Citation Nr: A20005444 Decision Date: 04/14/20 Archive Date: 04/14/20 DOCKET NO. 190828-27459 DATE: April 14, 2020 ORDER Entitlement to service connection for hepatitis C is denied. FINDING OF FACT The evidence of record does not establish that the Veteran’s hepatitis C is related to his active service. CONCLUSION OF LAW The criteria for service connection for hepatitis C have not been met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107(b); 38 C.F.R. §§ 3.102, 3.159, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served in the United States Navy from November1966 to October 1968, and from January 1991 to April 1991. These matters are before the Board of Veterans’ Appeals (Board) on appeal from a July 2019 Appeals Modernization Act (AMA) rating decision that considered the evidence of record on that date. The Veteran timely appealed this decision to the Board by requesting the AMA Direct Review lane for a reevaluation of the evidence considered by the Agency of Original Jurisdiction (AOJ). As this appeal comes to the Board through the Direct Review lane of AMA, the resulting Board decision is based upon the evidence of record at the time of the prior decision. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110. Generally, the evidence must show: (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 or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004); Caluza v. Brown, 7 Vet. App. 498, 505 (1995). For the showing of chronic disease in service, there is required a combination of manifestations sufficient to identify the disease entity and sufficient observation to establish chronicity at the time, as distinguished from merely isolated findings or a diagnosis including the word “chronic.” Continuity of symptoms after discharge is required where the condition noted during service is not, in fact, shown to be chronic or where the diagnosis of chronicity may be legitimately questioned. 38 C.F.R. § 3.303(b); Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). Regulations also provide that service connection may be granted for a disability diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disability is due to disease or injury which was incurred in or aggravated by service. 38 C.F.R. § 3.303(d). In the current appeal, the Veteran contends that his hepatitis C is related to his active service. In resolving reasonable doubt in favor of the Veteran, the Board finds that the criteria for service connection for hepatitis C have not been met. Department of Veterans’ Affairs (VA) medical records show that the Veteran was diagnosed with hepatitis C in October 2005. 38 C.F.R. § 3.385. McClain v. Nicholson, 21 Vet. App. 319 (2007). Indeed, in the appealed July 2019 rating decision, the AOJ made a favorable finding that the Veteran had a diagnosis of hepatitis C. The Board is bound by these favorable findings. 38 C.F.R. § 3.104(c). Given the favorable findings of the AOJ, the current disability prong of the claim for service connection for hepatitis C has been met. Accordingly, the issue on appeal turns on whether there is a relevant in-service event and a link between the Veteran’s current hepatitis C and his service. The Veteran contends that his hepatitis C is related to his service. VA medical records from August 2005 indicate that the Veteran had a risk factor for hepatitis C stemming from a blood transfusion he was given prior to 1992. The VA medical records from October 2005 that diagnose the Veteran with hepatitis C indicate that the route of the infection is a transfusion from 1982. This blood transfusion occurred between the Veteran’s two tours of active service and is unrelated to his service. It should be noted, however, that VA medical records from August 2016 state that there is no clear route of transmission. Even if reasonable doubt is resolved in the Veteran’s favor, there is no risk factor identified that could be specifically related to his active service. The Board acknowledges the Veteran’s contention that his hepatitis C is related to being exposed to tuberculosis while in the Navy and that he was informed that he should not give blood due to his exposure. See October 2005 VA medical records. Service treatment records (STRs) show that medical professionals noted that the Veteran was exposed to tuberculosis while in the Navy but also confirm that test results for tuberculosis were negative. Additional STRs include a dental questionnaire in which he indicated that he did, and did not, have tuberculosis; that he did not have hepatitis; and that he was never told that he should not donate blood. Even giving the Veteran the benefit of the doubt that he was exposed to tuberculosis in-service, there is no competent medical evidence supporting his assertion that his exposure to tuberculosis resulted in a diagnosis of hepatitis C. While the record does contain favorable evidence that the Veteran has a current diagnosis of hepatitis C, the record does not reflect that there was an in-service event—or a link between an in-service event and the currently diagnosed (CONTINUED ON NEXT PAGE) hepatitis C. As such, in view of the totality of the evidence, the Board finds that the evidence of record does not support a finding of service connection for hepatitis C. Accordingly, the Veteran’s claim for service connection for hepatitis C is denied. THERESA M. CATINO Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Edward G. Lent 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.