Citation Nr: 19151583 Decision Date: 07/02/19 Archive Date: 07/02/19 DOCKET NO. 18-36 302 DATE: July 2, 2019 ORDER Entitlement to service connection for hepatitis C is denied. FINDING OF FACT The preponderance of the evidence is against finding that the Veteran’s current diagnosis of chronic hepatitis C began during active service or is otherwise related to an in-service injury or disease. CONCLUSION OF LAW The criteria for service connection for hepatitis C have not been met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from June 1973 to June 1976. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from an April 2017 rating decision by the Regional Office (RO) of the Department of Veterans Affairs (VA). Entitlement to service connection for hepatitis C. The Veteran contends that that his current diagnosis of hepatitis C is related to an in-service diagnosis of “negative Australian antigen” hepatitis. 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). The question for the Board is whether the Veteran’s current diagnosis of chronic hepatitis C began during service or is at least as likely as not related to an in-service injury, event, or disease. The Board concludes that, while the Veteran has a current diagnosis of chronic hepatitis C, and evidence shows that he was treated for acute hepatitis during his active service, the preponderance of the evidence weighs against finding that the Veteran’s current diagnosis of chronic hepatitis C is causally related to the in-service diagnosis of acute hepatitis. Private treatment records show the Veteran was not diagnosed with chronic hepatitis C until 2016, 40 years after his separation from service. (6/20/2018, Medical Treatment Record – Non-Government Facility, p. 14). Further, in a March 2017 opinion and an April 2018 clarifying addendum opinion, a VA examiner opined that the Veteran’s hepatitis C is not at least as likely as not related to service as the Veteran’s contemporaneous service treatment records do not establish that the Veteran was diagnosed with hepatitis C during service. Instead, the examiner opined that the Veteran’s 1975 diagnosis of hepatitis was acute inflammation of the liver, as subsequent liver enzyme and urine tests were normal. Additionally, the examiner noted that there was no evidence of chronicity of symptoms from military service to the Veteran’s current diagnosis. (4/4/2018, C&P Exam, p. 2-3). The VA examiner’s opinion is probative, because it is based on an accurate medical history and provides an explanation that contains clear conclusions and supporting data. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). The Board acknowledges that the Veteran has provided two opinions from a private practitioner, Dr. B.C., who opined that “it is more likely than not that [the Veteran’s hepatitis C] is service connected.” In rendering his opinion, Dr. B.C. opined that the Veteran was diagnosed with an acute form of hepatitis while in-service, as opposed to chronic hepatitis. (1/27/2018, Medical Treatment Record – Government Facility, p. 1). The Board finds that Dr. B.C.’s opinion is less probative than the VA examiner’s opinion, as his finding that the Veteran’s in-service diagnosis of hepatitis C was “acute” indicates that it was a temporary condition. Moreover, neither the Veteran nor Dr. B.C. proffered evidence that the Veteran continued to experience symptoms of hepatitis during the period between his initial in-service treatment and his 2016 diagnosis. Indeed, the record suggests that the Veteran was not experiencing symptoms of hepatitis following his initial treatment, as his June 1976 separation examination was normal. (1/27/2017, STR – Medical, p. 23-24). Consequently, the Board assigns more probative weight to the VA examiner’s opinion. Further, while the Veteran believes his chronic hepatitis C diagnosis is related to an in-service injury, event, or disease, in this case he is not competent to provide a nexus opinion regarding this issue. The issue is medically complex, as it requires knowledge of pathology. Therefore, it is outside the competence of the Veteran in this case because the record does not show that he has the medical training or credentials to make such a determination. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007); see also Kahana v. Shinseki, 24. Vet. App. 428 (2011). Consequently, the Board gives more probative weight to the VA examiner’s opinion. Accordingly, the Board finds that the preponderance of the evidence is against the claim and, therefore, the benefit of the doubt rule is not applicable. 38 U.S.C. § 5107(b). Thus, the Board concludes that entitlement to service connection for hepatitis C is not warranted. 38 U.S.C. §5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Eric S. Leboff Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD R. Glenn, Law Clerk 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.