Citation Nr: 21070742 Decision Date: 11/24/21 Archive Date: 11/24/21 DOCKET NO. 14-26 256 DATE: November 24, 2021 ORDER Entitlement to service connection for a heart disability secondary to service-connected hepatitis C is granted. FINDING OF FACT The Veteran's heart disability is secondary to service-connected hepatitis C. CONCLUSION OF LAW The criteria for service connection for a heart disability have been met. See 38 U.S.C. § 1110; 38 C.F.R. § 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from September 1971 to June 1973. This matter comes to the Board of Veterans' Appeals (Board) from an October 2013 rating decision which denied entitlement to service connection for hepatitis C and for a heart disability secondary to hepatitis C. In February 2017, the Veteran testified at a hearing before the undersigned Veterans Law Judge. A transcript of the hearing is of record. In March 2018, the Board remanded both claims for further development. In March 2020, the Board denied service connection for hepatitis C and for a heart disability secondary to hepatitis C. In November 2020, the United States Court of Appeals for Veterans Claims granted the parties' joint motion for partial remand and vacated the March 2020 Board decision. In March 2021, the Board remanded both claims for further development. A June 2021 rating decision granted service connection for hepatitis C. Entitlement to service connection for a heart disability secondary to service-connected hepatitis C is granted. The Veteran asserts that service connection is warranted for a heart disability secondary to service-connected hepatitis C. Service connection will be granted on a secondary basis for a current disability that is the result of a service-connected disability. See 38 C.F.R. § 3.310. Service connection will be granted when the evidence supports the claim or is in relative equipoise. See Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990). A September 1971 entrance examination documented no heart abnormalities. Accordingly, the Board finds that the Veteran was in sound condition at entry to service. At a July 2013 VA examination, Dr. D. T. diagnosed the Veteran with hepatitis C, ventricular arrhythmia, heart block, and valvular heart disease. Dr. T. opined that it was as likely as not that the Veteran's heart disability was secondary to hepatitis C based on studies from Japan showing a large number of individuals with hepatitis also having cardiac conditions. The abstract of one study stated that arrythmias were the most frequent cardiac abnormality found in individuals with hepatitis C and that hepatitis C was an important cause of a variety of otherwise unexplained heart diseases. At an April 2021 VA examination, Dr. R.B. diagnosed the Veteran with supraventricular arrhythmia and premature ventricular contractions. Dr. B. opined that it was less likely than not that the Veteran's heart disability was secondary to hepatitis C because the medical literature did not implicate hepatitis C as a cause of this cardiac condition and none of the Veteran's cardiologists or providers referred to hepatitis C as a primary cause, contributing factor, or risk factor. It is undisputed that the Veteran has a current heart disability and is service connected for hepatitis C. Therefore, the relevant issue is whether this current heart disability is secondary to service-connected hepatitis C. The Board finds that the Veteran's current heart disability is secondary to service-connected hepatitis C. The Board accords probative weight to Dr. T.'s opinion. Dr. T. cited studies that, in his medical judgment, were sufficient to show that the Veteran's heart disability was secondary to hepatitis C. Indeed, one abstract stated that arrythmias were the most frequent cardiac abnormality found in individuals with hepatitis C and that hepatitis C was an important cause of a variety of otherwise unexplained heart diseases. The Board accords limited probative weight to Dr. B.'s opinion. While Dr. B. mentioned various pieces of evidence in his medical records review, he never mentioned Dr. T.'s opinion. Thus, Dr. B. did not consider the studies cited by Dr. T. in stating that medical literature did not implicate hepatitis C as a cause of this cardiac condition. Moreover, a review of the medical records shows that the Veteran's cardiologists and providers have not provided a clear opinion on the etiology of the Veteran's heart disability, and there is no indication that they excluded hepatitis C as a cause. Thus, Dr. B. improperly placed too much emphasis on the absence of hepatitis C being identified as a cause of the Veteran's heart disability. In sum, when weighing the conflicting evidence, the Board finds that the probative evidence of record supports the Veteran's claim. See Gilbert, 1 Vet. App. at 55. Accordingly, the Board finds that service connection is warranted for a heart disability secondary to service-connected hepatitis C. See 38 C.F.R. § 3.310. K. Parakkal Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. Ormson, 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.