etiologically related to the Veteran’s military service. In providing his or her opinion, the examiner must address the Veteran’s statements to the effect that the onset of his psychiatric symptoms occurred when he was placed on a legal hold related to false drug trafficking charges while stationed in Japan during service. The examiner must provide a rationale for any proffered opinion. If the examiner is unable to provide any required opinion, he or she should explain why. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation as to why this is so. If the inability to provide a more definitive opinion is the result of a need for additional information, the examiner should identify the additional information that is needed. 4. Undertake any other development determined to be warranted. (Continued on the next page)   5. Then, readjudicate the issues on appeal. If the benefits sought on appeal are not granted to the Veteran’s satisfaction, the Veteran and his representative should be furnished an appropriate supplemental statement of the case and be afforded the requisite opportunity to respond. Thereafter, the case should be returned to the Board for further appellate action, if needed. T. REYNOLDS Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Hampton, Associate Counsel