Citation Nr: 0510436 Decision Date: 04/12/05 Archive Date: 04/21/05 DOCKET NO. 03-33 484 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Providence, Rhode Island THE ISSUE Entitlement to service connection for status post chronic renal failure with left kidney transplant, to include cardiovascular-renal disease and hypertension. REPRESENTATION Appellant represented by: Diane Caggiano, Attorney ATTORNEY FOR THE BOARD A. Contreras, Associate Counsel INTRODUCTION The veteran served on active duty from April 1981 to April 1985. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a June 2002 decision by the Department of Veterans' Affairs (VA) Regional Office (RO) in Providence, Rhode Island. The post-service medical records show that in addition to being treated for end stage renal disease, the veteran was treated for hypertension. Pursuant to 38 C.F.R. §§ 3.307 and 3.309, there is a one-year presumptive period for cardiovascular-renal disease, including hypertension. The Board finds this issue is included in the current appeal. Accordingly, the issue is as stated on the title page of this decision. The appeal is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. VA will notify you if further action is required on your part. REMAND The appellant contends that while stationed at Camp Lejeune, he was exposed to tetrachloroethylene (PCE) and trichloroethylene (TCE), a solvent and a degreaser, respectively. He claims that these chemicals were used in the dry cleaning of his uniforms, were in the water he drank, and were used in the motor pool to clean machine parts. The appellant's primary occupational specialty was Organizational Automotive Mechanic. His main contention is that the above- mentioned chemicals caused his renal disease. The veteran submitted articles relating to contaminated water at Camp Lejeune. A review of the Agency for Toxic Substances and Diseases Registry (ATSDR) website article on Camp Lejeune regarding the 1997 Health Study of Contaminated Drinking Water shows that some wells in operation at Camp Lejeune prior to 1985 were found to be contaminated with TCE and PCE. The study concluded that there may be a relationship between exposure to organic solvents and adverse pregnancy outcomes. A Public Health Assessment, U.S. Marine Corps Camp Lejeune, shows that ATSDR concluded that base wide groundwater contamination posed no apparent public health hazard. The 2000 CPEO Military List Archive dated November 9, 2000, regarding dry cleaning and Camp Lejeune, notes that the U.S. Marines and ATSDR were engaged in locating families that were exposed to the chemicals PCE and TCE. Several of their studies indicated that exposure to the chemicals may increase the likelihood of birth defects and childhood cancers such as leukemia. Marine Corps Base Camp Lejeune Water Survey Chronology of Events and Historical Information 1972 through November 1, 2001, shows that there may be some correlation between exposure to the chemicals in drinking water during pregnancy and some adverse pregnancy outcomes. The September 1980 enlistment examination shows a blood pressure reading of 140/84. A November 1984 service medical record shows a blood pressure reading of 148/102. The March 1985 separation examination shows a blood pressure reading of 132/89. Private medical records show that the veteran had high blood pressure in November 1986, with a diagnosis of hypertension in December 1986. Subsequently renal disease was diagnosed. In light of the evidence, the Board is of the opinion that an examination by a kidney disease specialist is warranted, to determine the nature, severity, and etiology of the kidney disease and hypertension. Accordingly, this claim is REMANDED for the following actions: 1. The RO should make arrangements with the appropriate VA medical facility for the veteran to be examined by a kidney disease specialist to determine the nature, severity, and etiology of the kidney disease and hypertension. The claims folder should be made available to the examiner for review in conjunction with the examination. The RO should request the examiner to obtain a detailed clinical history of the veteran's in-service chemical exposure. All specialized tests deemed necessary should be performed. The examiner is to indicate whether the veteran's kidney disease is acquired or a congenital or developmental defect or disease. The examiner is requested to render opinions concerning the following: b) Whether it is as likely as not that the renal disease that resulted in the left kidney transplant and hypertension are related to his service, to include any exposure to chemicals, or that these disorder were manifested within one year after service. If no, it is requested that the examiner comment on the clinical significance of the inservice blood pressure readings, particularly the November 1984 reading of 148/102 as it relates to the post service diagnosis of hypertension and renal disease in late 1986. b) If it is determined that the kidney disease preexisted service, is it as likely as not that it underwent a chronic increase in severity during service beyond the disease's natural progression? A complete rationale for any opinion expressed should be included in the report. 2. Thereafter, the RO should re-adjudicate the claim. If the benefits sought are not granted, the veteran should be furnished a supplemental statement of the case and an opportunity to respond. The case should then be returned to the Board, if in order. The appellant has the right to submit additional evidence and argument on the matter or 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 The Veterans Benefits Act of 2003, Pub. L. No. 108-183, § 707(a), (b), 117 Stat. 2651 (2003) (to be codified at 38 U.S.C. §§ 5109B, 7112). _________________________________________________ ROBERT P. REGAN 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) (2004).