Citation Nr: 21061411 Decision Date: 10/04/21 Archive Date: 10/04/21 DOCKET NO. 20-05 610 DATE: October 4, 2021 ORDER Entitlement to service connection for chronic kidney disease is granted. FINDING OF FACT Resolving reasonable doubt in the Veteran's favor, his chronic kidney disease is at least as likely as not related to his in-service exposure to contaminated water at Camp Lejeune. CONCLUSION OF LAW The criteria for service connection for chronic kidney disease are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Marine Corps from May 1978 to March 1985 and from November 1986 to February 1990. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a December 2018 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Philadelphia, Pennsylvania. The Veteran presented sworn testimony at a hearing before the undersigned Veterans Law Judge in April 2021. At the April 2021 proceeding, the undersigned Veterans Law Judge granted the Veteran's motion to keep the record for a period of 30 days to afford the Veteran the opportunity to submit additional evidence in support of his appeal; that evidence will be considered by the Board in the adjudication of this case. 1. Entitlement to service connection for chronic kidney disease. The Veteran contends that his chronic kidney disease was caused by his exposure to contaminated water at Camp Lejeune. The Board concludes that the Veteran has a current disability that s related to his exposure to contaminated water at Camp Lejeune. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. See 38 U.S.C. § 1131; 38 C.F.R. § 3.303. A veteran seeking compensation under these provisions must establish three elements: "(1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service." Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). VA has acknowledged that persons residing or working at the U.S. Marine Corps Base Camp Lejeune between August 1953 and December 1987 were potentially exposed to drinking water contaminated with volatile organic compounds (VOCs). The chemical compounds involved have been associated by various scientific organizations with the possible development of certain chronic diseases. However, many unanswered questions remain regarding the extent of base water contamination, the type and duration of exposure experienced by base personnel, and the likelihood that contaminant levels in the water supply were high enough to result in a particular disease. While these issues are being studied, it will be assumed by VA that any given veteran who served at Camp Lejeune was potentially exposed in some manner to the full range of chemicals known to have contaminated the water there between 1957 and 1987. Effective March 14, 2017, 38 C.F.R. §§ 3.307 and 3.309 were amended to add eight diseases found to be associated with contaminants present in the water supply at Camp Lejeune. As amended, 38 C.F.R. §§ 3.307 and 3.309 establish presumptive service connection for veterans who served at Camp Lejeune for no less than 30 days from August 1, 1953, to December 31, 1987, and who have been diagnosed with certain diseases. 38 C.F.R. § 3.309(f). The Board notes that kidney disease is not a disease listed as presumptively related to contaminated water exposure under 38 C.F.R. § 3.309(f). When a claimed disorder is not included as a presumptive disorder, direct service connection may nevertheless be established by evidence demonstrating that the disease was in fact "incurred" during service, to include as based on exposure to contaminated water. See, Combee v. Brown, 34 F.3d 1039, 1042 (Fed. Cir. 1994). An October 2018 private treatment record from Einstein Healthcare Network notes the Veteran had a diagnosis of stage 2 chronic kidney disease. A VA medical opinion was obtained in November 2018. A VA examiner reviewed the claims file and opined that the Veteran's chronic kidney disease was less likely than not due to his exposure at Camp Lejeune, noting that "[a]lthough ATSDR data does show a potential association between CLJ contaminated water and kidney disease, there is no data in the files given to support a diagnosis of kidney disease." The examiner further noted that "[b]ased on the evidence from epidemiological studies, occupational biomarker studies, and animal studies, ATSDR concludes that there is equipoise and above evidence for causation for TCE and kidney diseases, in particular, ESRD." A July 2019 VA treatment record notes the Veteran has a history of chronic renal insufficiency. An October 2020 private treatment record from Einstein Healthcare Network notes the Veteran has a diagnosis of chronic kidney disease, stage III. VA has acknowledged the Veteran's exposure to contaminated water at Camp Lejeune. Here, the evidence shows the Veteran has been diagnosed with chronic kidney disease that is worsening since at least October 2018 and that a VA examiner has opined that research has shown a potential association between kidney disease and Camp Lejeune Water. Upon review of the record, the Board finds the evidence to at least be in equipoise as to whether the Veteran's current chronic kidney disease, stage III is related to service. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for chronic kidney disease is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. STEVEN D. REISS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Keeley, Brian 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.