Citation Nr: 21066212 Decision Date: 10/29/21 Archive Date: 10/29/21 DOCKET NO. 17-67 418 DATE: October 29, 2021 ORDER The request to reopen the claim of entitlement to service connection for hepatitis C is granted. REMANDED Entitlement to service connection for hepatitis C is remanded. FINDING OF FACT 1. An April 2003 rating decision denied service connection for hepatitis C; the Veteran perfected his appeal of the decision. 2. In July 2006, prior to the promulgation of a decision in the appeal, the Board received notification from the Veteran that he wished to withdraw his claim. 3. The Board issued a decision in August 2008 dismissing the Veteran's claim for service connection for hepatitis C based on his withdrawal. 4. The April 2003 rating decision became final when the Veteran withdrew his appeal. 5. Since the April 2003 rating decision, unadjudicated new and material evidence, including medical opinions dated in November 2004 and January 2005, as well as December 2017 medical opinions, has been received that raises a reasonable possibility of substantiating the Veteran's claim. CONCLUSIONS OF LAW 1. The April 2003 rating decision is final. 38 U.S.C. § 7105 (c) (2018); 38 C.F.R. §§ 20.202, 20.204, 20.302, 20.1103 (2021). 2. Evidence received since the April 2003 rating decision is new and material and the claim for service connection for hepatitis C is reopened. 38 U.S.C. §§ 5103A, 5107, 5108 (2018); 38 C.F.R. § 3.156 (a) (2021). REASONS AND BASES FOR FINDING AND CONCLUSIONS The Veteran served on active duty from September 1971 to September 1975. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a June 2017 decision. The Veteran presented testimony before the Board in October 2021. For the reasons outlined above, the request to reopen the claim for service connection for hepatitis C is reopened. REASONS FOR REMAND The Veteran contends that his hepatitis C is the result of exposure to blood pathogens while performing duties, without the proper protection, as a small boat search and rescue crewman. He alternatively contends his hepatitis C was contracted from the use of jet injectors when receiving vaccinations during service. In support of his appeal, the Veteran submitted November 2004 and January 2005 opinions indicating that given the severe nature of the Veteran's end stage liver disease leading to liver transplant in 2002, it was "suspected" that he acquired hepatitis C approximately 25 to 30 years prior. The Veteran submitted additional medical opinions in December 2017, which indicated that the Veteran "may" have contracted hepatitis C from a jet injector used for vaccines when he was in the military. These opinions are equivocal and inadequate for appellate review. Therefore, in light of the Veteran's contentions and the new evidence of record, the Board finds that remand is required for an opinion on whether the Veteran's hepatitis C was incurred during service. The matter is REMANDED for the following action: 1. Obtain an opinion from the appropriate provider regarding the etiology of the Veteran's hepatitis C. The examiner must review the claim file, which must be documented in the report. The examiner is asked to provide a response to the following: is hepatitis C at least as likely as not related to the Veteran's military service, including his contentions that he was exposed to blood pathogens while performing duties, without proper protection, as a small boat search and rescue crewman and/or from receiving jet injector vaccinations during service. In providing this opinion, the examiner must specifically address the November 2004 and January 2005 opinions that given the severe nature of the Veteran's end stage liver disease leading to liver transplant in 2002, it was suspected that he acquired hepatitis C approximately 25 to 30 years prior. The examiner must also address the December 2017 opinions that hepatitis C may have been contracted due to the use of jet injector vaccinations in service. If there is any medical reason to accept or reject the proposition that (a) hepatitis C was contracted in service and laid dormant before manifesting symptoms and/or (b) hepatitis C was contracted due to use of jet injector vaccinations in service, and thereafter caused end stage liver disease requiring multiple liver transplants, this should be noted. Stated another way, is the contention that hepatitis C can remain dormant for an extended period of time, with subsequent manifestations of symptoms and diagnosis, align with how hepatitis C is known to develop or are such contentions generally inconsistent with medical knowledge or implausible? Provide the complete rationale to support the opinions expressed. 2. If upon completion of the above action the claim remains denied, the matter must be returned to the Board after compliance with appellate procedures E. I. VELEZ Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K. L. Wallin, 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.