Citation Nr: 0707438 Decision Date: 03/12/07 Archive Date: 03/20/07 DOCKET NO. 01-03 553 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Seattle, Washington THE ISSUES 1. Entitlement to service connection for post-traumatic stress disorder (PTSD). 2. Entitlement to service connection for hepatitis C. REPRESENTATION Appellant represented by: Vietnam Veterans of America WITNESS AT HEARING ON APPEAL Appellant INTRODUCTION The veteran served on active duty from September 1964 to February 1968. This matter comes before the Board of Veterans' Appeals (Board) on appeal from November 2000 and June 2002 decisions of the Seattle, Washington, Regional Office (RO) of the Department of Veterans Affairs (VA). In November 2005, the Board denied the claims noted on the title page. The veteran appealed. In December 2006, the United States Court of Appeals for Veterans Claims (Court) granted a joint motion for remand. In November 2005 the Board remanded the issue of entitlement to service connection for a major depressive disorder. That remand remains active, and the remand below does not nullify any instruction contained in that remand. REMAND In December 2006, the Court remanded the Board's November 2005 decision for further proceedings. Specifically, the Court granted a joint motion for remand which stated that the veteran was to be offered a medical examination which specifically considered the appellant's complete medical history, to include his receipt of tattoos in-service. Further, the Court found that VA must inform the veteran that he could submit buddy statements relative to his alleged in- service stressors which he has discussed in support of his claim of entitlement to service connection for post traumatic stress disorder. In light of the foregoing, the case is REMANDED for the following action: 1. The RO should contact the veteran and request that he identify or submit any additional medical treatment records which have not been previously provided, and which would support the assertion that either PTSD and/or hepatitis C was incurred or aggravated in-service. He is also invited to identify or submit any evidence which would help verify any claimed in-service stressor, or verify the claim that he was exposed to hepatitis C while on active duty. All attempts to secure this evidence must be documented in the claims file. 2. The RO must specifically notify the veteran that he may submit buddy statements which support his alleged in- service stressors, to particularly include statements from buddies who may be able to verify the claimed particulars of an in-service helicopter accident. All attempts to notify the appellant must be carefully documented. 3. Thereafter, and regardless of any response from the appellant, the RO must schedule the veteran for a VA gastroenterology examination to determine the nature and etiology of the appellant's hepatitis C. The veteran's claims folders must be provided to the examiner for review. The examiner must carefully consider all possible methods by which the veteran could have been exposed to hepatitis C, to include a history of intravenous drug use, the sharing of equipment, and the receipt of four tattoos while on active duty. Thereafter, the examiner must specifically opine whether it is a least as likely as not, i.e., is there a 50/50 chance, that hepatitis C was incurred or aggravated in-service. The role, if any, that the veteran's in-service receipt of tattoos must be specifically addressed. If the examiner finds that it is more likely than not that hepatitis C is not related to service, the examiner must then explain what is the most probable source for the veteran being exposed to the infection. A complete rationale must be provided for any opinion proffered. 4. The RO should review the medical examination report to ensure that it is in complete compliance with the directives of this REMAND. If it is deficient in any manner, the RO must implement corrective procedures at once. 5. The veteran is hereby notified that it is his responsibility to report for the examination and to cooperate in the development of the claim. The consequences for failure to report for a VA examination without good cause may include denial of the claim. 38 C.F.R. §§ 3.158, 3.655 (2006). In the event that the veteran does not report for any scheduled examination, documentation should be obtained which shows that notice scheduling the examination was sent to the last known address. It should also be indicated whether any notice that was sent was returned as undeliverable. 6. After undertaking any other development deemed appropriate, the RO should readjudicate the issues on appeal. If the benefit is not granted, the veteran should be furnished with a supplemental statement of the case and afforded an opportunity to respond before the record is returned to the Board for future review. 7. If while in remand status, additional evidence or information received triggers a need for further development or assistance under the Veterans Claims Assistance Act of 2000 (VCAA), such as providing updated notice of what evidence has been received and not received by VA as well as who has the duty to request evidence, then such development must be undertaken. Dingess v. Nicholson, 19 Vet. App. 473 (2006); 38 U.S.C.A. §§ 5100, 5103, 5103A (West 2002 & Supp. 2006); 38 C.F.R. § 3.159 (2006). Thereafter, the case should be returned to the Board for further appellate review, if in order. By this remand, the Board intimates no opinion as to any final outcome warranted. No action is required of the veteran until he is notified by the RO. The appellant has the right to submit additional evidence and argument on the matters the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). This claim must be afforded expeditious treatment. The law requires that all claims that are remanded by the Board of Veterans' Appeals or by the United States Court of Appeals for Veterans Claims for additional development or other appropriate action must be handled in an expeditious manner. See 38 U.S.C.A. §§ 5109B, 7112 (West Supp. 2006). _________________________________________________ DEREK R. BROWN Veterans Law Judge, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 2002), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Appeals for Veterans Claims. This remand is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (2006).