Citation Nr: 20025390 Decision Date: 04/14/20 Archive Date: 04/14/20 DOCKET NO. 18-08 161 DATE: April 14, 2020 REMANDED 1. Service connection for diabetes mellitus, as secondary to service-connected hepatitis C, is remanded. 2. Service connection for a gastrointestinal disability, including bile gastritis and gastric erosions, as secondary to service-connected hepatitis C, is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1972 to June 1974. The Veteran declined a Board of Veterans’ Appeals (Board) hearing on the February 2018 VA Form 9, Appeal to the Board. These issues are on appeal from a June 2016 rating decision that denied service connection for diabetes mellitus and a gastrointestinal disability. As the Veteran specifically claimed service connection for both diabetes mellitus and a gastrointestinal disability as secondary to hepatitis C, the Board is addressing this theory of service connection. See May 2016 Application for Disability Compensation. 1. Service Connection for Diabetes Mellitus, as Secondary to Service-Connected Hepatitis C, is Remanded The Veteran claims that his current diabetes mellitus is caused or aggravated by the service-connected hepatitis C. A June 2018 VA examiner opined that hepatitis C does not cause diabetes mellitus; however, the VA examiner did not address whether the diabetes mellitus was aggravated by (worsened in severity beyond a natural progression by) the service-connected hepatitis C. To address this aggravation theory of service connection, the claim is remanded for an addendum VA medical opinion. 2. Service Connection for a Gastrointestinal Disability is Remanded The Veteran claims that his current gastrointestinal disability is caused or aggravated by the service-connected hepatitis C. The Veteran has a current diagnosis of bile gastritis and gastric erosions. The Veteran was hospitalized for three days in October 2012 with gastrointestinal symptoms. A February 2016 VA examiner wrote that the in-patient physician who treated the Veteran during that hospitalization did not indicate that hepatitis C played any role in the diagnosis or symptoms during that particular hospitalization. The VA examiner opined that it was less likely than not that the gastrointestinal symptoms were due to or the result of the hepatitis C; however, the VA examiner did not address whether the bile gastritis and gastric erosions were aggravated by the service-connected hepatitis C. To address this aggravation theory of entitlement to service connection, the claim is remanded for an addendum VA medical opinion. The matters are REMANDED for the following action: 1. Obtain a VA addendum opinion regarding the questions below. The relevant documents in the record should be made available to the examiner, who should indicate on the examination report that he/she has reviewed the documents. Examination of the Veteran is not required unless the examiner determines that an examination is necessary to provide a reliable opinion. If an examination is required, a detailed history of relevant symptoms should be obtained from the Veteran. A rationale for all opinions and a discussion of the facts and medical principles involved should be provided. The VA examiner should offer the following opinions: A) Is it at least as likely as not (50 percent or greater probability) that the currently diagnosed diabetes mellitus was aggravated by (worsened in severity beyond a natural progression by) the service-connected hepatitis C? B) Is it at least as likely as not (50 percent or greater probability) that the currently diagnosed gastrointestinal disability, to include bile gastritis and gastric erosions, are caused by the service-connected hepatitis C? C) Is it at least as likely as not (50 percent or greater probability) that the currently diagnosed gastrointestinal disability, to include bile gastritis and gastric erosions, are aggravated by (worsened in severity beyond a natural progression by) the service-connected hepatitis C? 2. The Agency of Original Jurisdiction (AOJ) should then readjudicate the issues on appeal in light of all pertinent evidence. J. PARKER Veterans Law Judge Board of Veterans’ Appeals Department of Veterans Affairs A. Caruso, Attorney for the Board 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.