Citation Nr: 21013217 Decision Date: 03/09/21 Archive Date: 03/09/21 DOCKET NO. 10-22 478 DATE: March 9, 2021 REMANDED Entitlement to service connection for Hepatitis C is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from March 1975 to March 1979. This matter originally came before the Board of Veterans’ Appeals (Board) from a January 2009 rating decision of the Department of Veterans Affairs (VA) Regional Office in Denver, Colorado (RO). The Veteran testified at a Board hearing before the undersigned Veterans Law Judge at a travel board hearing in October 2014. A transcript of the hearing is in the record. In April 2015, August 2019, and August 2020, the Board remanded the claim for further development. Entitlement to service connection for Hepatitis C is remanded. While the Board sincerely regrets further delay, a fully-informed decision on the issue of entitlement to service connection for Hepatitis C can not be made because there has not been substantial compliance with the Board’s remand directives. See Stegall v. West, 11 Vet. App. 268 (1998).   Once VA has provided a VA examination, it is required to provide an adequate one, regardless of whether it was legally obligated to provide an examination in the first place. Barr v. Nicholson, 21 Vet. App. 303 (2007).  A VA examiner must consider the Veteran’s lay statements regarding the incurrence of a disorder, and his statements regarding the continuity of symptomatology. Dalton v. Nicholson, 21 Vet. App. 23, 39-40. A Veteran is competent to report symptoms that are capable of lay witness observation. See Layno v. Brown, 6 Vet. App. 465, 469 (1994).  In August 2020, the Board found the April 2012 VA examination for the Veteran’s Hepatitis C inadequate, and remanded the claim for an addendum opinion to specifically address the Veteran’s lay statements. In September 2020, the VA obtained an addendum opinion. The September 2020 examiner opined that the Veteran’s Hepatitis C was less likely than not related to service because there was no mention of jaundice or acute liver injury in service, and he had a history of alcohol and drug use, as well as unprotected sex after service. However, the examiner failed to consider any of the Veteran’s lay statements. The Veteran stated in multiple lay statements, that he was diagnosed with Hepatitis C in 1981. Additionally, he said he was told by the doctor who diagnosed him in 1981, that he was likely not diagnosed during service because the military was not testing for Hepatitis C at the time. He also stated he was diagnosed with Hepatitis C before he began using drugs. The examiner did not discuss these contentions as to whether the Veteran likely had Hepatitis C before he started using drugs, or the etiology of his condition if he was not using drugs at the time. As such, a remand is necessary to afford the Veteran an addendum opinion that properly addresses his lay statements. The matters are REMANDED for the following action: 1. Obtain all VA treatment records not currently associated with the claims file. 2. Obtain an addendum opinion for the Veteran’s Hepatitis C. The examiner should opine as to whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s Hepatitis C: a) Had its onset in service, or  b) Is otherwise related to an in-service injury, event, or disease.  In rendering this opinion, the examiner must consider and address the following:  i. Medical treatment records regarding the Veteran’s substance abuse. ii. The Veteran’s statements, including his testimony at the November 2014 hearing and in September 2008 correspondence, regarding his original date of diagnosis around 1981. The examiner should specifically address whether the Veteran likely had Hepatitis C before he started using drugs, and the etiology of his condition if he was not using drugs at the time. The examiner is requested to provide a clear rationale and explain in detail the underlying reasoning for any opinions expressed. A discussion of the facts and medical principles involved would be of considerable assistance to the Board. If the examiner cannot provide the requested opinion without resorting to speculation, he or she should expressly indicate this and provide a supporting rationale as to why an opinion cannot be made without resorting to speculation.  TANYA SMITH Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Papacalos, Law Clerk 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.