Liver disease (hepatitis, cirrhosis) decisions — 2018

The Board has remanded the claims for increased ratings for hepatitis C and TBI residuals due to new evidence indicating worsening symptoms. A VA examination is needed to assess current severity.

The Board has remanded the Veteran's claims for service connection and rating of his back disability, as well as his TDIU claim due to inextricably intertwined issues. The case is returned to the AOJ for further development.

The Veteran's service connection claims for a respiratory disorder, hepatitis C, and dental disability have been denied. The Board found no evidence linking these conditions to his military service.

The Board has remanded the Veteran's claims for service connection due to insufficient development and examination of his medical history, including in-service noise exposure, symptomatology, and treatment records.

The Board has remanded the issues of service connection for osteopenia, cervical spine disorder, hearing loss, tinnitus, hepatitis C, left upper extremity radiculopathy and peripheral neuropathy as secondary to lumbar spine disability, right upper extremity radiculopathy and peripheral neuropathy as secondary to lumbar spine disability, left lower extremity radiculopathy and peripheral neuropathy as secondary to lumbar spine disability, and right lower extremity radiculopathy and peripheral neuropathy as secondary to lumbar spine disability. The Board also remanded the issue of a rating for service-connected lumbar contusion, myositis, and lumbar spondylosis in excess of 20 percent prior to May 17, 2012 and in excess of 40 percent from May 17, 2012.

The Board has decided to remand the case due to insufficient evidence regarding the presence and etiology of hepatitis C during the appeal period. The Veteran needs to be provided with a VA examination for this purpose.

The Board has granted service connection for hepatitis C, finding that it is at least as likely as not related to the Veteran's military service. The cause of death determination remains pending and requires a VA medical opinion.

The Veteran's claim for service connection for PTSD has been reopened, but the Board is remanding to obtain additional evidence related to this condition.,The Veteran's claims for service connection for a skin disability and hepatitis C have also been reopened. The Board is remanding these claims as well due to the need for additional medical opinions.

The Board has denied the Veteran's claims for service connection for various psychiatric and physical disabilities, including right shoulder pain, back pain, neck pain, left knee pain, right knee pain, sleep apnea, hepatitis C, kidney or renal failure, prostate cancer, and unspecified depressive disorder. The reasons provided include lack of in-service evidence linking these conditions to service.

The Veteran's service-connected hepatitis C and back disability prevented him from securing and maintaining substantially gainful employment, meeting the criteria for a total disability rating due to individual unemployability (TDIU) effective November 4, 2011.

The Board cannot make a fully-informed decision on the issue of service connection for hepatitis C because no VA examiner has opined whether the disability is due to possible in-service risk factors. The Veteran's history includes intravenous drug abuse and blood transfusions, but there is uncertainty about exposure to air gun injections during active service.

The Board has determined that a remand is needed to obtain a medical opinion regarding the relationship between the Veteran's service-connected disabilities and his death, as well as whether any service-connected conditions are related to active service.

The Board denied service connection for hepatitis C as the evidence did not support a finding that it was related to service, including vaccinations via air gun.

The Veteran's appeal is remanded due to the need for a new VA examination and potential increase in his service-connected hepatitis C rating.

An effective date of December 14, 1970 is granted for the establishment of service connection for PTSD. The appeal concerning a compensable rating for infectious hepatitis is dismissed. The appeals regarding an initial rating in excess of 30 percent for PTSD and entitlement to TDIU are remanded.

The Board denied the claims for service connection for the cause of death, nonservice-connected death pension benefits, and accrued benefits due to the character of the service member's release from service being a bar to VA benefits.

The Board has ordered the AOJ to obtain and associate with the claims file copies of the Veteran’s complete VA treatment records since September 2013. The AOJ is also instructed to request authorization for the Veteran's Mayo Clinic treatment records from Jacksonville, Florida. Additionally, an addendum opinion on the cause of the Veteran's left leg fracture should be obtained, addressing subsequent medical evidence reflecting a pattern of falls after episodes of dizziness. An addendum opinion on whether hypertension is related to herbicide exposure and secondary to diabetes should also be provided. Finally, an addendum opinion on the nature and etiology of the Veteran’s cirrhosis of the liver should be obtained, including its relation to presumed Vietnam exposure, service-connected diabetes, and pulmonary sarcoidosis.

The Board has determined that the Veteran's hepatitis C is at least as likely as not related to his service, and grants entitlement to service connection for this condition.

The Board has decided that additional development is needed to determine if the Veteran's liver diseases, including cirrhosis, hepatitis C, and liver cancer, are related to his service-connected PTSD or due to exposure to Agent Orange while serving in Vietnam.

The Veteran's prostate cancer residuals were rated at a maximum of 40 percent from August 26, 2013. The Board found that the Veteran's urinary frequency warranted this rating based on his competent lay statements and medical evidence.