Citation Nr: 18143793 Decision Date: 10/22/18 Archive Date: 10/22/18 DOCKET NO. 16-17 510 DATE: October 22, 2018 REMANDED Entitlement to service connection for multiple strokes is remanded. Entitlement to service connection for heart damage is remanded. Entitlement to service connection for bursitis, left arm is remanded. Entitlement to service connection for bursitis, left leg is remanded. REASONS FOR REMAND The Veteran had active duty from March 1975 to March 1977 and from April 1981 to November 1983. This case comes before the Board of Veteran’s Appeals (Board) on appeal from an August 2014 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). 1. Multiple Strokes The Veteran asserts that his multiple strokes were caused by his exposure to contaminated water at Camp Lejeune. Service treatment records (STRs) are negative for symptoms, treatment, or a diagnosis of multiple strokes. Post service treatment records indicate that the Veteran has had several strokes. Private medical records from ST. J.M. Center indicated that the Veteran has had multiple strokes since 2006. On November 2014 letter, the Veteran wrote that he experienced multiple strokes for the past 15 years, that left the doctors baffled at the root cause. The Veteran indicated that he was exposed to the contaminated water supply while stationed at Camp Lejeune. He noted that one of the effects of the contaminated water supply was neurobehavioral effects. He indicated that this could explain the differences in diagnoses on whether he had multiple strokes or if he experienced neurobehavioral disorder. He wrote that he was stuck in-between conflicting diagnoses from doctors. The Veteran has not been afforded a VA examination for this claim. Therefore, a remand is necessary to obtain a VA examination with an opinion on this issue. 2. Heart Damage The Veteran asserts that his heart condition is due to his military service and was caused by his exposure to contaminated water at Camp Lejeune. STRs are negative for any symptoms, treatment, or diagnosis of a heart condition. Post service treatment records reveal that the Veteran was diagnosed with fast heart beat and slow heart rate. The Veteran has not been afforded a VA examination for this claim. Therefore, a remand is necessary to obtain a VA examination with an opinion on this issue. 3. Left Arm/Left Leg The Veteran asserts that his left arm and left leg condition is related to his military service. STRs are negative for any symptoms, treatment, or diagnosis of a left arm or left leg condition. Post service treatment records reveal that the Veteran had a left arm and left leg condition. A July 2012 VA treatment note documented that the Veteran had a major stroke that caused loss of use of his left side. The Veteran has not been afforded a VA examination for these claims. Therefore, a remand is necessary to obtain VA examinations with opinions on these issues. The matters are REMANDED for the following action: 1. Obtain updated VA treatment records pertinent to the Veteran’s claims on appeal. 2. Please contact the Veteran and request that he provide or identify any outstanding private treatment records pertinent to his disabilities on appeal. After securing any necessary release(s), obtain those records. All attempts to procure records should be documented in the file. If the RO cannot obtain records identified by the Veteran, a notation to that effect should be inserted in the file. The Veteran is to be notified of unsuccessful efforts in this regard, in order to allow him the opportunity to obtain and submit those records for VA review. 3. Schedule the Veteran for the appropriate VA examination. The Veteran’s electronic file must be made available to the examiner prior to the examination, and the examiner must review the entire claims file in conjunction with the examination. The VA examiner is asked to offer the following opinions: A. Does the Veteran have a current multiple stroke and/or neurobehavioral disability? B. Is it at least as likely as not (a 50 percent probability or greater) that any current multiple stroke and/or neurobehavioral disability began during service or is otherwise etiologically related to active service, including as due to exposure to contaminated water at Camp Lejeune? 4. Schedule the Veteran for the appropriate VA examination. The Veteran’s electronic file must be made available to the examiner prior to the examination, and the examiner must review the entire claims file in conjunction with the examination. The VA examiner is asked to offer the following opinions: A. Does the Veteran have a current heart disability? B. Is it at least as likely as not (a 50 percent probability or greater) that any current heart disability began during service or is otherwise etiologically related to active service, including as due to exposure to contaminated water at Camp Lejeune? 5. Schedule the Veteran for the appropriate VA examination. The Veteran’s electronic file must be made available to the examiner prior to the examination, and the examiner must review the entire claims file in conjunction with the examination. The VA examiner is asked to offer the following opinions: A. Does the Veteran have a current left arm bursitis disability? B. Is it at least as likely as not (a 50 percent probability or greater) that any left arm bursitis disability began during service or is otherwise etiologically related to active service, including as due to exposure to contaminated water at Camp Lejeune? C. Is it at least as likely as not (a 50 percent probability or greater) that the Veteran’s left arm bursitis disability was (i) caused or (ii) aggravated by his multiple stroke disability? D. If the opinion is that the multiple stroke disability aggravated the left arm bursitis disability, the VA examiner should specify, so far as possible, the degree of disability resulting from such aggravation. The examiner is asked to please address the Veteran’s contentions. Also, please address the July 2012 VA treatment note documenting that the Veteran had a major stroke which caused loss of use of the Veteran’s left side. 6. Upon receipt of all additional records, schedule the Veteran for the appropriate VA examination. The Veteran’s electronic file must be made available to the examiner prior to the examination, and the examiner must review the entire claims file in conjunction with the examination. The VA examiner is asked to offer the following opinions: A. Does the Veteran have a current left leg bursitis disability? B. Is it at least as likely as not (a 50 percent probability or greater) that any left leg bursitis disability began during service or is otherwise etiologically related to active service, including as due to exposure to contaminated water at Camp Lejeune? C. Is it at least as likely as not (a 50 percent probability or greater) that the Veteran’s left leg bursitis disability was (i) caused or (ii) aggravated by his multiple stroke disability? D. If the opinion is that the multiple stroke disability aggravated the left leg bursitis disability, the VA examiner should specify, so far as possible, the degree of disability resulting from such aggravation. The examiner is asked to please address the Veteran’s contentions. Also, please address the July 2012 VA treatment note documenting that the Veteran had a major stroke which caused loss of use of the Veteran’s left side. K. J. ALIBRANDO Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD S. Baxter, Associate Counsel