Citation Nr: 18119388 Decision Date: 07/18/18 Archive Date: 07/18/18 DOCKET NO. 15-10 443A DATE: July 18, 2018 REMANDED Entitlement to service connection for hepatitis C is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1980 to January 1983. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a rating decision issued in February 2012 by a Department of Veterans Affairs (VA) Regional Office (RO). In April 2017, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge. A transcript of the hearing is associated with the record. At such time, the Veteran waived Agency of Original Jurisdiction (AOJ) consideration of the evidence associated with the record since the issuance of the March 2015 statement of the case. 38 C.F.R. § 20.1304(c). Therefore, the Board may properly consider the entirety of the evidence of record. Entitlement to service connection for hepatitis C. The Veteran contends that he incurred hepatitis C during his military service as a result of being stabbed in the neck or due to sexual activity that resulted in a sexually transmitted disease (STD). In this regard, he indicated that, following such events, he attempted to sell his blood in the winter of 1982, but was informed that he had hepatitis C. He denied any additional risk factors, to include blood transfusions, tattoos, multiple sexual partners and/or high risk sexual behavior, sharing needles, and IV drug use during or since service. The Veteran’s service treatment records (STRs) reflect complaints of a laceration on the right side of his neck, which was closed with four sutures, in April 1982. Additionally, a May 1982 record reflects a diagnosis of acute urethritis due to gonococcus. The Veteran was afforded a VA examination in August 2011 in order to determine the nature and etiology of his hepatitis C. At such time, a diagnosis of chronic hepatitis C with hepatomegaly was rendered, but the examiner determined that the cause of such disorder was not known without resorting to mere speculation. In this regard, she noted that the Veteran’s STRs reflect that he contracted venereal disease due to high risk sexual activity and received a neck wound during service; however, he denied any specific risk factors for hepatitis C and a stabbing in the right neck was not considered to be a specific risk factor as it was unknown if there was other blood or body fluid contact involved. The examiner also noted that there was no objective evidence that linked the Veteran’s hepatitis C to any behaviors or encounters he had while in service, and there was no evidence that he had a greater risk of exposure to hepatitis C in service compared with his behaviors and exposures after service. Thus, the examiner found that the Veteran’s hepatitis C could not be directly linked to an exposure in service. However, at the April 2017 Board hearing, the Veteran alleged that he was stabbed in the neck by the same knife that was used to stab someone else right before him. Thus, the Board finds an addendum opinion is warranted to address such contention. The matter is REMANDED for the following action: Return the record to the VA examiner who conducted the August 2011 examination. The record and a copy of this Remand must be made available to the examiner. If the August 2011 VA examiner is not available, the record should be provided to an appropriate medical professional. The need for an additional examination of the Veteran is left to the discretion of the clinician selected to write the addendum opinion. The examiner should offer an opinion as to whether it is at least as likely as not (a 50 percent or greater probability) that the Veteran’s hepatitis C had its onset in, or is otherwise related to, his military service, to include his in-service neck laceration and/or STD. The examiner should specifically address the Veteran’s contention that he was stabbed in the neck by the same knife used to stab someone else right before he was stabbed. In rendering his or her opinion, the examiner is advised that the sole basis of a negative opinion cannot be the fact that the Veteran’s service treatment records are silent as to hepatitis C or complaints thereof. A rationale should be provided for all opinions offered. If the examiner is unable to provide the requested opinion without resort to speculation, he or she should clearly describe what facts or information is missing that would permit a non-speculative opinion. A. JAEGER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD K. Clark, Associate Counsel