Citation Nr: 21008287 Decision Date: 02/16/21 Archive Date: 02/16/21 DOCKET NO. 14-38 577 DATE: February 16, 2021 REMANDED Entitlement to service connection for Hepatitis B, to include as secondary to service-connected residuals of a deviated nasal septum and/or service-connected chronic maxillary sinusitis, is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1970 to February 1972, to include service in the Republic of Vietnam. He was awarded a Combat Infantryman Badge, among other decorations. In June 2018, the Board remanded the Veteran’s service connection claims for a right knee disability; a nasal disability, to include residuals of a deviated septum and/or chronic sinusitis; and Hepatitis B for additional development. In a September 2020 rating decision, the RO granted the Veteran’s service connection claim for a right knee meniscal tear. In a December 2020 rating decision, the RO granted the Veteran’s service connection claims for residuals of a deviated septum and chronic maxillary sinusitis. As these grants constitute a full grant of benefits sought on appeal, the issues of service connection a right knee disability and a nasal disability are no longer before the Board. See AB v. Brown, 6 Vet. App. 35, 38 (1993). Therefore, the only issue remaining before the Board is the Veteran’s service connection claim for Hepatitis B. 1. Entitlement to service connection for Hepatitis B, to include as secondary to service-connected residuals of a deviated nasal septum and/or service-connected chronic maxillary sinusitis, is remanded. The Veteran contends that he has Hepatitis B due to an infection from a blood transfusion given after a septoplasty the Veteran underwent while in service in Vietnam in 1971. See November 2019 VA examination. At the outset, the Board notes that the Veteran has a diagnosis of Hepatitis B. See November 2019 VA examination. In May 2019, the VA examiner opined that the claimed condition was less likely than not (less than 50 percent probability) incurred in or caused by the claimed in-service injury, event, or illness. The examiner reasoned that the submitted medical records do not contain documentation of a blood transfusion or Hepatitis B infection during active duty. Therefore, the examiner concluded that his Hepatitis B was less likely than not incurred during active duty. The Board finds the May 2019 opinion inadequate, as the May 2019 VA examiner did not address whether the Veteran’s Hepatitis B was proximately due to or aggravated by the Veteran’s service-connected residuals of a deviated nasal septum and/or service-connected chronic maxillary sinusitis. The Board notes that, while the evidence does not demonstrate that a blood transfusion was conducted during the surgery, as the Veteran is now service-connected for these nasal disabilities, a remand is necessary for a VA examiner to address the Veteran’s Hepatitis B contention under the appropriate standard for secondary service connection. The matter is REMANDED for the following action: 1. Obtain a VA opinion for the Veteran’s Hepatitis B. The examiner must review the claims file. The examiner is asked to provide a response to the following: Is the Veteran’s Hepatitis B at least as likely as not proximately due to service-connected residuals of a deviated nasal septum and/or service-connected chronic maxillary sinusitis? Is the Veteran’s Hepatitis B at least as likely as not aggravated, i.e., worsened beyond its natural progression, by service-connected residuals of a deviated nasal septum and/or service-connected chronic maxillary sinusitis? Provide a rationale to support the opinion(s). In providing the requested opinion, consider the Veteran’s description of his in-service injury and symptoms as well as his post-service symptoms. If there is any medical reason to accept or reject the proposition that the Veteran’s reported injury and symptoms in service and thereafter represented the onset of his current disability, this should be noted. Stated another way, do the Veteran’s reports about his symptoms align with how the currently diagnosed disability is known to develop or are the Veteran’s reports generally inconsistent with medical knowledge or implausible? The examiner is requested to address the Veteran’s contention that he contracted Hepatitis B due to an infection from a blood transfusion given after a septoplasty the Veteran underwent while in service in Vietnam in 1971. 2. After completing the above action, and any other development as may be indicated by any response received as a consequence of the actions taken in the paragraphs above, the claim must be readjudicated. If the claim remains denied, a supplemental statement of the case must be provided to the Veteran and his representative. After the Veteran and his representative have had an adequate opportunity to respond, the appeal must be returned to the Board for appellate review. GAYLE STROMMEN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. E. Grossman, 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.