Citation Nr: 21020993 Decision Date: 04/09/21 Archive Date: 04/08/21 DOCKET NO. 16-16 642 DATE: April 9, 2021 ORDER Entitlement to service connection for hepatitis C as secondary to service-connected PTSD-associated IV drug use dependence is granted. FINDING OF FACT The Veteran’s hepatitis C is proximately due to service-connected PTSD-associated IV drug use dependence. CONCLUSION OF LAW The criteria for service connection for hepatitis C as secondary to connected PTSD-associated IV drug use dependence are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active duty service from February 1965 to February 1968. This matter comes before the Board of Veterans’ Appeals (Board) from an April 2010 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). The Board remanded the Veteran’s claim in September 2018 to obtain an addendum medical opinion addressing secondary service connection. Upon review, the Board finds that its remand directives were substantially complied with. See Stegall v. West, 11 Vet. App. 268, 271 (1998); August 2019 VA addendum medical opinions. Secondary Service Connection Secondary service connection may be granted for a disability that is proximately due to, or aggravated by, a service-connected disease or injury. 38 C.F.R. § 3.310. In order to prevail on the issue of entitlement to secondary service connection, there must be (1) evidence of a current disability; (2) evidence of a service-connected disability; and (3) nexus evidence establishing a connection between the service-connected disability and the current disability. See Wallin v. West, 11 Vet. App. 509, 512 (1998). 1. Entitlement to service connection for hepatitis C as secondary to service-connected PTSD-associated IV drug use dependence The Veteran contends that his claimed for hepatitis C condition is secondary to service-connected PTSD-associated IV drug use dependence. See April 2016 VA Form 9. As the Veteran's disability claim is being granted on a secondary basis, no other theory of entitlement raised by the record will be addressed herein. As to the first element of secondary service connection, the Veteran must show a current disability. Per the record, the Veteran has diagnosis of hepatitis C during the pendency of his claim. See July 21, 2015 VA treatment record. While the March 2020 VA examiner indicated that the Veteran’s condition has since resolved, the Board finds that the Veteran’s claim satisfies the first element of secondary service connection. See Romanowsky v. Shinseki, 26 Vet. App. 289 (2013); McClain v. Nicholson, 21 Vet. App. 319 (2007). As to the second element of secondary service connection, the Veteran must show a service-connected disability. The Veteran is currently service-connected for posttraumatic stress disorder (PTSD), and therefore the Board finds that the Veteran’s claim also satisfies the second element of secondary service connection. See March 2016 Decision Review Officer Decision. As to the last element of secondary service connection, the Veteran must show a causal relationship between the currently diagnosed condition and the service-connected disability. Upon remand, the August 2019 VA examiner opined that it is at least as likely as not that the Veteran’s claimed for hepatitis C condition is proximately due to or the result of PTSD-associated IV drug use dependence. The examiner explained that the medical literature reviewed supports the contention that an individual with PTSD is at higher risk that the general population for substance abuse. See also March 2020 VA examination report (indicating intravenous drug use as a risk factor for the Veteran’s diagnosed hepatitis C condition). The Board finds this opinion highly probative of the inherently medical question before it. It was rendered on the basis of a full review of the pertinent records. Furthermore, it provided the underlying reasons for the conclusions reached, which are not otherwise contradicted by the record. (CONTINUED ON NEXT PAGE) Accordingly, as the most probative evidence of record indicates drug use as the etiology for the Veteran’s hepatitis C condition, and as the Veteran’s drug use has been medically associated with his service-connected PTSD disability, the Board finds that service connection on a secondary basis is warranted for hepatitis C as due to PTSD-associated IV drug use dependence; the Veteran’s claim is granted. 38 C.F.R. § 3.310. Bethany L. Buck Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S.R. Fey, 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.