Citation Nr: 21064620 Decision Date: 10/21/21 Archive Date: 10/21/21 DOCKET NO. 17-42 892 DATE: October 21, 2021 REMANDED The issue of service connection for a kidney disability, to include kidney cysts and as due to exposure to contaminated water at Camp Lejeune, is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1969 to April 1974. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a December 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In June 2021, the Veteran presented testimony before the undersigned Veterans Law Judge. During the hearing, the Veteran's request for the record to be held open for an additional 60 days for submission of additional evidence was granted. The claim of service connection for a kidney disability (claimed as service connection for kidney cysts) has been recharacterized in light of Clemons v. Shinseki, 23 Vet. App. 1, 4-5 (2009) (a claim should not be limited to the disorder as characterized by the Veteran, but must be characterized and addressed based on the reasonable expectations of the non-expert claimant and the evidence in processing the claim). The issue of service connection for a kidney disability, to include kidney cysts and as due to exposure to contaminated water at Camp Lejeune, is remanded. The Veteran claims that his kidney cysts are due to his military service, to include as due to his in-service exposure to contaminated water when he was stationed at Camp Lejeune. See Board hearing transcript (June 2021). Additionally, he asserts that he has had low back and side pain, near his kidneys, in and since service. Id. The Veteran's exposure to water contaminated with volatile organic compounds (VOCs) at Camp Lejeune has been conceded. See rating decision (December 2016). The Veteran's private treatment records show that he was diagnosed as having renal cortical cysts. See, e.g., private treatment record (July 2009). Private treatment record indicate that the Veteran has continued treatment for his kidney cysts. These treatment record show that he underwent renal ultrasounds revealing that the renal cortical was normal. See, e.g., private treatment record (October 2006). In this case, the Veteran has not been afforded a VA examination nor has an opinion been obtained to determine the etiology of his kidney disability. In light of the Veteran's reports of pain in and since service, his in-service exposure to contaminated water at Camp Lejeune, and his current diagnosis of renal cysts, the "low threshold" requirement under McLendon v. Nicholson, 20 Vet. App. 79 (2006) is met. Therefore, a remand is necessary to afford the Veteran a VA examination to determine the nature and etiology of any current kidney disability, to include pain that causes functional impairment. See Saunders v. Wilkie, 886 F.3d 1356, 1368 (Fed. Cir. 2018) (holding pain alone could constitute a disability under 38 U.S.C. § 1110 when it results in functional impairment). Additionally, during the Board hearing, the Veteran testified that he sought treatment for his kidney disability, including treatment for kidney stones, following his separation from service. The evidence of record does not include private kidney treatment records following the Veteran's separation from service. Therefore, upon remand, outstanding treatment records regarding the Veteran's kidney treatment should be obtained. The matter is REMANDED for the following action: 1. Ask the Veteran to complete a VA Form 21-4142 regarding treatment for his kidney disability, including treatment for kidney stones, treatment from a Dr. Kirsch, and any treatment records following his separation from service regarding treatment for kidney stones, as reported during the June 2021 Board hearing. Make two requests for the authorized records, unless it is clear after the first request that a second request would be futile. Document all attempts to obtain such records as required in 38 C.F.R. § 3.159. 2. Schedule the Veteran for a VA examination regarding his claim of service connection for a kidney disability. The examiner should review the entire claims file, before answering the following: a. Identity the Veteran's kidney disability since the date of his claim in September 2016 by (1) diagnosis or (2) functional impairment, even if resolved. b. Is it at least as likely as not (50 percent or greater probability) that the Veteran's kidney's disability, including renal cysts, had its onset in service or is otherwise related to service, to include as due to in-service exposure to contaminated water when he was stationed at Camp Lejeune? The examiner should address the Veteran's complaints that he had low back and side pain (near his kidneys) in and since service, as well as the Veteran's wife's testimony that she witnessed the Veteran's continuous pain since 1974. The examiner should provide a complete rationale for each opinion. Tiffany Dawson Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Castillo, 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.