Citation Nr: 21072816 Decision Date: 12/06/21 Archive Date: 12/06/21 DOCKET NO. 14-26 110 DATE: December 6, 2021 REMANDED 1. Service connection for hepatitis C. 2. Service connection for hypertension. REASONS FOR REMAND The Veteran served on active duty from September 1981 to October 1987. The case is on appeal from an October 2013 rating decision. In October 2016, the Veteran testified at a Board hearing. In June 2020, VA informed the Veteran that the Veterans Law Judge (VLJ) retired and that to notify VA within 30 days whether she wanted a new hearing. Later in June 2020, the Veteran submitted a correspondence indicating that she does not want another Board hearing. In a July 2021 decision, the Board remanded the claims on appeal for further development. 1. Service connection for hepatitis C. Pursuant to the Board's July 2021 remand, an addendum opinion for this claim was obtained in August 2021. The examiner noted in the rationale that he was unable to confirm a current diagnosis with the current available records because the Veteran did have hepatitis C, but that it has now resolved with no residuals. The Board finds that a remand is necessary for another addendum opinion. In this regard, the examiner made an incorrect statement of fact related to the Veteran's manner of the drug use related to her posttraumatic stress disorder (PTSD), major depressive disorder, and cognitive disorder. Thus, the opinion offered is inadequate in regard to the issue of whether the Veteran's hepatitis C is secondary to her residuals of traumatic brain injury (TBI). See Barr v. Nicholson, 21 Vet. App. 303, 312 (2007) (holding that when VA undertakes to provide a VA examination or obtain a VA opinion, it must ensure that the examination or opinion is adequate). 2. Service connection for hypertension. Pursuant to the Board's July 2021 remand, the Veteran was provided an addendum opinion. However, since the VA examination, the Veteran's representative has submitted additional medical literature to support the assertion that the Veteran's hypertension is related to her service-connected disabilities. Therefore, the Board remands this matter for an addendum opinion as to the etiology of the Veteran's hypertension, with consideration of the Veteran's submitted medical literature and research. These claims are REMANDED for the following actions: 1. Obtain updated VA medical records dated from July 2021. 2. Obtain an opinion from an appropriate VA examiner to determine the nature and etiology of the Veteran's diagnosed hepatitis C. The entire claims file should be reviewed by the examiner. Thereafter, the examiner is to: (a.) State whether it is at least as likely as not that the hepatitis C had its onset during service or is otherwise related to service, to include air gun injections. (b.) State whether it is at least as likely as not that the hepatitis C is at least as likely as not that it is caused or aggravated by the residuals of a TBI of PTSD, major depressive disorder, or cognitive disorder, to include the resultant intranasal cocaine use or medications used to treat these conditions. Aggravation means an increase in severity beyond the natural progress of the disease. (c.) State whether it is at least as likely as not that the hepatitis C is at least as likely as not that it is caused or aggravated by the degenerative arthritis of the back, to include medications used to treat this condition. Aggravation means an increase in severity beyond the natural progress of the disease. (d.) State whether it is at least as likely as not that the hepatitis C is at least as likely as not that it is caused or aggravated by the left shoulder disability, to include medications used to treat this condition. Aggravation means an increase in severity beyond the natural progress of the disease. The examiner is asked to consider the medical research submitted by the Veteran's representative in October 2021 and the lay statements provided by the Veteran. A rationale should be provided for opinions expressed. 3. Obtain an opinion from an appropriate VA examiner to determine the nature and etiology of the Veteran's diagnosed hypertension. The entire claims file should be reviewed by the examiner. Thereafter, the examiner is to: (a.) State whether it is at least as likely as not that hypertension had its onset during service, within one year of discharge, or is otherwise related to service. (b.) State whether it is at least as likely as not that the hypertension is at least as likely as not that it is caused or aggravated by the residuals of a TBI of PTSD, major depressive disorder, or cognitive, to include the resultant stress and anxiety and medications used to treat these conditions. Aggravation means an increase in severity beyond the natural progress of the disease. (c.) State whether it is at least as likely as not that the hypertension C is at least as likely as not that it is caused or aggravated by the degenerative arthritis of the back, to include the resultant stress and anxiety and medications used to treat this condition. Aggravation means an increase in severity beyond the natural progress of the disease. (d.) State whether it is at least as likely as not that the hypertension C is at least as likely as not that it is caused or aggravated by the left shoulder disability, to include the resultant stress and anxiety and medications used to treat this condition. Aggravation means an increase in severity beyond the natural progress of the disease. The examiner is asked to consider the medical research submitted by the Veteran's representative in October 2021 and the lay statements provided by the Veteran. (Continued on the next page) A rationale should be provided for opinions expressed. David Jimerfield Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Becton, 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.