In the beginning, we had such high hopes…

DEPARTMENT OF VETERANS AFFAIRS CLEVELAND REGIONAL OFFICE 
Tiger Team Remand Unit P.O. Box 998020 Cleveland, Ohio 44199-8020
Rating Decision August 5, 2003

INTRODUCTION

The records reflect that the veteran served during the Vietnam Era in the Army from August 25, 1967 to April 17, 1971. The Board of Veterans Appeals remanded the case on December 27,2001; and based upon a review of the evidence listed below, the following decision(s) were made in the claim. .

DECISION
Service-connection for hepatitis C is granted with an evaluation of 10 percent effective April 17,2000. .

EVIDENCE
. VA Fonn 21-526, Application for Compensation and/or Pension received April 12, 2OO2′

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• .Service Medical Records from the National Personnel Records Center
  Outpatient treatment reports from the VA Medical Center, Buffalo for the period of August 1999 through October 2000
  Medical Records from 1996 through 1999 DD Form 214 ,
  Article submitted entitled “Risk Factors for Hepatitis C Virus Infection in United States Blood Donors”,
  Statement received from the Veteran on January 29,2001 Board of Veterans Appeals’ Order dated December 27,2001
  VA Form 4138, Statement in Support of a Claim received January 8, 2002 with attachment .
  Medical Records .from for’ the period of May 30, 1995 through March 22, 2000
  Response from the National Personnel Records Center (NPRC) dated August 2, 2002 .
  VA Examination dated June 5, 2003 and Hospital for the period of ‘

……….REASONS FOR DECISION

Service-connection for hepatitis C.

Service-connection for hepatitis C has been established as directly related to military
service. -This decision is based upon the VA examiner’s opinion dated June 5,2003
coupled with the supporting evidence of articles relative to jet inoculations submitted by’, .
the veteran. ,Specifically, the V A examiner provided a causal relationship finding that the
veteran’s hepatitis C currently diagnosed was incurred in service as a result of the jet
inoculations given therein. Moreover, the examiner relied upon these articles which note
that due to cross-contamination, anyone who had inoculations with Jet injectors were at
risk for having hepatitis C and should be tested.'” Further, the veteran denied having
incurred any of the known risk factors subsequent to service, such as N drug use; blood
transfusions; tattoos; surgeries, or needle sticks. Accordingly, service-connection is
granted as a result of the evidence of record. ‘An evaluation of 10 percent is assigned from
April 17, 2000. This date is being used, because it is the date of the veteran’s original claim
for service-connection that was subsequently denied, and timely appealed
to the Board of Veterans’ Appeals. .

An evaluation of 10 percent is assigned for chronic liver disease without cirrhosis; but with
intermittent fatigue, malaise, and anorexia, or; incapacitating episodes (with . symptoms
such as fatigue, malaise, nausea, vomi1ing, anorexia, arthralgia, and right upper quadrant
pain) having a total duration of at least one week, but less than two weeks, during the past
12-monthperiod.

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In this case, the most recent VA opinion of June 2003 was merely a review of records
contained in the claims file, and thus, no objective or subjective evidence was obtained
that could be used for evaluation purposes. However, the medical records o coupled with
the outpatient treatment records from the V A Medical Center, Buffalo do provide such
evidence. Specifically, these records demonstrate that prior to inception of the claim, the
veteran was placed on Interferon, but due to complications of the medication, it was
.ceased. . Subsequently, between 1998 and 1999, he remained asymptomatic for the
disease. However, right around inception of this claim in 2000; the. notes indicate that the
veteran’s viral load started to rise. Subsequently, he was placed on Infergen, 15
mg three times per week. A note of September 2000, indicates that, at that time, the
veteran complained of incurring flu-like symptoms for a day after the shot is given. Also,
between March 2000 and September 2000, he had lost 20 pounds of weight due to these
problems. Accordingly, based upon these complaints, an evaluation
of 10 percent is assigned. .

A higher evaluation of 20 percent is not warranted at this time, because there has been no
evidence submitted demonstrating that the veteran suffers from chronic liver disease
without cirrhosis, but with daily fatigue malaise and anorexia (without weight loss C?r .
hepatomegaly), requiring dietary restriction or continuous medication, or; incapacitating
episodes (with symptoms such as fatigue; malaise, nausea, vomiting, anorexia, art a1gia,
and right upper quadrant pain) having a total duration of at least two weeks, but less than
four weeks, during the past 12-month period.

REFERENCES: .

Title 38 of the Code of Federal Regulations, Pensions, Bonuses and Veterans’ Relief
contains the regulations of the Department of Veterans Affairs which govern entitlement
to all veteran benefits. For additional information regarding applicable laws and .
regulations, please consult your local library, or visit us at our web site, http://www.va.gov.