Citation Nr: 22017598
Decision Date: 03/25/22	Archive Date: 03/25/22

DOCKET NO. 17-58 663
DATE: March 25, 2022

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.

Entitlement to service connection for hepatitis C is remanded.

The issue on appeal was remanded by the Board of Veterans' Appeals (Board) in May 2021 and January 2022 for additional development. The Veteran has a current diagnosis of hepatitis C that had not been granted service connection as it was determined to be the result of his willful misconduct due to his in-service use of heroin. The Board noted, however, that the Veteran was service-connected for PTSD and that the Veteran had contended that his drug use was a result of this service-connected condition. The issue was remanded to address this contention.

While a medical opinion was obtained in January 2022, the Board finds that the opinion provided is inadequate to address the issue on appeal. With regard to secondary service connection, the examiner opines that the Veteran's PTSD is less likely than not due to his in-service drug use. This is the reverse of the question posed by the January 2022 remand. The Veteran is already service-connected for PTSD. Moreover, the examiner appears to discount the Veteran's reports of in-service trauma due to lack of documentation during service of the occurrence of these events in order to support the rationale for the opinion provided. The Veteran's lay statements cannot be disregarded solely due to lack of contemporaneous medical evidence. See Buchanan v. Nicholson, 451 F.3d 1331, 1336 (Fed. Cir 2006). As such, the Board finds that a new medical opinion must be obtained. See Barr v. Nicholson, 21 Vet. App. 303, 312 (2007) (when VA undertakes to provide an examination or obtain a medical opinion, it must ensure that the examination or opinion is adequate).

The matters are REMANDED for the following action:

1. Undertake appropriate efforts to obtain a medical opinion from a psychiatrist or psychologist regarding the etiology of the Veteran's in-service drug use. The claims file must be made available for review. An examination of the Veteran is not required, unless deemed necessary by the examiner.

The examiner should review the claims folder, and then respond to the following question. 

Is it at least as likely as not (i.e., probability of 50 percent or greater) 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.  The examiner is reminded that the Veteran is competent to provide information about observable symptoms and events. The Veteran's lay statements cannot be disregarded solely due to lack of contemporaneous medical evidence. 

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A complete rationale for all opinions must be 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.