Citation Nr: 0004112 Decision Date: 05/08/00 Archive Date: 09/08/00 DOCKET NO. 98-01 576A DATE MAY 08, 2000 On appeal from the Department of Veterans Affairs Regional Office in Phoenix, Arizona ORDER The following correction is made in a decision issued by the Board in this case on February 16, 2000: On the title page, Kenneth M. Carpenter, Attorney, is removed as the veteran's representative as he had withdrawn from representing the veteran prior to the issuance of the Board's decision. Richard B. Frank Member, Board of Veterans'Appeals Citation Nr: 0004112 Decision Date: 02/16/00 Archive Date: 02/23/00 DOCKET NO. 98-01 576A) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Phoenix, Arizona THE ISSUE Entitlement to compensation benefits for hepatitis based on the provisions of 38 U.S.C.A. § 1151 (West 1991). REPRESENTATION Appellant represented by:Kenneth C. Carpenter, Attorney ATTORNEY FOR THE BOARD T. Hal Smith, Counsel INTRODUCTION The veteran served on active duty from November 1966 to December 1969. This matter comes to the Board of Veterans' Appeals (Board) from a rating determination of the Department of Veterans Affairs (VA) Regional Office (RO) in Phoenix, Arizona. REMAND The record reflects that the veteran's February 1994 anti-HCV (hepatitis C virus) test was reactive. At that time, he gave a history of jaundice when he was 15 years old. During a period of treatment (essentially for psychiatric complaints and substance abuse) from April to July 1994, it was noted that he had a mild elevation of AST (aspartate transaminase). It was noted, however, that his AST declined and that he had a normal bilirubin value in June 1994. A highly elevated AST of 377 was reported upon laboratory tests in November 1994. Hepatitis was shown as a diagnosis in February 1995. A private physician reported in a May 1996 that the veteran was under this care for hepatitis C virus and undergoing a course of interferon therapy. At the time, the physician reported that it was uncertain whether the veteran would get a lasting response from this medication, but therapy continued. While the veteran felt some fatigue, this was not disabling as of yet. It is the veteran's contention that the VA failed to diagnose and treat hepatitis resulting in permanent liver damage. The record contains competent evidence of the current existence of the claimed disability. It also contains a mass of raw medical data relating to VA treatment that is not interpreted as to what it discloses about the material facts in this case. Since the Board does not have the medical expertise to interpret the data, it can not ascertain whether the claim is ultimately well grounded. Basically, even to determine that the claim is not well grounded, the Board would effectively be entering a medical determination as to what the VA treatment records do or do not disclose. Generally, if further evidence or clarification of the evidence or correction of a procedural defect is essential for a proper appellate decision, the Board shall remand the case to the agency of original jurisdiction, specifying the action to be undertaken. 38 C.F.R. § 19.9 (1999). Accordingly, the case is remanded for the following: 1. The appellant has the right to submit additional evidence and argument on the matter or matters the Board has remanded to the regional office. Kutscherousky v. West, 12 Vet. App. 369 (1999). 2. The RO should request the veteran to identify the names, addresses, and approximate dates of treatment for all health care providers, VA or private, inpatient or outpatient, who may possess additional records of treatment pertinent to his claim that are not already of record. After securing any necessary authorization from the veteran, the RO should attempt to obtain copies of these treatment records identified by the veteran. 3. Thereafter, all volumes of the claims file should be forwarded by the RO to an appropriately qualified VA physician who should be requested, after review of the entire evidentiary record, to render comprehensive medical opinion(s) as to whether the appellant incurred hepatitis C virus due to VA hospitalization or medical treatment or the lack thereof. The examiner is specifically requested to discuss whether elevated levels of AST during periods of VA treatment reflect increased hepatitis disability beyond the natural progression. 4. Following completion of the foregoing, the RO must review the entire claims folder and ensure that all the foregoing development actions have been conducted and completed in full. If any development is incomplete, including the possibility that the requested medical opinion(s) does not include all requested information, appropriate correction actions should be taken. If any benefit sought is not granted to the veteran's satisfaction, the RO should issue a supplemental statement of the case. The requisite period of time for a response should be afforded. Thereafter, the case should be returned to the Board for final appellate review, if otherwise in order. By this remand, the Board intimates no opinion as to any final outcome warranted. No action is required of the veteran until notified by the RO. This claim must be afforded expeditious treatment by the RO. 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 The Veterans' Benefits Improvements Act of 1994, Pub. L. No. 103-446, § 302, 108 Stat. 4645, 4658 (1994), 38 U.S.C.A. § 5101 (West Supp. 1999) (Historical and Statutory Notes). In addition, VBA's Adjudication Procedure Manual, M21-1, Part IV, directs the ROs to provide expeditious handling of all cases that have been remanded by the Board and the Court. See M21-1, Part IV, paras. 8.44- 8.45 and 38.02-38.03. Richard B. Frank Member, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 1991 & Supp. 1999), 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) (1999).