Citation Nr: 21074251
Decision Date: 12/14/21	Archive Date: 12/14/21

DOCKET NO. 18-28 347A
DATE: December 14, 2021

REMANDED

Entitlement to a disability rating in excess of 10 percent for hepatitis B and duodenal ulcer is remanded.

Entitlement to service connection for hepatitis C is remanded.

REASONS FOR REMAND

The Veteran had active service from July 1971 to July 1975. The Veteran testified before the undersigned at a March 2021 Board hearing. A transcript of the hearing is of record.

The Board remanded the claim in June 2021 to the Department of Veterans Affairs (VA) Agency of Original Jurisdiction (AOJ).  The case has since been returned to the Board for appellate review.

1. Entitlement to a higher rating for hepatitis B, duodenal ulcer is remanded

The Veteran contends that he is entitled to a higher rating for his service-connected hepatitis B and duodenal ulcer.  In June 2021 the Veteran underwent a VA examination for hepatitis.  The Veteran was diagnosed with hepatitis C.  The Veteran stated that he was diagnosed with hepatitis during active service and with hepatitis C approximately 10 years earlier.  His current symptoms included shortness of breath, abdominal swelling, constipation, and fatigue.  Laboratory results found hepatitis C viral titers.  All other laboratory results were within normal limits.  Notably, hepatitis B testing was negative.  Therefore, the examiner noted that the VA established diagnosis of hepatitis B is changed as the Veteran does not have the disease, which indicated that the diagnosis was made in error.  In light of the June 2021 VA examination, a VA addendum opinion is required to clarify whether the Veteran's in-service hepatitis has always been hepatitis C, or whether the Veteran has any current residuals of his previously diagnosed hepatitis B.

2. Entitlement to service connection for hepatitis C is remanded

The Veteran contends that his hepatitis C is secondary to his service-connected hepatitis B.  The Veteran does not contend that the Veteran's hepatitis C had its onset in service, or that the disability is otherwise directly related to the Veteran's military service. However, in light of the most recent VA examination, the etiology of the Veteran's hepatitis C is unclear and required further medical opinion. 

The matter is REMANDED for the following action:

1. Obtain a VA addendum opinion pertaining to the Veteran's hepatitis from the June 2021 examiner, or a similarly qualified individual.  The record must be made available to the examiner and the examiner should indicate in his/her report whether the record was reviewed.  Based on a review of the record, the examiner should provide an opinion as to the following questions:

(a.) The VA examiner must opine as to whether the Veteran ever had hepatitis B.  If so, (1) are you able to identify when the disease was cured/resolved and (2) are there any current residuals?

(b.) Are you able to determine whether the Veteran's in-service diagnosis of hepatitis was actually hepatitis C.  Please provide an explanation for your answer.

The examiner should provide a complete rationale for all opinions expressed and conclusions reached. If it is not possible to provide an opinion without speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training).

 

 

S. L. Kennedy

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	J. Costello, 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.