Citation Nr: 21001319 Decision Date: 01/07/21 Archive Date: 01/07/21 DOCKET NO. 18-48 819 DATE: January 7, 2021 REMANDED Entitlement to service connection for prostate cancer due to exposure to contaminants in the water supply at Camp Lejeune is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1955 to April 1959. In July 2019, the Veteran testified under oath before the undersigned Veterans Law Judge at a videoconference hearing. A transcript of the hearing is of record. In August 2019 and June 2020, this matter was remanded by the Board for further development. Although the Board regrets the additional delay, and for the reasons outlined below, the Board finds that another remand is necessary before this matter can be properly adjudicated. Entitlement to service connection for prostate cancer due to exposure to contaminants in the water supply at Camp Lejeune is remanded. The June 2020 Board remand specifically required that a VA opinion provider address the following articles: (a) “Contaminated Camp Lejeune Water Associated with Higher Cancer Incidence”; (b) “Morbidity Study of Former Marines, Employees, and Dependents Potentially Exposed to Contaminated Drinking Water at U.S. Marine Corps Base Camp Lejeune”; (c) “Camp Lejeune Claims –Update –April 2015”; and (d) “Evaluation of mortality among marines and navy personnel exposed to contaminated drinking water at USMC base Camp Lejeune: a retrospective cohort study.” The September 2020 VA opinion provider referred to a number of sources found on the Agency of Toxic Substances and Diseases Registry (ATSDR) website. Although the ATSDR website includes some of the articles listed above, it does not appear that any of the specifically requested articles were addressed. Therefore, the Board has no choice but to remand this matter again so that the requested articles may be addressed. Additionally, the June 2020 Board remand required that the person providing the opinion by a toxicologist or oncologist. It is unclear if the September 2020 VA opinion provider, Dr. J.W.B., DO, MPH, qualifies as a toxicologist or oncologist. On remand, confirmation of such is requested. The matter is REMANDED for the following action: 1. Obtain a VA opinion from a qualified specialist (toxicologist or oncologist) to address the Veteran’s contention that his prostate cancer was caused by exposure to contaminants in the water supply at Camp Lejeune. If necessary, schedule the Veteran for an examination (or telehealth interview, review of the record, etc., if an in-person examination is not feasible). The examiner is asked to provide an opinion as to whether it is at least as likely as not (i.e., a 50 percent or greater probability) that the Veteran’s prostate cancer was caused by the Veteran’s active duty service, to include contaminants in the water supply at Camp Lejeune. Under 38C.F.R. § 3.307(a)(7)(i), contaminants in the water supply means the volatile organic compounds trichloroethylene (TCE), perchloroethylene (PCE), benzene and vinyl chloride, that were in the on-base water-supply systems located at United States Marine Corps Base in Camp Lejeune, during the period beginning on August 1, 1953, and ending on December 31, 1987. In the opinion, the examiner is asked to specifically address articles submitted by the Veteran, including: (a) “Contaminated Camp Lejeune Water Associated with Higher Cancer Incidence”; (b) “Morbidity Study of Former Marines, Employees, and Dependents Potentially Exposed to Contaminated Drinking Water at U.S. Marine Corps Base Camp Lejeune”; (c) “Camp Lejeune Claims –Update –April 2015”; and (d) “Evaluation of mortality among marines and navy personnel exposed to contaminated drinking water at USMC base Camp Lejeune: a retrospective cohort study.” The VA opinion provider/examiner must specifically address the finding in the article entitled “Morbidity Study of Former Marines, Employees, and Dependents Potentially Exposed to Contaminated Drinking Water at U.S. Marine Corps Base Camp Lejeune” issued in 2018 which determined that subsequent evaluation of the literature identified additional diseases, including prostate cancer, for inclusion based on the evidence of positive associations in epidemiological studies. Finally, the examiner is asked to address the June 2019 and November 2019 nexus opinions submitted by the Veteran. The Board requires confirmation that the VA opinion provider/examiner is a toxicologist or oncologist. The VA examiner should be given access to the claim file. The examiner should state that a review of the claim file was completed. The examiner must provide a comprehensive report including complete rationales for all opinions and conclusions reached, citing the objective medical findings leading to the conclusions. A detailed rationale is requested for all opinions provided. 2. If upon completion of the above action the issue is denied, the case should be returned to the Board after compliance with appellate procedures. E. I. VELEZ Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Matta, 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.