Citation Nr: 20042020 Decision Date: 06/19/20 Archive Date: 06/19/20 DOCKET NO. 19-33 696 DATE: June 19, 2020 REMANDED Entitlement to service connection for rectal/anal cancer, to include as due to exposure to contaminated water at Camp Lejeune, is remanded. Entitlement to service connection for neurobehavioral effects, to include as due to exposure to contaminated water at Camp Lejeune, is remanded. Entitlement to service connection for ulcerative colitis, also claimed as an autoimmune disorder, to include as due to exposure to contaminated water at Camp Lejeune, is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1961 to February 1962. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a May 2018 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). 1. Entitlement to service connection for rectal/anal cancer, to include as due to exposure to contaminated water at Camp Lejeune, is remanded. 2. Entitlement to service connection for neurobehavioral effects, to include as due to exposure to contaminated water at Camp Lejeune, is remanded. 3. Entitlement to service connection for ulcerative colitis, also claimed as an autoimmune disorder, to include as due to exposure to contaminated water at Camp Lejeune, is remanded. The Veteran contends that he has rectal/anal cancer, neurobehavioral effects, and ulcerative colitis related to exposure to contaminated water while serving at Camp Lejeune. The Veteran’s service personnel records confirm service of at least 30 days at Camp Lejeune during the applicable time period, and so exposure to contaminated drinking water is conceded. See 38 C.F.R. § 3.307(a)(7). The disabilities for which the Veteran seeks service connection as due to exposure to contaminated water at Camp Lejeune are not on the presumptive list. See 38 C.F.R. § 3.309(f). However, the absence of a disease from the presumptive list does not preclude the Veteran from otherwise proving that the disability directly resulted from his period of active service, to include his exposure to contaminated water therein. See Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994). The Veteran’s treatment records document diagnoses of rectal cancer, a benign essential tremor, and chronic ulcerative colitis. Additionally, the Veteran has submitted articles regarding a possible relationship between his claimed disabilities and his in-service exposure to contaminated water at Camp Lejeune. Accordingly, the Board finds that an opinion should be obtained regarding the nature and etiology of his claimed conditions. See McLendon v. Nicholson, 20 Vet. App. 79 (2006). The matters are REMANDED for the following action: 1. After obtaining any necessary releases, obtain any outstanding VA or private treatment records pertinent to the Veteran’s claims. 2. Thereafter, obtain a VA opinion regarding the nature and etiology of the Veteran’s rectal/anal cancer, neurobehavioral effects, and colitis. The VA medical provider must review the claims file, to include a copy of this remand. If an examination or telehealth interview is deemed warranted, one should be arranged. All indicated tests and studies should be completed. After thorough review of the claims file, the VA examiner should respond to the following: (a.) Is it at least as likely as not (a 50 percent or greater probability) that the Veteran’s rectal/anal cancer was incurred in service or is the result of any incident in service, to specifically include his presumed exposure to contaminated water at Camp Lejeune? (b.) Does the Veteran suffer from a neurobehavioral condition? In rendering this decision, the examiner should address post-service treatment records documenting a benign essential tremor. (c.) If so, is it at least as likely as not (a 50 percent or greater probability) that the Veteran’s neurobehavioral condition was incurred in service or is the result of any incident in service, to specifically include his presumed exposure to contaminated water at Camp Lejeune? (d.) Is it at least as likely as not (a 50 percent or greater probability) that the Veteran’s ulcerative colitis was incurred in service or is the result of any incident in service, to specifically include his presumed exposure to contaminated water at Camp Lejeune? A complete rationale should be provided for all opinions and conclusions expressed. CAROLINE B. FLEMING Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board L. Connor, Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.