Citation Nr: 21000619 Decision Date: 01/05/21 Archive Date: 01/05/21 DOCKET NO. 20-05 519 DATE: January 5, 2021 REMANDED Entitlement to service connection for colon cancer as due to exposure to contaminated water at Camp Lejeune is remanded. Entitlement to service connection for prostate cancer as due to exposure to contaminated water at Camp Lejeune is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1967 to May 1970. This case comes to the Department of Veterans Affairs (VA) Board of Veterans’ Appeals (Board) on appeal from an Agency of Original Jurisdiction (AOJ) rating decision dated in January 2018. Unfortunately, due to the reasons that follow, a remand to the AOJ is required. Although the Board sincerely regrets this additional delay, it is necessary to ensure that the Veteran is afforded adequate due process and every possible consideration. 1. Entitlement to service connection for colon cancer as due to exposure to contaminated water at Camp Lejeune is remanded. 2. Entitlement to service connection for prostate cancer as due to exposure to contaminated water at Camp Lejeune is remanded. The Veteran contends that his prostate cancer and colon cancer are due to exposure to contaminated water at Camp Lejeune. The Veteran’s military personnel records indicate that he was stationed at Camp Lejeune for at least 30 days prior to 1987. Therefore, he is presumed to have been exposed to contaminated water. However, the AOJ denied service connection because these cancers are not listed in 38 C.F.R. § 3.309(f), which lists diseases to be presumptively service connected due to association with exposure to contaminants in the water supply at Camp Lejeune, and because the Veteran did not have cancer within a year of separation from service. Nevertheless, the AOJ failed to otherwise consider service connection on a direct basis and failed to obtain an opinion as to whether there is a nexus between the Veteran’s exposure to contaminated water and his cancers. See Combee v. Brown, 34 F.3d 1039, 1042 (Fed. Cir. 1984). Additionally, the Veteran reported that his daughter, who was born at Camp Lejeune, also had cancer, and his oncologist believed that all three cancers were not coincidental. This contention must be addressed on remand. The matters are REMANDED for the following action: 1. Obtain a supplemental opinion from an appropriate VA clinician to determine the etiology of the Veteran’s prostate cancer and colon cancer. If the examiner determines that he or she cannot respond to the Board’s inquiry as set forth in detail below without examination of the Veteran, the Veteran should be afforded such an examination. If an in-person examination is not feasible, the Veteran must be afforded an examination by other means. The examiner should address the following: (a.) The examiner should provide an opinion as to whether it is at least as likely as not (50 percent or greater) that the Veteran’s prostate cancer is etiologically related to, incurred in, or caused by the Veteran’s active service, to include exposure to contaminated water at Camp Lejeune. (b.) The examiner should provide an opinion as to whether it is at least as likely as not (50 percent or greater) that the Veteran’s colon cancer is etiologically related to, incurred in, or caused by the Veteran’s active service, to include exposure to contaminated water at Camp Lejeune. (c.) The examiner must address the contention that development of the Veteran’s colon and prostate cancer and bladder cancer in his daughter, who was born at Camp Lejeune, may show that the Veteran’s cancer is related to military service, to include exposure to contaminated water at Camp Lejeune. A complete explanation for all opinions expressed must be provided. A clearly stated rationale must not be based solely on lack of documentation or records. The reasons for any opinion must include a discussion of the relevant evidence, including lay statements. If the clinician cannot provide a requested opinion without resorting to speculation, it must be so stated, and the clinician must provide the reasons why. D. SMART Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Smith, Associate 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.