HEPATITIS

Summary

The Veteran, an Army Veteran who served from October 1972 to October 1975, appeals the denial of service connection for Hepatitis B and Hepatitis C. The Veteran contended that his hepatitis was related to his military service or secondary to his psychiatric disorders, specifically citing high-risk sexual activity and intravenous drug use as contributing factors. The Board reviewed a November 2021 VA medical opinion which initially provided a negative opinion regarding direct service connection for hepatitis. However, the examiner noted the Veteran's history of drug use, including heroin and cocaine, and stated that hepatitis could be linked to these high-risk behaviors, which occurred before, during, and after service. The examiner ultimately linked the Hepatitis B and C diagnoses to the Veteran's drug use, which is considered part of his service-connected acquired psychiatric disability. The Board found the evidence to be in equipoise regarding whether the hepatitis was secondary to the Veteran's service-connected PTSD, acquired psychiatric disorder, major depressive disorder, and alcohol and drug abuse disorder. Resolving all doubt in the Veteran's favor, the Board granted service connection for both Hepatitis B and Hepatitis C as secondary to his service-connected psychiatric conditions.

Rationale

VA examiner linked hepatitis to drug use; Drug use considered part of service-connected psychiatric disability; Evidence in equipoise, doubt resolved in Veteran's favor

Full Decision Text

Citation Nr: 22026911
Decision Date: 05/06/22	Archive Date: 05/06/22

DOCKET NO. 16-15 420A
DATE: May 6, 2022

ORDER

Entitlement to service connection for Hepatitis B is granted.

Entitlement to service Connection for Hepatitis C is granted.

FINDING OF FACT

Resolving all reasonable doubt in the Veteran's favor his Hepatitis B and Hepatitis C are secondary to his service-connected posttraumatic stress disorder with acquired psychiatric disorder, major depressive disorder (MDD), with alcohol and drug abuse disorder.

CONCLUSIONS OF LAW

1. The criteria for service connection for Hepatitis B as secondary to service-connected posttraumatic stress disorder with acquired psychiatric disorder, major depressive disorder (MDD), with alcohol and drug abuse disorder are met.  38 U.S.C. §§ 1110, 1131, 5107 (2018); 38 C.F.R. §§ 3.102, 3.310 (2021).

2. The criteria for service connection for Hepatitis C as secondary to service-connected posttraumatic stress disorder with acquired psychiatric disorder, major depressive disorder (MDD), with alcohol and drug abuse disorder are met.  38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the United States Army from October 1972 to October 1975.  

Service Connection

The Veteran also contends that his current hepatitis is related to his military service or secondary to his claimed acquired psychiatric disorder.  Specifically, the Veteran has asserted that his high-risk sexual activity and intravenous drug use contributed to his current hepatitis.

As noted in the Board's March 2021 remand, the ultimately question at issue here is whether the Veteran's psychiatric disorders cause him to engage in high-risk activity which are known risk factors for contracting hepatitis.

In November 2021, VA obtained a medical opinion addressing the questions at issue in this appeal.  In reference to the whether the Veteran's Hepatitis B and Hepatitis C were directly related to his military service, the examiner provided a negative opinion.  However, in the supporting rationale, the examiner noted his substantial drug use, to include heroine and inter-nasal cocaine use, as well as his alcohol use dating back to his teenage years.  The examiner then noted that his hepatitis diagnoses could not be directly linked to his service-connected posttraumatic stress disorder because hepatitis was a viral condition.  Nevertheless, the examiner when on to say he could "link it to his drug usage by IV drugs and cocaine use, since such were high risk behaviors."  The examiner then noted that the Veteran's drug use occurred before, during, and after his military service, and that he believed that "his Hepatitis B and C was due to his risky behavior documented in the service record."

Upon review of the record, the Board finds the evidence to at least be in equipoise as to whether the Veteran's Hepatitis B and Hepatitis C are secondary to his service-connected posttraumatic stress disorder with acquired psychiatric disorder, major depressive disorder (MDD), with alcohol and drug abuse disorder.  Significantly, the November 2021 VA examiner associated the Veteran's Hepatitis B and Hepatitis C with his drug use and, since drug abuse disorder is considered to be a part of his service-connected acquired psychiatric disability, see August 2020 Rating Decision, the examiner's association is sufficient to support the award of service connection.  Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for Hepatitis B and Hepatitis C is warranted.  38 U.S.C. § 5107; 38 C.F.R. § 3.102.

 

 

James Springer

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	V-N. Pratt, 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. 


 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.