Citation Nr: 21063328 Decision Date: 10/13/21 Archive Date: 10/13/21 DOCKET NO. 19-00 635 DATE: October 13, 2021 REMANDED Entitlement to service connection for the cause of the Veteran's death is remanded. REASONS FOR REMAND The Veteran passed away in February 2018. The Appellant is his surviving spouse. The Appellant testified before the undersigned Veterans Law Judge in a September 2021 virtual hearing. The Veteran served on active duty from December 1972 to November 1976, from January 1978 to January 1980 and from September 1980 to September 1982 in the United States Marine Corps. The Appellant contends that the Veteran's death was caused by his military service. Specifically, she testified that the Veteran's renal disease was caused by the contaminated water at Camp Lejeune. Under 38 C.F.R. § § 3.307 and 3.309 there is a presumption where service connection may be warranted for those veterans exposed to contaminants in the water supply, 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 Camp Lejeune, during the period beginning on August 1, 1953, and ending on December 31, 1987. The Veteran did file a service connection claim for kidney disease. This claim was denied in a May 2015 rating decision, and again in a July 2016 rating decision. The Veteran did not appeal the July 2016 rating decision and it became final. The RO did concede exposure to contaminated water while stationed at Camp Lejeune. Despite the conceded exposure, there is no probative evidence in the record to show an enumerated condition under 38 C.F.R. § 3.309. Additionally, as stated above, the service connection claim for kidney disease has been adjudicated and denied, with the denial based in part on the medical opinion of the January 2015 subject matter expert. As a medical opinion has been provided regarding the etiology of the Veteran's kidney disease and the July 2016 rating decision was not appealed, the Board will not request an additional medical opinion regarding the Veteran's kidney disease. According to the death certificate the immediate cause of death was cardiac arrest, due to myocardial infarction, due to end stage renal disease, due to low back pain, immobility. At the time of the Veteran's death service connection was in effect for back strain, tinnitus, and bilateral hearing loss. In a May 2019 Brief, the Appellant's representative argued that service connection for the Veteran's death is warranted as his lack of mobility due to his service-connected low back disability was a contributing factor in his death. As the Veteran's service-connected low back disability is listed on the death certificate, the Board finds that a medical opinion to determine whether it contributed substantially or materially to his death is required. The Board acknowledges that in the May 2019 Brief, reference is made to a Dr. K.S. with implication that she made a medical conclusion regarding the Veteran's back at the time of his death. A review of the file shows that a Dr. K.S. was the primary care provider for the Veteran at Raleigh VAMC. However, there does not appear to be a medical opinion of record. Additionally, the Veteran passed away while in the care of a non-VAMC. Notwithstanding, on remand, the Appellant should be invited to submit any evidence pertinent to her claim. The matter is REMANDED for the following action: 1. Invite the Appellant to submit any additional evidence she would like considered in connection with this claim, to include any medical opinions regarding the death of the Veteran. 2. Request an opinion from an appropriate clinician as to the etiology of the Veteran's death. The electronic claims file must be sent to the clinician for review. Following a thorough review of the file, to include this remand, the clinician should address the following questions: (a.) Whether it is as least as likely as not (50 percent probability or more) that the Veteran's service-connected low back disability contributed substantially or materially to his death. 1. Specifically, when addressing this question, the examiner must note and comment on the Veteran's death certificate and discuss the role his low back pain and immobility may have had on the development of his renal disease, myocardial infarction, and cardiac arrest. (b.) Whether it is as least as likely as not (50 percent probability or more) that the Veteran's service-connected tinnitus contributed substantially or materially to his death. (c.) Whether it is as least as likely as not (50 percent probability or more) that the Veteran's service-connected bilateral hearing loss contributed substantially or materially to his death. The examiner is asked to provide a complete rationale for all opinions offered. H.M. WALKER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Talamantes, 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.