Citation Nr: 21000324 Decision Date: 01/05/21 Archive Date: 01/05/21 DOCKET NO. 14-24 138A DATE: January 5, 2021 REMANDED Entitlement to an evaluation in excess of 10 percent prior to October 26, 2010, in excess of 20 percent from October 26, 2010 to September 19, 2018, and a compensable evaluation thereafter, to include the propriety of the rating reduction, is remanded. Entitlement to a total disability rating based on individual unemployability due to service-connected disabilities (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1974 to August 1977. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a March 2011 rating decision by the Department of Veterans Affairs (VA). This case was remanded in January 2018 for further development. In October 2017, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge; a transcript of that hearing is of record. Since the last Board remand, the Agency of Original Jurisdiction (AOJ) reduced the rating for the Veteran’s hepatitis C from 20 percent to zero percent. See February 2020 rating decision. The Board has recharacterized the issue accordingly. The propriety of the rating reduction will be addressed in a future Board decision, if otherwise applicable. 1. Entitlement to an evaluation in excess of 10 percent prior to October 26, 2010, in excess of 20 percent from October 26, 2010 to September 19, 2018, and a compensable evaluation thereafter, to include the propriety of the rating reduction. The appeal period for this matter is extensive. The Veteran is service-connected for two disabilities, hepatitis C and cirrhosis, that may have overlapping symptomatology. Moreover, the effective date for the grant of service connection for cirrhosis, September 20, 2018, is late in the appeal period. The Board remanded this matter, in part, to determine when the Veteran’s hepatitis C went into remission and whether it was possible to distinguish the symptoms of hepatitis C and cirrhosis. See January 2018 Board remand. While the AOJ obtained several opinions, including an August 2018 VA examiner’s opinion that the Veteran’s hepatitis C does not cause any symptoms because it is in remission, there is no answer to the question of when the Veteran’s hepatitis C went into remission, nor any clarity about the symptoms of the two disabilities. Thus, the Board is unable to determine whether to attribute the Veteran’s symptoms early in the appeal period to hepatitis C or cirrhosis and remand is necessary for a medical opinion. See Stegall v. West, 11 Vet. App. 268, 271 (1998). 2. Entitlement to TDIU is remanded. The matter of entitlement to TDIU is inextricably intertwined with the Veteran’s other remanded issue; accordingly, it must be remanded as well. The matters are REMANDED for the following action: 1. The AOJ should obtain copies of VA treatment records from October 2020 to the present. 2. After the above development is completed, the AOJ should arrange for a retrospective VA medical opinion, with examination or telehealth interview of the Veteran only if deemed necessary by a medical professional, to determine the nature and severity of the Veteran’s hepatitis C during the appeal period. The examiner should review the claim file (including this remand) and note such review was conducted. Based on review of the record, the examiner should provide an opinion with detailed rationale that responds to the following: (a.) When did the Veteran’s hepatitis C go into remission? The examiner must discuss February 2011 private treatment records discussing a relapse. (b.) Has the Veteran had any Hepatitis C symptoms from the date of remission? Please explain why or why not. If so, please describe the symptoms attributable to Hepatitis C with the applicable dates of any changes. (c.) What symptoms did the Veteran experience prior to the remission of Hepatitis C that were caused only by hepatitis C? (d.) If the Veteran’s hepatitis C and cirrhosis of the liver symptoms cannot be distinguished, please explain why and any applicable dates of changes during the appeal period (since June 2009). 3. If upon completion of the above action the issues remain denied, the case should be returned to the Board after compliance with appellate procedures. E. I. VELEZ Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Sandler, 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.