Citation Nr: 21009962 Decision Date: 02/23/21 Archive Date: 02/23/21 DOCKET NO. 05-30 126 DATE: February 23, 2021 REMANDED Service connection for hepatitis C. REASONS FOR REMAND The Veteran served on active duty from October 1972 to April 1974. The case is on appeal from a September 2004 rating decision. Most recently, in a September 2015 decision, the Board remanded the issues of service connection for hepatitis C and hearing loss for additional development. By rating decision in February 2020, service connection for bilateral hearing loss was granted, and by rating decision in January 2021, service connection for tinnitus was granted. The awards represent a full grant of the benefits sought with respect to those issues. The Board notes that, in August 2011, June 2015 and December 2020, the Veteran testified at Board hearings before the undersigned. Service connection for hepatitis C. The Veteran maintains that he contracted hepatitis C during service, including as a result of intravenous (IV) drug use due to stress and immunizations administered by air inoculation mode that allowed for cross-contamination. See August 2011 & December 2020 Board hearing testimony. Pursuant to the Board’s December 2017 remand, the Veteran was afforded a VA examination. The January 2020 VA examiner stated that it was not possible to determine the exact date the Veteran acquired hepatitis C due to inconsistent statements, other than that it was before 2004, and likely due to IV drug use, and less than likely related to service-connected major depressive disorder (MDD). However, the opinion is not completely adequate. See El-Amin v. Shinseki, 26 Vet. App. 136, 140-41 (2013) (holding that findings of “not due to,” “not caused by,” and “not related to” a service-connected disability are insufficient to address the question of aggravation under § 3.310(b)). In addition, and although the February 2020 VA opinion states that the Veteran’s hepatitis C resolved in July 2019 following an 8-week treatment protocol and was no longer detectable on laboratory testing, noting normal liver function tests, an opinion was not provided as to whether the Veteran’s hepatitis C shown during the appeal period was related to service or was caused or aggravated by service-connected MDD. Thus, the opinion is not completely adequate. The Board notes that the requirement of the existence of a current disability is satisfied when a Veteran has a disability at the time the claim for service connection is filed or during the pendency of that claim, even if the disability resolves prior to adjudication of the claim. See McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). As such, a new opinion is warranted. On remand, the RO will have an opportunity to address the additional VA treatment records associated with the file in January 2021. In view of the remand, complete VA treatment records since the issuance of the March 2020 supplemental statement of the case (SSOC) should be obtained. The matter is REMANDED for the following action: 1. Obtain complete VA treatment records since March 2020. 2. After completion of the above, return the claims file to the VA examiner who conducted the February 2020 examination. If the February 2020 examiner is not available, the claims file should be provided to an appropriate medical professional to render the requested opinion. The need for another examination (or telehealth interview, records request, etc. if an in-person examination is not feasible) for hepatitis C, is left to the discretion of the medical professional offering the addendum opinion. The clinician should provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s hepatitis C had its onset during or within the initial year after service or is otherwise related to an in-service injury, event, or disease, including inoculations and drug use. The examiner should also provide an opinion as to whether it is as least as likely as not (50 percent or greater probability) that his hepatitis C is caused by or aggravated by his service-connected psychiatric disorder via self medicating with drugs and/or alcohol. Specifically, the examiner is asked to determine whether the Veteran used substances to self-medicate to treat his service-connected psychiatric disorder and whether his hepatitis C was caused by his substance abuse. Aggravation is an increase in severity beyond the natural progress of the disease.   For any aggravation found, the clinician should state, to the extent possible, the baseline of symptomatology and the amount, quantified if possible, of aggravation beyond the baseline symptomatology by the aggravation. Rationale for all opinions expressed should be provided, to include by citing to the record. If the clinician is unable to provide the requested opinions without resort to speculation, it must be so stated, and he or she must provide the reasons why an opinion would require speculation. RYAN T. KESSEL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Taylor 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.