Citation Nr: 18130368 Decision Date: 08/29/18 Archive Date: 08/29/18 DOCKET NO. 12-17 433 DATE: August 29, 2018 ORDER Entitlement to service connection for hepatitis C is granted. REMANDED Entitlement to an initial rating in excess of 50 percent for posttraumatic stress disorder (PTSD) and major depressive disorder is remanded. Entitlement to a total disability rating based on individual unemployability due to service-connected disabilities (TDIU rating) is remanded. FINDING OF FACT The Veteran’s hepatitis C was incurred during his active service. CONCLUSION OF LAW The criteria for entitlement to service connection for hepatitis C have been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from November 1971 to November 1973. In October 2012, a videoconference hearing was held before the undersigned Veterans Law Judge, and a transcript of the hearing is associated with the record. In July 2015, the case was remanded for additional development. Entitlement to service connection for hepatitis C. The Veteran contends that he was exposed to hepatitis C in service while performing duties as a Medical Corpsman, including debriding the skin from chemical burn patients as well as administering thousands of needle injections (some of which accidentally punctured him in the process). He also contends that he may have been exposed to hepatitis C when he received his own jet injection vaccinations in service. The medical evidence of record, including a March 2018 VA hepatitis examination report, shows that the Veteran has a current diagnosis of hepatitis C. The Veteran’s service treatment records (STRs) are negative for any complaints, findings, diagnosis, or treatment of hepatitis C. His DD Form 214 confirms that his military occupational specialty (MOS) in the Army was Medical Corpsman. In light of the Veteran’s specialty in service, the Board finds that the Veteran possesses medical knowledge and therefore is not a lay person with regard to medical matters. The Veteran has alleged that he first learned that he had hepatitis C while trying to donate blood in 1988. The earliest medical evidence of record which reflects a diagnosis of hepatitis C consists of an August 1995 VA treatment record, which noted that he had a positive anti-HCV test. An October 2001 VA treatment record noted that his reported risk factors for hepatitis C included intravenous drug use (1975 to 1985) and a history of excessive alcohol intake (1968 to 1974). On an April 2012 questionnaire, he reported that his risk factors for hepatitis C included intravenous drug use (though he said that this was five years after he was discharged from military service) and his aforementioned medical work in service. At his October 2012 hearing, he testified with regard to his military duties as a Medical Corpsman, and also reported that he drank alcohol all through his military service and had jaundice while stationed in Okinawa. With regard to his intravenous drug use, the Veteran also stated that he always used a clean needle and never used anyone else’s needle. In January 2018, a private physician indicated reviewing the Veteran’s STRs and post-service treatment records, and opined that the Veteran’s hepatitis C is most likely caused by or a result of (51% probability or better) an onset or events while in service. For rationale, the private physician noted: “[The Veteran] was exposed to blood and body fluids in the service in his work as a medic.” While the March 2018 VA hepatitis examiner opined that the Veteran’s hepatitis C was less likely than not (less than 50 percent probability) caused by or incurred in his military service, the Board finds that the rationale provided for this opinion (i.e., that the Veteran underwent a hepatitis screen in October 1984 which was negative and an abdominal ultrasound in 2013 which was also negative) is entitled to less probative weight than the January 2018 private physician’s opinion, because the same private physician provided a new statement in May 2018 (submitted by the Veteran) which noted that the negative hepatitis screen in October 1984 was for hepatitis A (not hepatitis C), that hepatitis C cannot be diagnosed by abdominal ultrasound (such as the one conducted in 2013), and that it was “within reasonable medical probability” that the Veteran could have acquired hepatitis C while in the military service (either by exposure to blood and bodily fluids in his duties as a medic or by a contaminated vaccine apparatus) and it was “unlikely” that he would have acquired hepatitis C after 1984 (because he had been continuously free of drug and substance abuse for the last 33 years). The January and May 2018 opinions collectively provide a thorough rationale for the conclusions reached and are persuasive of a conclusion that the Veteran’s hepatitis C was incurred during his active service. As such, the Board concludes that service connection for hepatitis C is warranted. 38 U.S.C. §§ 1110, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). REASONS FOR REMAND 1. Entitlement to an initial rating in excess of 50 percent for PTSD and major depressive disorder. 2. Entitlement to a TDIU rating. The Veteran is seeking a higher initial rating for his PTSD and major depressive disorder, as well as a TDIU rating (raised in the context of the increased rating claim on appeal, pursuant to Rice v. Shinseki, 22 Vet. App. 447 (2009)). Pursuant to the Board’s July 2015 remand, records pertaining to the Veteran from the Social Security Administration (SSA) were obtained. A January 2013 SSA Disability Determination and Transmittal Sheet documents that the Veteran’s disability began on July 1, 2010 with a primary diagnosis of Affective/Mood Disorders and a secondary diagnosis of Anxiety Disorders. In the contemporaneous January 2013 SSA decision, the SSA Administrative Law Judge noted that the Veteran and two expert witnesses had all testified at an SSA hearing held on November 28, 2012. The Board notes that the transcript of this November 28, 2012 SSA hearing is not of record and may contain evidence pertinent to the current increased rating and TDIU claims on appeal. On remand, all records pertaining to the Veteran’s award of SSA disability benefits should be obtained. See Murincsak v. Derwinski, 2 Vet. App. 363 (1992); see also Stegall v. West, 11 Vet. App. 268, 271 (1998). The matters are REMANDED for the following actions: 1. Obtain the Veteran’s VA treatment records for the period from April 2018 to the present. 2. Request and obtain from the SSA all documents pertaining to any application by the Veteran for SSA disability benefits, including any decisions and/or determinations, and all supporting medical documentation utilized in rendering any decision or determination, as well as the transcript of the Veteran’s November 28, 2012 SSA hearing. Any negative search result should be noted in the record and communicated to the Veteran. M. SORISIO Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD L. B. Yantz, Counsel