Citation Nr: 20029192 Decision Date: 04/27/20 Archive Date: 04/27/20 DOCKET NO. 17-34 213 DATE: April 27, 2020 REMANDED The issue of service connection for Hepatitis C is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Navy from August 1971 to December 1977. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2016 rating decision of the Seattle, Washington Regional Office (RO). In February 2020, the Veteran was afforded a videoconference hearing before the undersigned Veterans Law Judge (VLJ). During the hearing, the VLJ engaged in a colloquy with the Veteran toward substantiation of the claim. Bryant v. Shinseki, 23 Vet. App. 488, 496-97 (2010). A hearing transcript is in the record. Hepatitis C The matter is remanded for the following action: 1. BACKGROUND FOR THE RO ADJUDICATOR The evidence reflects a diagnosis of Hepatitis C and the Veteran contends that his Hepatitis C was caused by having been inoculated with an air-gun during service. A VA examination is warranted. 2. Schedule the Veteran for a VA examination to obtain an opinion as to the nature and etiology of his Hepatitis C. All relevant medical and non-medical records must be made available to the examiner for review of pertinent documents. The examination report should specifically state that such a review was conducted. The examiner must provide a comprehensive explanation for all opinions provided. The examiner must respond to the question of whether the Veteran’s Hepatitis C caused by having been inoculated with an air-gun during service? Although the examiner must review the VBMS file, his or her attention is drawn to the following: • In the November 1972 service medical history report, the Veteran answered in the affirmative to the question of whether he had been a patient in any type of hospital. The Veteran reported having experienced “blood poisoning” in 1965 and mononucleosis in 1970. • In the November 1972 service medical examination report, laboratory testing revealed normal findings and no abnormalities pertaining to Hepatitis C were noted. • In the October 1975 pre-separation medical examination report, laboratory testing revealed normal findings and no abnormalities pertaining to Hepatitis C were noted. • A military personnel record titled “Immunization Record” reflects that the Veteran received two vaccinations against smallpox, three triple typhoid vaccinations, two tetanus toxoid and diptheria toxoid combination vaccinations and one yellow fever vaccination. • A military personnel record titled “Other Immunizations” reflects that the Veteran received an influenza vaccination, an oral polio trivalent #1 vaccination, an oral polio trivalent #2 vaccination and three illegible vaccinations. • The Veteran was discharged from active duty in December 1977. • A December 2010 private treatment record reflects a diagnosis of Hepatitis C with stage II disease. • In a May 2019 letter, the Veteran’s private provider opined, without supporting rationale, that the Veteran’s Hepatitis C was “directly service-connected.” • In the February 2020 Board hearing, the Veteran testified to having experienced no complications of Hepatitis C prior to his diagnosis. • In a March 2020 letter, the Veteran’s private provider opined that the Veteran’s Hepatitis C was caused by the in-service immunizations via an air-syringe gun because the air gun was not disinfected between soldiers, the Veteran had no other risk factors for Hepatitis C, and the Veteran was asymptomatic for approximately 30 years until he was tested for Hepatitis C due to elevated liver enzymes. However, the private provider did not consider the Veteran’s in-service report of having experienced blood poisoning in 1965 and mononucleosis in 1970. The private provider further did not specify the basis of his observation that the air guns were not disinfected between uses, other than his observation of having treated other veterans. 3. Readjudicate the issue on appeal. If the benefit on appeal remains denied, the Veteran should be provided a supplemental statement of the case (SSOC). An appropriate period should be allowed for response before the case is returned to the Board. Vito A. Clementi Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board B. Cohen, 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.