Citation Nr: 21063241
Decision Date: 10/13/21	Archive Date: 10/13/21

DOCKET NO. 18-01 241
DATE: October 13, 2021

REMANDED

Entitlement to service connection for residuals of a stroke due to exposure to contaminated water at Camp Lejeune is remanded.

REASONS FOR REMAND

The Veteran served on active duty from October 1978 to October 1982.

This matter comes to the Board of Veterans' Appeals (Board) on appeal from a November 2014 rating decision by the Regional Office (RO) of the Department of Veterans Affairs (VA).

Entitlement to service connection for residuals of a stroke due to exposure to contaminated water at Camp Lejeune is remanded.

Upon review of the claims file, the Board has determined that further development is necessary before the claim can be adjudicated.  38 U.S.C. § 5103A; 38 C.F.R. § 3.159.  The Board cannot make a fully informed decision on the issue of entitlement to service connection for residuals of a stroke because no VA examiner has opined whether the Veteran's chronic headaches were a precursor to her future stroke.  Additionally, no VA examiner has opined whether her stroke was related to exposure to contaminated water while serving at Camp Lejeune. 

The Veteran's medical records confirm that she suffered a brainstem stroke in 1998 and her military personnel records confirm that she was stationed at Camp Lejeune in March 1982.  (7/9/2021, Medical Treatment Record, p. 1); (3/17/2014, Military Personnel Record, p. 28).  Given that she was stationed at Camp Lejeune between August 1953 and December 1987, she is presumed to have been exposed to contaminants in the water supply at Camp Lejeune.  38 C.F.R. § 3.307(a)(7)(iii).  

In rendering this decision, the Board acknowledges that only disabilities enumerated in 38 C.F.R. § 3.309(f) are presumptively related to exposure to contaminants.  However, this does not preclude a grant of service connection on a direct basis.  Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994).  In light of the aforementioned, the Board finds that the claim must be remanded for further medical development.     

The matter is REMANDED for the following action:

1. The AOJ should obtain copies of VA treatment records for the Veteran's disabilities from August 2018 to the present.

2. Schedule the Veteran for a VA examination for residuals of a stroke.  The examiner must review the claims file and provide a response to the following:

	Is the Veteran's 1998 brainstem stroke, and the subsequent residuals of said stroke, at least as likely as not related to service?  In rendering an opinion, the examiner should specifically address whether her reported chronic headaches were a precursor of her stroke. 

	Is the Veteran's 1998 brainstem stroke, and the subsequent residuals of said stroke, at least as likely as not related to exposure to contaminants in the water supply while serving at Camp Lejeune?

The examiner is advised that a negative opinion cannot be based solely on the fact that strokes are not on the list of diseases that are presumptively associated with exposure to contaminants in the water supply at Camp Lejeune.  As such, concluding that service connection is not warranted solely because strokes are not a presumptive disease is not adequate.

 

Eric S. Leboff

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	R. Glenn, 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.