Citation Nr: 21066065 Decision Date: 10/28/21 Archive Date: 10/28/21 DOCKET NO. 16-31 239 DATE: October 28, 2021 ORDER Entitlement to service connection for hepatitis C is granted. Entitlement to service connection for an acquired psychiatric disorder, diagnosed as depression, is granted. FINDINGS OF FACT 1. The Veteran's hepatitis C is etiologically related to service. 2. The Veteran's acquired psychiatric disorder, diagnosed as depression, is caused by his hepatitis C. CONCLUSIONS OF LAW 1. The criteria to establish service connection for hepatitis C have been met. 38 U.S.C. §§ 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria to establish service connection for an acquired psychiatric disorder, diagnosed as depression, have been met. 38 U.S.C. §§ 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from November 1983 to April 1985. The Veteran appealed a May 2015 rating decision by the Agency of Original Jurisdiction (AOJ). In October 2018 and April 2021, the Board remanded the Veteran's claims to the AOJ for further action consistent with the Board's remand directives. The claims are back before the Board for further appellate proceedings. The Board finds there has been substantial compliance with its remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998). A veteran is entitled to Department of Veteran Affairs (VA) disability compensation if there is a disability resulting from personal injury suffered or disease contracted in the line of duty in active service, or for aggravation of a preexisting injury suffered or disease contracted in the line of duty in active service. 38 U.S.C. § 1131. Generally, to establish a right to compensation for a present disability, a veteran must show: (1) a present disability; (2) an 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, the so-called "nexus" requirement. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may be granted for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that a disease was incurred in service. 38 C.F.R. § 3.303(d). Under section 3.310(a) of VA regulations, service connection may be established on a secondary basis for a disability which is proximately due to or the result of service-connected disease or injury. 38 C.F.R. § 3.310(a). Establishing service connection on a secondary basis requires evidence sufficient to show: (1) a current disability; (2) a service-connected disability; and (3) a nexus between the current disability and the service-connected disability. See Wallin v. West, 11 Vet. App. 509, 512 (1988). As to the third Wallin element, the current disability may be either (a) proximately caused by or (b) proximately aggravated by a service-connected disability. Allen v. Brown, 7 Vet. App. 439, 448 (1995) (en banc). 1. Hepatitis C The Veteran is diagnosed with hepatitis C. See July 2021 examination report. The Veteran contends that he contracted hepatitis C due to in-service injections. See January 2006 VA Form 21-526. As to nexus, Dr. T.B. submitted two separate opinions in May and October 2010 noting that it is plausible that the Veteran contracted hepatitis C from air gun injection immunizations or sexual contacts during service. Dr. T.B. also noted that the Veteran denied other potential risk factors for Hepatitis C such as IV drug use and blood transfusions. The Board finds Dr. T.B.'s opinions probative. The May 2010 opinion noted that VA has acknowledged there is a possible risk factor for acquiring hepatitis C from air gun injectors. The Veteran also noted that he suffered from symptoms of hepatitis C during service, to include fatigue, nausea, vomiting, and abdominal pain. The Veteran is competent to attest to the existence of such symptoms during service. The Board finds the Veteran's assertions credible. The Veteran submitted an article in July 2006 noting that the blood test to detect hepatitis C was not developed until the 1990s. Overall, the Veteran entered service without hepatitis C symptoms. See August 1983 service treatment records (STRs). The Veteran would receive various immunizations during service and also would have various sexual contacts during service as well. A medical professional has found the Veteran's hepatitis C linked to his in-service air gun immunizations and sexual contacts. A VA examiner also noted that VA has recognized air gun injectors as a possible risk factor for acquiring hepatitis C. The Board finds that the evidence is at least in equipoise as to whether the Veteran's hepatitis C had its onset in service. Resolving reasonable doubt in the Veteran's favor, the Board finds that the Veteran's hepatitis C originated during service. Accordingly, service connection for hepatitis C is warranted. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. 2. Psychiatric Disorder The Veteran is diagnosed with depression. See November 2019 and 2020 treatment records. Pursuant to this decision, the Veteran is service connected for hepatitis C. As to nexus, Dr. R.D.'s September 2009 opinion noted the Veteran underwent treatment for his hepatitis and that he continues to feel the side effects of the medication including depression, emotional liability, and anger outbursts. This demonstrates that the Veteran's treatment and medication for hepatitis C contributes to the Veteran's psychiatric symptoms, to include depression. The Board finds Dr. R.D.'s opinion probative. There is not a negative nexus opinion to the contrary. The Board finds that there is persuasive evidence of record establishing a link between the Veteran's depression and his service-connected hepatitis C. Accordingly, the Board finds that a grant of service connection is warranted for an acquired psychiatric disorder, diagnosed as depression. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. DONNIE R. HACHEY Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Zheng, 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.