Citation Nr: 18143307 Decision Date: 10/18/18 Archive Date: 10/18/18 DOCKET NO. 14-27 948 DATE: October 18, 2018 REMANDED Entitlement to service connection for the cause of the Veteran’s death is remanded. REASONS FOR REMAND The Veteran served honorably on active duty in the United States Marine Corps from June 1955 to April 1959, including at Camp Lejeune, North Carolina. The Veteran died in September 2006 and the Appellant is his surviving spouse. This matter comes before the Board of Veterans’ Appeals (Board) from a February 2014 rating decision issued by a Regional Office (RO) of the Department of Veterans Affairs (VA). The Board previously considered and denied the Appellant’s claim in a September 2017 decision. The Appellant appealed the Board’s decision to the United States Court of Appeals for Veterans Claims (Court). In June 2018, the Court granted a Joint Motion for Remand (JMR) which moved the Court to vacate and remand the September 2017 Board decision. The claim has been returned to the Board for further development consistent with the JMR. Entitlement to service connection for the cause of the Veteran’s death is remanded. As explained above, the Board’s previous decision denying service connection for the cause of the Veteran’s death was vacated and remanded by the Court in June 2018. In the JMR underlying that order, VA was found to have failed to fulfill its duty to assist the Appellant in the development of her claim. Specifically, it was found that the Board had incorrectly relied on a January 2014 VA medical opinion in which the examiner opined that the known risk factor of the Veteran’s history of tobacco use outweighed the limited/suggestive evidence of associated risk of lung cancer with exposure to contaminated water at Camp Lejeune. The JMR found that this examiner did not answer the question that was central to the Appellant’s claim. Namely, the JMR found that the examiner should have addressed whether the Veteran’s service in Camp Lejeune and exposure to contaminated water at that posting either caused the Veteran’s death or contributed substantially or materially to the development of his fatal lung cancer and ultimate death. See 38 C.F.R. § 3.312. Once a claim is remanded by the Court, a claimant is legally entitled to compliance with the directives of the remand. See Stegall v. West, 11 Vet. App. 268 (1998). As the Court directed the Board to obtain an additional medical opinion, the Board must remand this claim pursuant to Stegall. The matter is REMANDED for the following action: 1. Obtain an addendum opinion from a qualified medical professional regarding whether it is at least as likely as not that the Veteran’s exposure to contaminated water at Camp Lejeune caused or contributed to the development of his fatal lung cancer and ultimate death. The examiner should specifically answer the following questions: (a.) Is the Veteran’s service in Camp Lejeune and his associated exposure to contaminated water at least as likely as not the primary cause of the Veteran’s death? The examiner is reminded that for a disability to be considered the primary cause of death for VA’s purposes, it must singly, or with some other condition, be the immediate or underlying cause, or be etiologically related thereto. In other words, in order for the contaminated water exposure to be considered the primary cause of the Veteran’s death, it must be found to be singly, or with some other condition, the immediate or underlying cause of the development of the Veteran’s fatal lung cancer. (Continued on the next page)   (b.) Did the Veteran’s service in Camp Lejeune and exposure to contaminated water at least as likely as not contribute to his death? The examiner is also reminded that, to be considered contributing to the Veteran’s death, the disability must have contributed substantially or materially to the production of death, that it combined to cause death, or that it aided or lent assistance to the production of death. In terms specific to the Appellant’s claim, therefore, the examiner should determine whether the Veteran’s service in Camp Lejeune and his exposure to contaminated water either contributed substantially or materially to the development of the Veteran’s lung cancer, that it combined to cause the development of the Veteran’s lung cancer, or that it aided or lent assistance to the development of the Veteran’s lung cancer. MATTHEW TENNER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD B. Whitelaw, Associate Counsel