Citation Nr: 18141741 Decision Date: 10/11/18 Archive Date: 10/11/18 DOCKET NO. 16-27 784 DATE: October 11, 2018 REMANDED Entitlement to service connection for fatigue, also claimed as neurobehavioral effect as due to exposure to contaminated water at Camp Lejeune is remanded. Entitlement to service connection for high blood pressure (hypertension), claimed as due to exposure to contaminated water at Camp Lejeune is remanded. Entitlement to service connection for diabetes mellitus type II, claimed as due to exposure to contaminated water at Camp Lejeune is remanded. Entitlement to service connection for memory loss, claimed as neurobehavioral effect as due to exposure to contaminated water at Camp Lejeune is remanded. Entitlement to service connection for anxiety, claimed as neurobehavioral effect as due to exposure to contaminated water at Camp Lejeune is remanded. Entitlement to service connection for depression, claimed as due to exposure to contaminated water at Camp Lejeune is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1978 to October 1982. These matters are before the Board of Veterans’ Appeals (Board) on appeal from a May 2015 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). 1. Entitlement to service connection for fatigue, memory loss, and anxiety also claimed as neurobehavioral effects as due to exposure to contaminated water at Camp Lejeune are remanded. The Veteran contends that his fatigue, memory loss, and anxiety are neurobehavioral effects that are due to his exposure to contaminated water at the Camp Lejeune United States Marine Corps Base. The Veteran asserts that he was stationed at Camp Lejeune from August 1979 to September 1982. His personnel records and military treatment records show that he was stationed at Camp Lejeune for more than 30 days, thus exposure to contaminated water is presumed. 38 C.F.R. § 3.307(a)(7)(iii). In addition, medical treatment records in July 2014 and March 2015 reveal that the symptoms the Veteran has asserted were recorded in his medical records, specifically reports of anxiety, fatigue and memory loss. VA has acknowledged that persons residing or working at Camp Lejeune from August 1953 through December 1987 were potentially exposed to drinking water contaminated with volatile organic compounds (VOCs). Certain diseases including kidney cancer, liver cancer, non-Hodgkin’s lymphoma, adult leukemia, multiple myeloma, Parkinson’s disease, aplastic anemia and other myelodysplastic syndromes, and bladder cancer shall be service-connected even though there is no record of such disease during service. However, the absence of a disease from the presumptive list does not preclude a Veteran from otherwise proving that his disability resulted from exposure to contaminated water at Camp Lejeune. Combee v. Brown, 34 F.3d 1039, 1042 (Fed. Cir. 1994). Service connection may still be granted on a direct basis. Here, the Board finds there is probative evidence of a current disabilities or persistent recurrent symptoms of disabilities that could be related to the Veteran’s service at Camp Lejeune. As such, remand is warranted in order for the Veteran to be afforded a VA examination to determine the etiology of his symptomatology. See McLendon v. Nicholson, 20 Vet. App. 79, 81-86 (2006). 2. Entitlement to service connection for high blood pressure (hypertension), diabetes type II, and depression claimed as due to exposure to contaminated water at Camp Lejeune is remanded. The Veteran contends that his high blood pressure, diabetes and depression were all caused by his exposure to contaminated water at Camp Lejeune. The Veteran’s medical record show a diagnosis for hypertension in January 2014, a diagnosis for diabetes in January 2014, and a diagnosis for depression in December 2014. As noted above, the Veteran’s exposure to contaminated water at Camp Lejeune is presumed based on his service at the base. Here, again the Veteran has not been provided VA examinations to determine if any of his current diagnosed ailments are related to his exposure to contaminated water at Camp Lejeune. Therefore, remand is warranted to afford VA examinations to determine the etiology of his disabilities. Additionally, updated VA treatment records should be associated with the record on remand. See Sullivan v. McDonald, 815 F.3d 786, 792 (Fed. Cir. 2016) (finding that because § 3.159(c)(3) expanded the VA’s duty to assist to include obtaining VA medical records without consideration of their relevance.) The matters are REMANDED for the following actions: 1. Update/Obtain VA treatment records from May 2015 to the present. Document all requests for information as well as responses in the claims file. 2. After associating any records with the claims file develop the Veteran’s claim in accordance with the special handling procedures for Camp Lejeune claims, to include scheduling the Veteran for VA examination(s). Request an etiology opinion for each of the above listed issues. A comprehensive rationale is to be provide for each opinion.   If a physical examination cannot be obtained, then obtain a medical opinion as to the issues covered by the requested medical examination. Paul Sorisio Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. M. Williams, Associate Counsel