Citation Nr: 19141074 Decision Date: 05/29/19 Archive Date: 05/29/19 DOCKET NO. 17-62 355 DATE: May 29, 2019 ORDER Entitlement to service connection for a right shoulder condition also claimed as joint pains is denied. REMANDED Entitlement to service connection for Hepatitis C with cirrhosis of the liver also claimed as Hepatitis C Virus (HCV) exposure due to hernia operation is remanded. Entitlement to secondary service connection for bilateral foot condition also claimed as skin discoloration is remanded. FINDING OF FACT The preponderance of the evidence is against finding that a right shoulder condition began during active service or is otherwise related to an in-service injury or disease. CONCLUSION OF LAW The criteria for entitlement to service connection for a right shoulder condition have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from January 1975 to December 1977. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a September 2016 rating decision and a December 2016 rating decision issued by the Department of Veteran Affairs (VA) Regional Office (RO). Entitlement to service connection for a right shoulder condition. The Veteran seeks entitlement to service connection for a right shoulder condition, which he contends had its onset during his active service and persisted since that time. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004). On the January 1975 entrance examination and the November 1977 examination, the Veteran reported that he was in good health and took no medications. There were no complaints, treatments, or diagnosis of a shoulder issue. However, the Veteran’s treatment records show that he complained several times about pain in his left shoulder. In a January 1977 service treatment record, the Veteran reported that he experienced pain in his left shoulder when he raised his arm to the side and when he pushed his arm forward. The Veteran stated that he was told that his shoulder would hurt when it was exposed to cold. After service, In a November 1990 treatment record, the Veteran reported that he pulled a muscle in his left shoulder ten days earlier and was prescribed a muscle relaxer. The RO denied service connection in a September 2016 rating decision for a right shoulder condition because the evidence did not show that the right shoulder condition occurred in or was caused by service. No other evidence in relation to the right shoulder condition has been submitted since this decision was issued. The Board finds the evidence of record does not support an injury in service for the right shoulder. In-service treatment records and post service treatment records only support an injury in the left shoulder. The Board acknowledges the Veteran’s contention that his right shoulder condition occurred in and was caused by service. However, the evidence of record does not support this contention. The Board notes that VA must provide a VA medical examination when there is: (1) competent evidence of a current disorder or persistent or recurrent symptoms of a disorder; and, (2) evidence establishing that an event, injury, or disease occurred in service or establishing certain diseases manifesting during an applicable presumptive period for which the claimant qualifies; and, (3) an indication that the disorder, or persistent or recurrent symptoms of a disorder, may be associated with the Veteran’s active military service or with another service-connected disability; but, (4) insufficient competent medical evidence on file for the VA Secretary to make a decision on the claim. See McLendon v. Nicholson, 20 Vet. App. 79 (2006). The Board notes that there is no evidence of a right shoulder injury in service, and the evidence does not indicate the Veteran’s right shoulder condition manifested itself within one year after separation from service. Further, there is insufficient competent evidence otherwise suggesting a link between the Veteran’s current right shoulder and his service. Therefore, despite the low bar set by McLendon, a VA examination is not warranted. In view of the foregoing, the Board concludes that the preponderance of the evidence is against the claim for entitlement to service connection for right shoulder condition. Because the preponderance of the evidence is against the claim, the benefit-of-the-doubt doctrine is not for application, and the claim must be denied. 38 U.S.C. § 5107(b); see also Gilbert v. Derwinski, 1 Vet. App. 49 (1990). REASONS FOR REMAND 1. Entitlement to service connection for Hepatitis C with cirrhosis of the liver. The Veteran seeks entitlement to service connection for Hepatitis C with cirrhosis of the liver, which he contends had its onset in service due to a blood transfusion he received during a hernia operation. Alternatively, the Veteran contends that he contracted Hepatitis C in service due to vaccination guns used on him. In the September 2016 rating decision, the RO deferred rendering a decision for this claim pending a VA examination. The Veteran filed an October 2016 notice of disagreement. However, this notice was not proper because a final decision had not been made on the claim. Once the VA examination was associated with the file, the RO considered the evidence and denied service connection for Hepatitis C in a December 2016 rating decision. Within one year after the December 2016 rating decision, the Veteran filed a Form 9 in November 2017 asking for reconsideration of his claim for a liver disorder. The Board acknowledges this as a notice of disagreement to the December 2016 rating decision. Thus, the Board must remand for the RO to provide a statement of the case and to allow the Veteran and his representative an opportunity to perfect an appeal. Manlicon v. West, 12 Vet. App. 238 (1999). 2. Entitlement to secondary service connection for bilateral foot condition claimed as skin discoloration. The Veteran seeks entitlement to service connection for bilateral foot condition, which he contends is secondary to his condition of Hepatitis C with cirrhosis of the liver. In a June 2016 statement, the Veteran stated he contracted Hepatitis C through a blood transfusion he received during a hernia operation while in service. The Veteran also stated the he contracted Hepatitis C through numerous vaccine guns used him during service. The Veteran contends the Hepatitis C led to liver failure which in turn caused the skin discoloration of his feet. The Veteran submitted an article entitled “Vaccine ‘Guns’ at Fault?” published in Spring 2016. In sum, the article stated that vaccine guns in the military were designed to immunize veterans in mass quantity, but they were not sterilized between uses; therefore, a person exposed to the use of a vaccine gun were susceptible to any diseases other had. The article argued that symptoms of Hepatitis C can be dormant for years and if left untreated, it can lead to liver failure and death. Because a decision on the remanded issue of entitlement to service connection for Hepatitis C with cirrhosis of the liver could significantly impact a decision on the issue of entitlement to secondary service connection for bilateral foot condition, the issues are inextricably intertwined, and a remand is required. This matter is REMANDED for the following action: (Continued on the next page)   Issue a Statement of the Case addressing the issue of entitlement to service connection for Hepatitis C with cirrhosis of the liver. The appellant and his representative should be advised of the time afforded for perfecting an appeal in this matter and given the opportunity to do so. After that occurs, this matter should be returned to the Board for appellate review. MICHAEL MARTIN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD T. Harris, Attorney Advisor The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.