Citation Nr: 21041057 Decision Date: 07/08/21 Archive Date: 07/07/21 DOCKET NO. 16-61 254 DATE: July 8, 2021 ORDER Service connection for hepatitis B is denied. FINDING OF FACT The preponderance of the evidence is against finding that Veteran's hepatitis B began during active service, or is otherwise related to an in-service injury or disease. CONCLUSION OF LAW The criteria for service connection for hepatitis B are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from May 1978 to December 1983, March 1986 to March 1990, October 2001 to October 2002, and August 2003 to July 2004. In April 2015, the Veteran filed a claim seeking service connection for hepatitis B. An August 2015 rating decision denied this claim and the Veteran filed a timely notice of disagreement (NOD). In his NOD, the Veteran asserted that he was of the belief that he was exposed to hepatitis B through blood exposure as a corpsman while stationed at Camp LeJeune in the 1980s. This matter was previously before the Board in July 2020 when it was remanded in order for the Agency of Original Jurisdiction (AOJ) to review new evidence received and issue a Supplemental Statement of the Case (SSOC). Of note, in January 2020, the Veteran wrote to the Board to indicate that he wished to withdraw his request for a hearing on this matter and indicated that he did not have hepatitis B or C. Service Connection Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active military service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Service connection requires competent evidence showing: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service (nexus). Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). The Veteran seeks service connection for hepatitis B, which he asserts he contracted due to his military service as a field medical technician at Camp Lejeune from 1986 to 1990, during which time he was potentially exposed to blood or blood products. On September 24, 2020, the AOJ sent the Veteran a subsequent development letter requesting medical evidence confirming his diagnosis of hepatitis B and information on which hepatitis risk factor(s) apply to the Veteran. The Veteran was provided VA Form 21-4138, Statement in Support of Claim to provide this information, including dates and descriptions of the circumstances of any incident involving his exposure to any of the risk factors listed. To date, no response has been received. Military personnel records indicate that the Veteran served from October 2001 to October 2002 as a Field Medical Service Technician at Camp LeJeune. A review of the Veteran's service treatment records (STRs) indicate that he received hepatitis B vaccinations in 1996, 1997, and 1998. Additionally, at both a December 2000 and a July 2003 medical examination, there were no notations or diagnoses of hepatitis B indicated. No lab records indicating a diagnosis of hepatitis B were found in the Veteran's STRs. A December 2020 VA examination records review diagnosed the Veteran with hepatitis B and provided an onset date of 2001. The examiner indicated that VA lab records since 2001 show positive reactivity for hepatitis B surface antibodies and that a January 2018 lab test provided similar results. However, the examiner opined that the Veteran's condition was less likely than not (less than 50% probability) incurred in or caused by the claimed in-service injury, event or illness. The examiner opined that it was possible that the exposure and chronic infection with hepatitis B occurred during military service as a field medical technician during 1986 to 1990; however, because the Veteran had not responded to requests for information regarding his possible hepatitis B exposure risk factors during this period of military service, it was not possible to assess his risk. VA treatment records show that in August 2001 the Veteran was given a Hepatitis C risk assessment where he denied having risk factors for Hepatitis C, notably one of which is a positive blood test for Hepatitis B. VA treatment records from 2015 through 2019 show reports of the Veteran having a history of hepatitis B. An April 2017 liver function test showed that serum glutamic oxaloacetic transaminase (SGOT) and serum glutamate pyruvate transaminase (SGPT) were 23 and 33 respectively. A January 2018 lab result indicated that the Veteran's result for "Hepatitis B Virus Surface Ab" was "reactive." In January 2020, the Veteran informed the Board that he does not have a diagnosis of hepatitis B. However, the December 2020 VA examiner, after reviewing the Veteran's medical records, indicated that he did have a diagnosis of hepatitis B. The Board concludes that, while a records review indicates that the Veteran has a current diagnosis of hepatitis B, the preponderance of the evidence weighs against finding that the Veteran's diagnosis of hepatitis B began during service or is otherwise related to an in-service injury, event, or disease. VA treatment records show the Veteran was not diagnosed with hepatitis B until 2001, several years after his alleged exposure date, and there is no medical opinion suggesting that the latency period between service and diagnosis would suggest it was contracted in service. Although personnel records confirm the Veteran's service as a Field Medical Service Technician, this information alone is not sufficient to support an exposure to a hepatitis risk factor. To date, no response has been received from the Veteran regarding the details of his exposures as requested. The Veteran is encouraged to file a supplemental claim describing how and when he came in contact with hepatitis B risk factors during service. Further, the December 2020 VA examiner opined that the Veteran's hepatitis B is not at least as likely as not related to an in-service injury, event, or disease, including exposure to blood or blood products. The rationale was that although the Veteran's contentions were plausible, the lack of evidence provided regarding exposures to risk factors from the Veteran made the examiner unable to opine that the exposure occurred during service. The examiner's opinion is probative, because it is based on an accurate medical history and provides an explanation that contains clear conclusions and supporting data. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). Without further information from the Veteran regarding exposure to risk factors to hepatitis B, the preponderance of the evidence is against finding that the Veteran's hepatitis B began during active service, or is otherwise related to an in-service injury or disease. Accordingly, service connection for hepatitis B is denied. MATTHEW W. BLACKWELDER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Jennifer M. Narvaez, 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.