Citation Nr: 21040196
Decision Date: 07/02/21	Archive Date: 07/02/21

DOCKET NO. 16-13 946
DATE: July 2, 2021

REMANDED

Entitlement to service connection for hepatitis C, to include as secondary to service-connected posttraumatic stress disorder (PTSD) with polysubstance use is remanded.

REASONS FOR REMAND

The Veteran served on active duty from February 1969 to March 1971, including service in the Republic of Vietnam. His awards and decorations include the Combat Infantryman Badge.

This appeal comes before the Board of Veterans' Appeals (Board) from a rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). A May 2019 Board decision found that new and material evidence had been received to reopen a claim of entitlement to service connection for hepatitis C. The Board remanded the issues of entitlement to service connection for hepatitis C and a heart disorder. Upon remand, the AOJ granted service connection for ischemic heart disease. This is a full grant of benefits and this issue is no longer before the Board. 

The Board remanded the service connection claim for hepatitis C for an examination to discuss whether the Veteran's hepatitis C was related to the Veteran's service, to include as due to the induction process and herbicide agent exposures while serving in the Republic of Vietnam.

A July 2020 examiner opined that the Veteran's hepatitis C was less likely than not related to the Veteran's military service. The examiner indicated that risk factors for hepatitis C included social and behavioral risks, including substance abuse. The records indicate the Veteran has sought assistance for substance abuse, and further, is service connected for depression disorder NOS, post-traumatic stress disorder with polysubstance use disorder in remission. 

Further, in a May 2021 brief, the Veteran's representative suggested that the Veteran's PTSD had caused his substance abuse, which resulted in his contracting hepatitis C, and provided medical evidence related to that theory. 

As the Veteran's representative has raised the possibility of this alternate theory of service connection, an addendum opinion should be obtained that addresses secondary service connection.

The matters are REMANDED for the following action:

1. Provide the Veteran's file to an appropriate VA clinician. The examiner's attention is directed to the records of the Veteran's diagnosis of PTSD with polysubstance use disorder and the May 2021 brief submitted by the Veteran's representative. 

2. Then, provide an addendum opinion regarding whether the Veteran's service-connected depression disorder and PTSD with polysubstance use disorder in remission caused or aggravated his hepatitis C. 

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The examiner should comment on the medical references provided in the May 2021 brief. 

3. After completing the above actions, to include any other development as may be indicated by any response received as a consequence of the actions taken in the preceding paragraphs, the Veteran's claim should be readjudicated based on the entirety of the evidence.

 

 

S. Sorathia 

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	V. Geer, 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.