Citation Nr: 21000710 Decision Date: 01/06/21 Archive Date: 01/06/21 DOCKET NO. 10-08 141 DATE: January 6, 2021 REMANDED Entitlement to service connection for hepatitis C is remanded. Entitlement to service connection for right foot fungus is remanded. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the Marine Corps from June 1966 to April 1969 and from August 1973 to January 1974. He served in the Army National Guard from August 1987 to October 1989, with periods of active duty for training (ACDUTRA) from July 23, 1988, to August 6, 1988, and June 10, 1989, to June 24, 1989. The Veteran also served in the Army Reserve from October 1989 to January 2008, with periods of active duty from January 1997 to January 1998, January 2006 to May 2006, and June 9, 2006, to June 30, 2006. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a rating decision issued in May 2009 by a Department of Veterans Affairs (VA) Regional Office. In May 2017, the Veteran testified at a Board hearing before a Veterans Law Judge. A transcript of the hearing is associated with the record. In October 2017 and November 2019, the Board remanded the issues on appeal, as well as a claim for service connection for bilateral hearing loss, for additional development. While on remand, the Agency of Original Jurisdiction (AOJ) granted service connection for bilateral hearing loss in an August 2020 rating decision. As such is a full grant of the benefits sought in connection with such issue, it is no longer on appeal. The remaining issues now return for further appellate review. REASONS FOR REMAND 1. Entitlement to service connection for hepatitis C. In the November 2019 remand, the Board found that, as a December 2018 VA examiner indicated that she could not offer an opinion as to the etiology of the Veteran’s hepatitis C without resorting to mere speculation, a remand was necessary in order to obtain an addendum opinion from a different VA examiner. However, an addendum opinion was obtained in December 2019 from the same December 2018 VA examiner who essentially reiterated her prior statement that she could not offer an opinion as to the etiology of the Veteran’s hepatitis C without resorting to mere speculation. Thus, a remand is necessary in order to ensure compliance with the November 2019 remand directives and to obtain an opinion from a different VA examiner. Stegall v. West, 11 Vet. App. 268, 271 (1998). 2. Entitlement to service connection for right foot fungus. In December 2018, a VA examiner opined that the Veteran’s right foot fungus was not at least as likely as not related to his military service based on the fact that his service treatment records (STRs) were negative for onychomycosis of the right foot. However, the Veteran’s STRs contain several references to right foot fungus, to include an April 1997 diagnosis of tinea cruris, a July 1997 diagnosis of right hallux (great toe) onychomycosis, and an April 2006 diagnosis of right foot onychomycosis. Further, the December 2018 examiner did not consider the Veteran’s report that his right foot and nail fungus began in service and has continued to the present. Thus, an addendum opinion was obtained in December 2019. At such time, the VA examiner again offered a negative nexus opinion. As rationale, she stated that a July 1979 STR reflecting treatment for fungal dermatitis and a July 1997 STR showing treatment for onychomycosis do not specify which foot. However, upon close inspection of the July 1997 record it would appear that such is specific to the right foot. Further, the examiner did not consider the Veteran’s active duty STRs from his service in the Army Reserve, which include the April 2006 diagnosis of right foot onychomycosis, or address the Veteran’s statements that his right foot and nail fungus began in service and has continued to the present. Thus, a remand is necessary in order to obtain another addendum opinion addressing such matters. The matters are REMANDED for the following action: 1. Forward the record to an appropriate VA examiner other than the December 2018/2019 examiner to obtain an addendum opinion addressing the etiology of the Veteran’s hepatitis C. Following a review of the record, the examiner should offer an opinion as to whether the Veteran’s hepatitis C is at least as likely as not (i.e., a 50 percent or greater probability) related to military service, to include his reports of exposure to blood and sexual risk factors in Vietnam. The examiner is advised that the sole basis of a negative nexus opinion may not be the fact that the Veteran’s STRs are negative for complaints, treatment, or a diagnosis of hepatitis C. Thus, the examiner should consider and address the Veteran’s statements regarding the onset and continuity of symptomatology. A rationale for any opinion offered should be provided and, if possible, include a discussion as to factors aside from the absence of a diagnosis of hepatitis C in service. 2. Forward the record to an appropriate VA examiner so as to obtain an addendum opinion addressing the etiology of the Veteran’s right foot fungus. Following a review of the record, the examiner should offer an opinion as to whether the right foot fungus diagnosed proximate to the Veteran’s January 2008 claim at least as likely as not (i.e., a 50 percent or greater probability) had its onset in, or is otherwise related to, his military service. In offering such opinion, the examiner should consider an April 1997 STR showing a diagnosis of tinea cruris, a July 1997 STR reflecting a diagnosis of right hallux (great toe) onychomycosis, and an April 2006 STR noting a diagnosis of right foot onychomycosis. The examiner is advised that the sole basis of a negative nexus opinion may not be the fact that the Veteran’s service treatment records are negative for complaints, treatment, or a diagnosis referable to right foot fungus. Thus, the examiner should consider and address the Veteran’s statements regarding the onset and continuity of symptomatology. A rationale for any opinion offered should be provided. A. JAEGER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. M. Kelly, 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.