Citation Nr: 21027014 Decision Date: 05/04/21 Archive Date: 05/04/21 DOCKET NO. 17-58 663 DATE: May 4, 2021 REMANDED Entitlement to service connection for hepatitis C is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1971 to January 1973. The Veteran testified at a hearing before the undersigned in March 2021. A copy of the transcript has been associated with the claims file. 1. Entitlement to service connection for hepatitis C is remanded. Although the Board greatly regrets the additional delay, the Veteran's claim must be remanded before the Board is able to make a determination on the merits. The evidence demonstrates that the Veteran contracted hepatitis C due to intravenous drug use during his period of active service. Service treatment records from October 1972 document the Veteran's diagnosis with the condition and report that it was the result of his willful misconduct due to the use of heroin. The law prohibits a grant of direct service connection for drug or alcohol abuse on the basis of incurrence or aggravation in the line of duty during service. See VAOPGCPREC 7-99; VAOPGCPREC 2-98. However, a veteran may be service connected for an alcohol or drug abuse disability acquired as secondary to, or as a symptom of, his service-connected disability. In order to qualify for service connection, the Veteran must establish, by clear medical evidence, that his alcohol or drug abuse disability is secondary to or is caused by their primary service-connected disorder, and that it is not due to willful wrongdoing. See Allen v. Principi, 237 F.3d 1368 (Fed. Cir. 2001). The Veteran has contended that his drug use was due to the onset of his posttraumatic stress disorder (PTSD) during his service in Germany in 1972. "I realize that I contracted hepatitis C due to my own misconduct (drug use); however, I began using drugs after we were assaulted off base. The trauma and mental state of the incident was overwhelming, and I couldn't function with my daily activities." See Correspondence received October 6, 2015; see also Correspondence received October 31, 2017. The Veteran is service-connected for PTSD with major depressive disorder. The evidence indicates that the Veteran may have used intravenous drugs, or increased his use of them, to treat his service-connected PTSD symptoms and medical evidence indicates that the Veteran's drug use resulted in his hepatitis C. The Board notes that no medical opinion has been obtained to determine if the Veteran's drug use was caused, or aggravated, by his service-connected PTSD; accordingly, the Board finds that a medical opinion must be obtained prior to adjudication of the Veteran's claim. The matters are REMANDED for the following action: 1. Undertake appropriate efforts to schedule the Veteran for an examination to determine the nature and etiology of his hepatitis C. The examiner should review the claims folder, and then respond to the following questions. (a). Is it at least as likely as not (i.e., probability of 50 percent or greater) that the Veteran's current hepatitis C is related to a disease, event, or injury during service? (b). To the extent that the Veteran's current hepatitis C was caused by the Veteran's in-service drug use, it is as likely as not that the Veteran's in-service drug use was caused, or aggravated, by his service-connected PTSD with major depressive disorder? The examiner should consider the Veteran's lay statements including his March 2021 hearing testimony and his October 2015 and October 2017 correspondence. A complete rationale should be included to support any opinions provided. K. Parakkal Veterans Law Judge Board of Veterans' Appeals Attorney for the Board P.M. Johnson, 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.