Citation Nr: 21072182 Decision Date: 12/02/21 Archive Date: 12/02/21 DOCKET NO. 15-32 157 DATE: December 2, 2021 REMANDED Entitlement to service connection for hepatitis C is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1977 to December 1979. The matter comes before the Board of Veterans' Appeals (Board) on appeal from a rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). This matter was previously before the Board in April 2021, at which time it was remanded for development. It returns to the Board for appellate review. 1. Entitlement to service connection for hepatitis C is remanded. While the Board regrets the additional delay, a remand of this matter is necessary in order to obtain an adequate opinion as to the etiology of the Veteran's hepatitis C, and specifically to determine whether the condition, which the evidence establishes clearly and unmistakably preexisted service, was clearly and unmistakably not aggravated by service. A VA examiner who considered the question in a September 2020 opinion indicated that it could not be said that the condition was clearly and unmistakably not aggravated by service, but did not furnish an adequate rationale, indicating only that there was insufficient evidence to opine whether the condition was aggravated or not. A VA examiner who reviewed the record in October 2021 opined that there was no aggravation, but did not express correctly the standard to be applied to the question, indicating that, "there is insufficient evidence to establish, with greater than 50% probability, that this [Veteran's] hepatitis C, which clearly and unmistakably existed prior to service, was permanently aggravated beyond its natural progression by military service." The Board notes that the standard to be applied is whether the condition was clearly and unmistakably not aggravated by service. On remand, the file should be retuned to the VA examiner who furnished the October 2021 opinion for consideration in light of the correct evidentiary standard. The matters are REMANDED for the following action: 1. Return the claim file to the VA examiner who furnished the October 2021 medical opinion, or to another qualified examiner if necessary. The examiner is requested to state whether the Veteran's hepatitis C clearly and unmistakably preexisted entry into active duty service, and if so, whether hepatitis C was clearly and unmistakably not aggravated beyond its normal progression by active duty service. If the examiner finds that the Veteran's hepatitis C did not clearly and unmistakably preexist service or if the examiner finds that the Veteran's preexisting hepatitis C was aggravated by service, the examiner should opine as to whether it is at least as likely as not that the Veteran's current hepatitis C is related to service or the aggravation of the hepatitis C in service. All opinions expressed should be accompanied by a thorough rationale. GAYLE STROMMEN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Z. Sahraie, 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.