Citation Nr: 21010300 Decision Date: 02/24/21 Archive Date: 02/24/21 DOCKET NO. 14-26 110 DATE: February 24, 2021 REMANDED Entitlement to service connection for hepatitis C, also as secondary to traumatic brain injury (TBI), is remanded. Entitlement to service connection for hypertension, also as secondary to traumatic brain injury (TBI), is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from September 1981 to October 1987. This case originally came before the Board of Veterans’ Appeals (Board) on appeal from an October 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Roanoke, Virginia. The Board remanded the claims in December 2017, March 2019 and August 2020 to obtain medical opinions. A September 2020 rating decision granted service connection for the Veteran’s left arm or shoulder disability that was previously before the Board. Due to reasons discussed below, the Board finds that there has not been substantial compliance with the Board’s previous remand directives and another remand is needed. Stegall v. West, 11 Vet. App. 268 (1998) (holding that a Court or Board remand confers upon the appellant the right to compliance with that order). 1. Entitlement to service connection for hepatitis C, also as secondary to traumatic brain injury (TBI), is remanded 2. Entitlement to service connection for hypertension, also as secondary to traumatic brain injury (TBI), is remanded The Veteran contends that service connection is warranted for hepatitis C and hypertension because the condition is secondary to her service-connected traumatic brain injury (TBI). The Board previously remanded the issue because previous VA examinations had not issued an opinion regarding secondary service connection and aggravation. Post-remand, the Veteran was afforded VA examinations in September 2020. In addressing the issue of aggravation for hypertension, the examiner opined that “it was less likely than not the claimed condition of hypertension was caused or incurred by the traumatic brain injury (TBI).” In addressing the issue of aggravation for hepatitis C, the examiner opined that “there is no link between Hep C and traumatic brain injury (TBI).” See September 2020 VA examinations. The Court of Appeals for Veterans Claims (Court) has indicated 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 38 C.F.R. § 3.310(b). El-Amin v. Shinseki, 26 Vet. App. 136, 140 (2013). The Court also has indicated that an opinion that there is “no etiological relationship” may be insufficient to address the question of aggravation. Allen v. Brown, 7 Vet. App. 439, 448-49 (1995) (en banc). As a result, in order to ensure compliance with the Board’s previous remand directives, an addendum opinion is necessary to address secondary service connection, including aggravation for the issues on appeal herein. See Stegall, supra. Accordingly, the matters are REMANDED for the following action: 1. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s hepatitis C and hypertension are secondary to her service-connected traumatic brain injury (TBI). The examiner must review the evidence of record, including any submitted lay statements pertaining to the issues on appeal, and a copy of this Remand. 2. In addressing the Veteran’s hepatitis C, the examiner must opine whether: a. the Veteran’s hepatitis C is at least as likely as not proximately due to traumatic brain injury (TBI)? b. the Veteran’s hepatitis C is at least as likely as not aggravated, i.e., worsened beyond its natural progression, by the traumatic brain injury (TBI)? 3. In addressing the Veteran’s hypertension, the examiner must opine whether: a. the Veteran’s hypertension is at least as likely as not proximately due to traumatic brain injury (TBI)? b. the Veteran’s hypertension is at least as likely as not aggravated, i.e., worsened beyond its natural progression, by the traumatic brain injury (TBI)? 4. The AOJ must review the claims file and ensure that the foregoing development actions have been completed in full. If any development is incomplete, appropriate corrective action must be implemented. If any report does not include adequate responses to the specific opinions requested, it must be returned to the providing examiner for corrective action. 5. After completing any additional development needed, the AOJ should readjudicate the issues on appeal. If the benefits sought on appeal are not granted to the Veteran’s satisfaction, the AOJ should furnish to her and her representative a supplemental statement of the case (SSOC) and afford them the requisite opportunity to respond before the case is returned to the Board. KRISTI L. GUNN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. Khan, 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.