Citation Nr: 20079760 Decision Date: 12/17/20 Archive Date: 12/17/20 DOCKET NO. 09-27 972A DATE: December 17, 2020 REMANDED Entitlement to service connection for hepatitis C is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1971 to November 1980. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a December 2007 rating decision issued by the Department of Veterans Affairs (VA), Regional Office (RO) in Houston, Texas. In July 2015, the Veteran testified at a Board hearing at the Central Office in Washington, DC before the undersigned Veterans Law Judge of the Board. A transcript of the hearing is associated with the record. This case was previously before the Board in September 2015 and February 2018. The Veteran’s claim was remanded for additional development. The case is now again before the Board for further appellate action. Entitlement to service connection for hepatitis C is remanded. In February 2018, the Board remanded the Veteran’s service connection claim for hepatitis C to obtain an addendum medical opinion that “must reflect consideration of the Veteran’s July 2015 hearing testimony, lay statements of record of January and December 2017, and medical literature submitted by the Veteran on Hepatitis C.” The Veteran was provided a medical opinion in September 2019. The examiner’s evidence comments note that the Veteran submitted a statement in which he reported that he was injected with an unsanitary needle air gun that contained blood and tissue from other airmen and that hepatitis C was not a known diagnosis in April 1974. The examiner opined that the Veteran’s hepatitis C was less likely than not incurred in or caused by an in-service, injury, event, or illness. As rationale, the examiner provided the following: The veteran did not have any signs or symptoms of hepatitis on enlistment. He was diagnosed with hepatitis B while in service in 1974. Hepatitis C was not a diagnosis in the medical community at that time. He did not have any symptoms of hepatitis on separation but there are not always symptoms associated with hepatitis C. However if he had contracted hepatitis C at the same time as B, he would have some type of lesion develop on his liver after 43 years. His Ultrasound dated 9/11/2012 did not show any liver lesions. He also has many other risk factors for hepatitis C such as IV drug use, intranasal cocaine use and polysubstance abuse. Neither the examiner’s evidence comments nor the rationale for her medical opinion reflect consideration of the medical literature submitted by the Veteran on hepatitis C. In failing to provide a medical opinion that reflected consideration of the medical literature submitted by the Veteran, the RO has not complied with the Board’s September 2019 remand directive. Stegall v. West, 11 Vet. App. 268, 271 (1998); D’Aries v. Peake, 22 Vet. App. 97, 105 (2008) (holding that there must be substantial compliance with the terms of a Board remand). Thus, the Board finds that a remand is warranted for an addendum medical opinion. By this remand, the Board makes no determination, express or implied, concerning the credibility of any lay statements on file. The matter is REMANDED for the following action: 1. Obtain an addendum medical opinion from the examiner who provided the September 2019 opinion to provide an addendum opinion for the Veteran’s service connection claim for hepatitis C. If the September 2019 examiner is not available, the request may be referred to another, equally qualified medical professional, who must independently review the claims folder in its entirety. A note that it was reviewed should be included in the opinion. If the examiner determines that additional examination of the Veteran is necessary to provide a reliable opinion, such examination should be scheduled. 2. After reviewing the claims file, the examiner is to provide an opinion as to whether it is at least as likely as not (a 50 percent or greater probability) that the claimed hepatitis C had an onset in service or is directly linked to the Veteran’s active service. The examination opinion must reflect consideration of the Veteran’s July 2015 hearing testimony, lay statements of record of January and December 2017, and medical literature submitted by the Veteran on hepatitis C. The examiner is advised that the Veteran is competent to report his symptoms and history, and such reports must be specifically acknowledged and considered in formulating any opinions. The examiner must set forth a complete rationale for all findings and conclusions. 3. Thereafter, and after undertaking any additional development deemed necessary, readjudicate the issue on appeal. If the benefits sought on appeal remain denied, the Veteran and his representative should be provided with a Supplemental Statement of the Case and be afforded reasonable opportunity to respond. The case should then be returned to the Board for further appellate review, if otherwise in order. The Veteran has the right to submit additional evidence and argument on the matter the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). This claim must be afforded expeditious treatment. The law requires that all claims that are remanded by the Board of Veterans’ Appeals or by the United States Court of Appeals for Veterans Claims for additional development or other appropriate action must be handled in an expeditious manner. See 38 U.S.C. § §§ 5109B, 7112. KELLI A. KORDICH Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Moore, Associate Counsel 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.