Citation Nr: 20045461 Decision Date: 07/08/20 Archive Date: 07/08/20 DOCKET NO. 16-34 534 DATE: July 8, 2020 ORDER Service connection for Hepatitis C is denied. FINDINGS OF FACT 1. The Veteran served on active duty from November 1974 to August 1977 and from February 1984 to June 1991. 2. Hepatitis C is not related to service, to include any injury or event therein. CONCLUSION OF LAW Hepatitis C was not incurred in service. 38 U.S.C. §§ 1110, 1116, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.303, 3.307, 3.309 (2019). REASONS AND BASES FOR FINDINGS AND CONCLUSION Service connection may be granted on a direct basis as a result of disease or injury incurred in service based on nexus using a three-element test: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred in or aggravated by service. See 38 C.F.R. §§ 3.303(a), (d); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009). As to a current disorder, a May 2020 VA examiner noted that the Veteran had been diagnosed with hepatitis C in 2008. Therefore, a current diagnosis is shown. As to an in-service incurrence, the Veteran asserts that he contracted hepatitis C through air gun inoculations. Service treatment records (STRs) reflect routine inoculations and he is competent to report receiving inoculations and asserts that the injectors were bloody as were the arms of other servicemembers. As he is competent to report that which he perceives through the use of his senses, such as blood from inoculations, for purposes of this decision, the second element of service connection has been met. As to a causal relationship (nexus) between hepatitic and service, in a May 2020 VA examination and medical opinion, the examiner reflected that the Veteran had been diagnosed with hepatitis C in 2008 and received treatment with combination therapy (Pegasys and ribavirin) for the condition at the time of the examination. He claimed that air gun vaccinations had caused hepatitis C. He denied any organ transplant before 1992, blood transfusion or accidental exposure in service, intravenous drug use or intranasal cocaine use, or high-risk sexual activity. There was no history of hepatitis in service. He denied any history of drug abuse. The examiner opined that hepatitis C was less likely related to service or to air gun inoculation. The examiner reasoned that the Veteran’s medical records showed no evidence of the diagnosis, treatment or symptoms suggestive of hepatitis C. The examiner explained that “there has been considerable concern over the relationship between hepatitis C and immunization with jet injectors (air gun injection) (mass immunizations) in the military, however, the likelihood is so remote that it does not meet the evidentiary standard for possibility.” The examiner noted that a review of the medical literature did not support an association with hepatitis C infection and jet injectors, although there were some studies in the 1990’s on animal models that were inconclusive and did not support plausibility for such transmission. This evidence weighs against the claim and there is no contradictory medical opinion of record. The Board has considered the Veteran’s lay statements that hepatitis C was caused by service. He is competent to report symptoms because this requires only personal knowledge as it comes to him through his senses. In addition, he is competent to report his experiences receiving air gun inoculations in service. However, he is not competent to offer an opinion as to the etiology of his current disorder due to the medical complexity of the matters involved. Such competent evidence has been provided by the medical personnel who have examined the Veteran during the current appeal and by service records obtained and associated with the claims file. The Board attaches greater probative weight to the examination report and clinical findings than to his statements. As such, the medical records are more probative than his lay assertions of a connection with service. In sum, after a careful review of the evidence, the benefit of the doubt rule is not applicable, and the appeal is denied. Finally, the Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record, for the Board’s consideration. See Doucette v. Shulkin, 28 Vet. App. 366, 369-370 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). L. HOWELL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Grzeczkowicz 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.