Citation Nr: 21061957 Decision Date: 10/05/21 Archive Date: 10/05/21 DOCKET NO. 17-61 654 DATE: October 5, 2021 ORDER Service connection for non-Hodgkin's lymphoma is granted. FINDING OF FACT The Veteran was likely exposed to contaminants in the water supply while stationed at Camp Lejeune, and his non-Hodgkin's lymphoma is etiologically related to those exposures. CONCLUSION OF LAW The criteria for service connection for non-Hodgkin's lymphoma are met. 38 U.S.C. §§ 1110, 1112, 1113, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from October 1987 to March 1988. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a June 2016 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). In June 2021, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge. Here, the Veteran contends that he was exposed to contaminated water supply while stationed at Camp Lejeune, and that his currently diagnosed non-Hodgkin's lymphoma is the result of that exposure. Based on a review of the evidence and resolving all reasonable doubt in favor of the Veteran, the Board finds that the evidence is at least in equipoise that the Veteran's currently diagnosed non-Hodgkin's lymphoma is etiologically related to exposure to contaminants in the water supply at Camp Lejeune, such that service connection is warranted. Generally, establishing service connection requires medical or, in certain circumstances, lay evidence of (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may be granted on a presumptive basis for certain diseases associated with exposure to contaminants (defined as the volatile organic compounds trichloroethylene (TCE), perchloroethylene (PCE or PERC), benzene, and vinyl chloride) in the on-base water supply located at Camp Lejeune, even though there is no record of such disease during service, if they manifest to a compensable degree at any time after service, in a veteran, former reservist, or a member of the National Guard, who had no less than 30 days (consecutive or nonconsecutive) of service at the United States Marine Corps Base Camp Lejeune and or Marine Corps Air Station New River in North Carolina, during the period beginning on August 1, 1953, and ending on December 31, 1987. 38 C.F.R. § 3.307(a)(7). Of note, non-Hodgkin's lymphoma is a disease deemed associated with exposure to contaminated water at Camp Lejeune. 38 C.F.R. § 3.309(f). Thus, the Veteran has been diagnosed with a disease that qualifies under the presumption. See 38 C.F.R. § 3.309(f). Additionally, service personnel records show that the Veteran served at Camp Lejeune in February 1988. Nevertheless, because the evidence shows that the Veteran was not stationed at Camp Lejeune until after December 31, 1987, he is not entitled to presumptive service connection for his non-Hodgkin's lymphoma. However, despite not qualifying for presumptive service connection due to exposure to contaminants in the water supply at Camp Lejeune, the Veteran is not precluded from establishing service connection with proof of direct causation. Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994). Here, the Veteran has submitted evidence that supports an association between benzene and TCE exposures and non-Hodgkin's lymphoma; evidence that the Environmental Protection Agency (EPA) did not begin its assessment of the contamination at Camp Lejeune until February 1988, and did not start remedial action until 1993; and, evidence from the EPA indicating that, because ground water moves slowly, contamination often remains undetected for long periods of time and makes cleanup of a contaminated water supply difficult, if not impossible. The Board finds that, based on the EPA evidence regarding the timeline for assessment and remediation at Camp Lejeune and the difficulty with clean-up of a contaminated water supply, combined with the fact that the Veteran has been diagnosed with one of the presumptive diseases under VA regulations for exposure to contaminants in the water supply, it is highly plausible that the Veteran was exposed to contaminated water during his period at Camp Lejeune beginning in February 1988, less than two full months following the end of the presumptive period. Indeed, if the EPA did not begin clean-up until years later, the Board finds it highly likely that the contaminate water was still present in the months following the end of the presumptive period. Moreover, the Veteran testified that he did not have any chemical exposures post service and, as discussed, VA has already recognized the association between contaminated water at Camp Lejeune and non-Hodgkin's lymphoma. Further, in May 2021, a VA provider noted that the Veteran had stage IV non-Hodgkin's lymphoma secondary to water contamination in North Carolina. Significantly, there is no evidence to the contrary in this case, and the Court has cautioned VA against seeking a medical opinion where favorable evidence in the record is unrefuted. See Mariano v. Principi, 17 Vet. App. 305, 312 (2003). In summary, the Board finds that the evidence is at least in equipoise that the Veteran was exposure to contaminants in the water supply at Camp Lejeune and that his currently diagnosed non-Hodgkin's lymphoma is etiologically related to that exposure. Given the law and the totality of the evidence of record, the Board is compelled to afford the Veteran the benefit of the doubt; therefore, service connection is granted. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). S. C. Krembs Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Fagan 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.