Citation Nr: 21013591 Decision Date: 03/09/21 Archive Date: 03/09/21 DOCKET NO. 14-41 499 DATE: March 9, 2021 REMANDED Entitlement to service connection for hepatitis C is remanded. Entitlement to service connection for multiple joint pain is remanded. REASONS FOR REMAND The Veteran, who is the appellant in this case, served on active duty from February 1979 to November 1982. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from rating decisions dated July 2009 and July 2010. In March 2017, the Veteran testified at a Travel Board hearing before another Veterans Law Judge. A copy of the hearing transcript is of record and has been reviewed. In September 2020, VA notified the Veteran that the Veterans Law Judge before whom he testified was no longer acting in a Judge capacity and provided him the opportunity to request another Board hearing. To date, the Board has not received any response from the Veteran. As noted in the letter to the Veteran, because the Board has not received a response, it will assume that the Veteran does not want another hearing and will proceed accordingly. By way of procedural background, this matter was previously before the Board in August 2018, at which time it denied service connection for multiple joint pain, hepatitis C, and a neck condition and remanded the issue of service connection for an acquired psychiatric disability. The Veteran timely appealed the Board’s decision to the United States Court of Appeals for Veterans Claims (Court) which, by way of a July 2020 Memorandum Decision, vacated and remanded the issues of service connection for hepatitis C and multiple joint pain and affirmed the Board’s denial of service connection for a neck condition. In a September 2020 rating decision, the RO granted service connection for posttraumatic stress disorder (PTSD) with major depressive disorder (MDD) and alcohol use disorder and assigned a 70 percent disability rating, effective February 9, 2009. As this is considered a full grant of the benefits on appeal for that claim, the issue of service connection for an acquired psychiatric disability is no longer before the Board for appellate consideration. AB v. Brown, 6 Vet. App. 35 (1993). 1. Entitlement to service connection for hepatitis C is remanded. The Veteran asserts he is entitled to service connection for hepatitis C. The Board finds that additional development is necessary prior to appellate review of this claim. In the July 2020 Memorandum Decision, the Court noted that the parties agreed remand was warranted to obtain an adequate VA examination and medical opinion that addressed the Veteran’s in-service risk factors for hepatitis C, to include shared razors and needles, an ear piercing with a sewing needle, a bite he received from another servicemember during a fight, and military sexual trauma. Therefore, on remand, the VA examiner must adequately address all applicable risk factors when providing an etiology opinion as to the Veteran’s hepatitis C. 2. Entitlement to service connection for multiple joint pain is remanded. The Veteran asserts that he is entitled to service connection for multiple joint pain. The Board finds that additional development is necessary prior to appellate review of this claim. In a January 2015 VA nursing emergency department E & M note, the Veteran endorsed chronic generalized joint pain, and the provider noted limited range of motion, pain, and stiffness on physical examination. Additionally, several service treatment records (STRs) document complaints of pain and injuries to the Veteran’s joints during active service, and the Veteran testified during the March 2017 Board hearing that his joint pain started while he was in service and he “didn’t know what it was.” See STRs dated December 1981 to June 1982; September 1982 Report of Medical History; March 2017 Board hearing transcript. To date, VA has not obtained a competent medical examination and opinion addressing this claim. Given that there is medical evidence of pain resulting in functional impairment of earning capacity, in-service complaints and injuries involving the Veteran’s joints, and the Veteran’s testimony that his joint pain onset during service, a VA examination should be afforded to the Veteran. See McClendon v. Nicholson, 20 Vet. App. 79 (2006). Accordingly, the matters are REMANDED for the following action: 1. Provide the Veteran an additional VA examination, if possible, to determine the nature and likely etiology of his hepatitis C. The claims file, including a copy of this Remand, must be made available to, and be reviewed by, the examiner. ** IF an in-person examination is not feasible given the circumstances surrounding the recent pandemic, refer the case to an appropriate examiner for a thorough review of the record, possible telephone/virtual interview with the Veteran, and medical opinion. After a thorough review of the claims file and examination of the Veteran (if possible), the examiner is asked to: (a) Elicit from the Veteran and the record the history of his risk factors for hepatitis C during active service. (b) Provide an opinion as to whether the Veteran’s hepatitis C at least as likely as not (50 percent probability or greater) had its onset during active service or is otherwise related to it, to include as due to the Veteran’s identified in-service risk factors, including shared razors and needles, an ear piercing with a sewing needle, a bite he received from another servicemember during a fight, and military sexual trauma. 2. Provide the Veteran a VA examination, if possible, to determine the nature and likely etiology of his claimed multiple joint pain. The claims file, including a copy of this Remand, must be made available to, and be reviewed by, the examiner. ** IF an in-person examination is not feasible given the circumstances surrounding the recent pandemic, refer the case to an appropriate examiner for a thorough review of the record, possible telephone/virtual interview with the Veteran, and medical opinion. After a thorough review of the claims file and examination of the Veteran (if possible), the examiner is asked to: (a) Elicit from the Veteran and the record the history of his multiple joint pain symptoms. In doing so, also elicit information as to any functional impairment caused by multiple joint pain. See Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018) (holding that a “disability” under 38 U.S.C. § 1110 refers to functional impairment of earning capacity; pain need not be diagnosed as connected to a current underlying condition to function as an impairment). (b) Identify all diagnoses relating to the Veteran’s claimed multiple joint pain (to include symptoms resulting in functional impairment of earning capacity). (c) For each currently diagnosed disability relating to the Veteran’s claimed multiple joint pain (to include symptoms resulting in functional impairment of earning capacity), provide an opinion as to whether it at least as likely as not (50 percent probability or greater) had its onset during service or is otherwise related to it. S. B. MAYS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. M. Gill, 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.