Citation Nr: 21001223 Decision Date: 01/07/21 Archive Date: 01/07/21 DOCKET NO. 18-35 692 DATE: January 7, 2021 REMANDED Service connection for bladder cancer, to include exposure to contaminated water at Camp Lejeune. Service connection for prostate cancer, to include exposure to contaminated water at Camp Lejeune.   REASONS FOR REMAND The Veteran served on active duty from March 1952 to March 1954. The matter is on appeal to the Board from a March 2018 rating decision. In a February 2019 decision, the Board remanded the claims for additional development. Service connection for bladder cancer, to include exposure to contaminated water at Camp Lejeune. Service connection for prostate cancer, to include exposure to contaminated water at Camp Lejeune. The Veteran’s service records demonstrate sufficient service at Camp Lejeune to qualify for the VA established presumption of exposure to contaminated water. See 38 C.F.R. § 3.307(a)(7). Bladder cancer is a disease presumed to be related to such exposure. See 38 C.F.R. § 3.309(f). The record contains a one-page document submitted in February 2017 summarizing the Veteran’s medical history, including the dates tumors were removed from the bladder in 2005, 2006, 2007, and 2016, a date for prostate cancer in 2008, chemo treatments, medicines, and private care providers. In a December 2017 medical opinion based on available records and in conjunction with a telephone interview with the Veteran, the VA examiner diagnosed the Veteran with bladder cancer and urinary frequency. The VA examiner noted the Veteran’s history of cystoscopies for tumor removal in 2005, 2006, 2007, 2016, and 2017 and his chemotherapy treatment. The VA examiner attributed the Veteran’s voiding dysfunction as a residual of treatment for the Veteran’s bladder cancer. In February 2018, another VA examiner determined the Veteran’s diagnosis of bladder cancer is not confirmed based on a review of available records. The VA examiner explained the record contains only a lay person’s list of diagnoses and medications and a provider progress note questionnaire. The VA examiner noted the absence of any office notes, treatment notes, surgical records, hospital records, diagnostic studies, pathology results, risk factors, a family history, review of occupational exposure, or a medical history. The VA examiner stated the information provided in the record was insufficient to confirm the diagnosis of bladder cancer. In February 2019, the Board remanded the Veteran’s claims to provide an opportunity for the VA to secure the Veteran’s medical care records. In April 2020, the VA sent a letter to the Veteran sharing the additional evidence needed from the Veteran to support his claim, including: treatment records related to his bladder and prostate cancer; any treatment received at a VA facility; and certified statements from the Veteran or people familiar with the Veteran’s disabilities. The letter included a form for the Veteran’s signature to authorize release of medical provider information to the VA. The Veteran did not submit any information to support his claims since the Board’s remand. Based on the two contrary VA examiner opinions, the case is remanded to schedule a VA examination to resolve if the Veteran has a bladder cancer diagnosis or residuals of bladder cancer and to determine if the Veteran has prostate cancer. Accordingly, the matter is REMANDED for the following action: 1. Ask the Veteran to identify and authorize VA to obtain any outstanding private treatment records relevant to his claims. He should be return any authorizations to obtain such records. 2. Schedule the Veteran for a VA examination to in connection with the bladder cancer and prostate cancer claims. The examiner must review the claims file in conjunction with the examination. The examiner should provide an opinion with rationale on the following questions: Does the Veteran have a diagnosis of bladder cancer? This should include any residuals of bladder cancer. If not, it should be explained why this is o. Does the Veteran have a diagnosis of prostate cancer? If the examiner finds the Veteran does have a diagnosis of prostate cancer, is it at least as likely as not (a 50 percent or greater probability) that the prostate cancer was caused by service, to include exposure to contaminated water at Camp Lejeune? RYAN T. KESSEL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M.L. Thomas 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.