Citation Nr: 21040722 Decision Date: 07/06/21 Archive Date: 07/06/21 DOCKET NO. 18-02 212 DATE: July 6, 2021 REMANDED The claim for service connection for hepatitis C is remanded. The claim for service connection for liver damage, claimed as secondary to hepatitis C is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1970 to January 1972. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a January 2017 rating decision rendered by the Department of Veterans Affairs (VA) Regional Office (RO). In March 2021 the Veteran provided testimony at a Board videoconference hearing before the undersigned Veterans Law Judge at the RO. A transcript of that hearing is included in the record. The Veteran was diagnosed with active hepatitis in 1979, and he contends that his current hepatitis C and secondary liver damage are the result of a tainted blood transfusion received during a 1971 splenectomy. He acknowledges that he tried IV drugs in approximately 1978, but he believes the timeframe between that usage and the diagnosis of active hepatitis in 1979 was too short for the IV drug use to have been responsible for the contraction of the disease. to have been the result of his in-service blood transfusion. He thus believes that it was the blood transfusion he received in 1971 that resulted in his contracting of hepatitis C. While service treatment records were silent as to any findings, complaints, or diagnosis of hepatitis, to include hepatitis C, service clinical records detailed that the Veteran received three units of blood during a 1971 splenectomy. Post-service VA treatment records reflect that the Veteran had abnormal liver tests in May 1978. At that time, he provided a history of drinking three (3) beers a day that had increased to six (6) to 12 a day. He also reported that 10 days prior to admission to the facility, he had occasionally used drugs, including mescaline and LSD. Over a period of a month ending several weeks previously, he took morphine and Dilaudid intravenously, but stated that he used Insulin syringes that were sterilized with alcohol. The Veteran indicated that the syringe had been used on more than one occasion and that one of his syringes had also been used previously by a friend who had jaundice and hepatitis one year previously. In August 1979, the Veteran was seen for an infection under the arm. It was noted that he had liver disease. A March 1980 report reflects that the Veteran had a history of chronic active hepatitis since October 1979. In November 2016, a VA examiner provided a negative nexus as to the relationship between the Veteran diagnosed hepatitis C (which was noted to have been diagnosed after 1992), and his in-service transfusion during the 1971 splenectomy. After a review of the above-cited STRs and post-service records, the VA examiner reasoned that although blood products were not screened for hepatitis during 1971 and that it is a possible source of hepatitis, the Veteran's chronic hepatitis was much more likely (more than 50% probability) to have been contracted through his intravenous drug use. The examiner stated that this was particularly noteworthy since there was medical documentation that indicated that the needles he had used were previously used by his symptomatic friend who was Hepatitis positive. See November 2016 VA opinion. The Board finds that prior to further appellate review of the claim for service connection for hepatitis C, an addendum opinion is required to address the Veteran's theory that the time period from his IV drug use in 1978 and diagnosis of active hepatitis in 1979 (and resulting diagnosis of hepatitis C) was too short not to have been the result of the 1971 blood transfusion, especially considering the slow-moving progress of the disease. A remand is also required to obtain outstanding Social Security Administration (SSA) records. A 2021 Social Security Administration (SSA) Profile and Benefit Data Sheet, received by VA in March 2021, reflects that the Veteran has been entitled to disability benefits from that agency since June 2014. Thus, this evidence reflects that there are potentially outstanding relevant SSA records. A remand is required to allow VA to request these records The matters are REMANDED for the following action: 1. Obtain the Veteran's federal records from SSA. Document all requests for information as well as all responses in the claims file 2. Obtain an addendum opinion to address the etiology of the Veteran's Hepatitis C. If a physical examination is necessary to answer the Board's questions, one should be scheduled. The examiner should answer the following questions: i) Is it at least as likely as not (50 percent probability or greater) that the Veteran's hepatitis C was first manifested in service, within a year after discharge, or is otherwise related to active service, notably as a result of a blood transfusion during the Veteran's 1971 surgery? Why or why not? The examiner should specifically consider and address the Veteran's contention (as voiced during his Board hearing in March 2021) that it was too short of a timeframe from when he engaged in intravenous drug use in 1978 to when he was diagnosed with active hepatitis in 1979 (and resulting diagnosis of hepatitis C) not to have been the result of his blood transfusion during the 1971 splenectomy. ii) If the Veteran's hepatitis C is found to be the result of his in-service blood transfusion, is it at least as likely as not (50 percent or greater) that it caused or made worse the Veteran's liver disease. Why or why not? MATTHEW W. BLACKWELDER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Carole Kammel, 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.