Citation Nr: 1030946 Decision Date: 08/18/10 Archive Date: 08/24/10 DOCKET NO. 05-12 587 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Philadelphia, Pennsylvania THE ISSUE Entitlement to service connection for multiple sclerosis (MS). REPRESENTATION Veteran represented by: Disabled American Veterans WITNESS AT HEARING ON APPEAL Veteran ATTORNEY FOR THE BOARD C. C. Dale, Associate Counsel INTRODUCTION The Veteran had active duty service from September 1972 to April 1974. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a March 2003 rating decision by a Regional Office (RO) of the Department of Veterans Affairs (VA). The Veteran was afforded a June 2010 videoconference Board hearing before the undersigned Veterans Law Judge. The hearing transcript is associated with the record. The appeal is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. VA will notify the Veteran if further action is required. REMAND During the pendency of the appeal, the Veteran raised an additional theory of entitlement. He asserted that his MS is related to contaminated water exposure at Camp Lejeune, North Carolina. The Veteran submitted evidence confirming that hazardous chemicals were present in the water supply at Camp Lejeune from 1957 through 1987. Service records confirm that the Veteran was stationed at Camp Lejeune within this time period. The Veteran submitted a July 2009 letter from K.M., MD stating that he could not rule out the possibility that such contaminated water exposure "may have" initiated or exacerbated MS. The record does not include a VA medical opinion addressing this theory of entitlement. The Board is required to consider all issues which have been raised either by the claimant, or by the evidence of record. Robinson v. Mansfield, 21 Vet. App. 545, 552 (2008). VA is obliged to provide an examination when the record contains competent evidence that the claimant has a current disability or signs and symptoms of a current disability, the record indicates that the disability or signs and symptoms of disability may be associated with active service; and the record does not contain sufficient information to make a decision on the claim. 38 U.S.C.A. § 5103A(d) (West 2002); McLendon v. Nicholson, 20 Vet. App. 79 (2006). The threshold for finding a link between current disability and service is low. Locklear v. Nicholson, 20 Vet. App. 410 (2006). The RO/AMC must contact an appropriately qualified healthcare provider for a medical opinion regarding whether it is more or less likely that the Veteran's MS was affected by his exposure to contaminated water exposure during service at Camp Lejeune. The claims file and a copy of this remand must be made available to the examiner. He or she is to note that the Veteran was stationed at Camp Lejeune during his period of active service from September 1972 to April 1974. A National Research Council study concluded that several volatile organic compounds resulting in adverse health outcomes were present in Camp Lejeune drinking water during the Veteran's period of active duty. Based on the Veteran's history, the examiner must provide a medical opinion as to whether it is more or less likely that exposure to the contaminated water at Camp Lejeune is related to Veteran's present MS disability. The opinion must be expressed in terms of scientific certainty and be accompanied by a scientific rationale. If the examiner cannot express an opinion without resort to speculation, he or she must state and note any missing information that would generate a non-speculative opinion. Lastly, any evidence showing treatment for MS symptoms during the seven year presumptive period is critical to the present issue. The Veteran reported treatment for vision disorders in 1979 or 1980, but unfortunately the physician holding these records responded that they are destroyed. However, if the Veteran received hospital treatment, the RO/AMC needs to determine if these records are available. The RO/AMC must contact the Veteran to ascertain if he had a hospital treatment for his report vision disorder in 1979 or 1980 and attempt to obtain any identified hospital records. Accordingly, the case is REMANDED for the following action: 1. Ascertain if the Veteran received hospital treatment or can identify any additional custodian holding records pertaining to his reported medical treatment for vision disorders in 1979 or 1980. Request that he provide the contact information and a release form for these records. Contacts all identified custodians of these records and incorporate all correspondence into the record. 2. Contact an appropriately qualified healthcare provider for a medical opinion regarding whether it is more or less likely that the Veteran's MS was affected by his exposure to contaminated water during service at Camp Lejeune. The claims file and a copy of this remand must be made available to the examiner. He or she is to note that the Veteran was stationed at Camp Lejeune during his period of active service from September 1972 to April 1974. A National Research Council study concluded that several volatile organic compounds resulting in adverse health outcomes were present in Camp Lejeune drinking water during the Veteran's period of active duty. Based on the Veteran's history, the examiner must provide a medical opinion as to whether it is more or less likely that exposure to the contaminated water at Camp Lejeune is related to Veteran's present MS disability. The opinion must be expressed in terms of scientific certainty and be accompanied by a scientific rationale. If the examiner cannot express an opinion without resort to speculation, he or she must state and note any missing information that would generate a non-speculative opinion. 3. To help avoid future remand, the VA must ensure that all requested action has been accomplished (to the extent possible) in compliance with this remand. If any action is not undertaken, or is taken in a deficient manner, appropriate corrective action should be undertaken. See Stegall v. West, 11 Vet. App. 268 (1998). 4. After completing the requested actions, and any additional notification and/or development deemed warranted, readjudicate the Veteran's claim on appeal. If any benefit sought on appeal remains denied, furnish to the Veteran and his representative an appropriate supplemental statement of the case, and afford them the appropriate time period for response before the claims file is returned to the Board for further appellate consideration. The Veteran 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 38 U.S.C.A. §§ 5109B, 7112 (West Supp. 2009). _________________________________________________ MARY GALLAGHER 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) (2009).