Citation Nr: A21016359 Decision Date: 10/05/21 Archive Date: 10/05/21 DOCKET NO. 190315-4473 DATE: October 5, 2021 ORDER Entitlement to service connection for hypogonadism, to include low testosterone, with consideration as due to contaminated water exposure at Camp Lejeune, is granted. FINDING OF FACT The Veteran's hypogonadism, to include low testosterone, is related to his military service. CONCLUSION OF LAW The criteria for service connection for hypogonadism, to include low testosterone, are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active military service from March 1981 to March 1984. In the March 2019 VA Form 10182, Decision Review Request: Board Appeal, the Veteran elected the Hearing docket. Therefore, the Board may only consider the evidence of record at the time of the agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran or his representative at the hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a). Entitlement to service connection for hypogonadism, to include low testosterone, claimed as due to contaminated water exposure at Camp Lejeune The Veteran contends that his hypogonadism, to include low testosterone, is related to his military service. Specifically, the Veteran alleges that his condition is related to contaminated water at Camp Lejeune. Generally, service connection may be established for disability resulting from disease or injury incurred in or aggravated by active military service. 38 U.S.C. §§ 1131; 38 C.F.R. § 3.303. To establish service connection on a direct incurrence basis, the Veteran must show: (1) 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. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). A veteran, who served at Camp Lejeune for at least 30 days during the period from August 1953 to December 1987, is presumed to have been exposed to the contaminants in the water supply, unless there is affirmative evidence to the contrary. 38 C.F.R. § 3.307 (a)(7)(iii). Service at Camp Lejeune means any service within the borders of the entirety of the United States Marine Corps Base Camp Lejeune and Marine Corps Air Station New River, North Carolina. Id. VA has acknowledged that persons residing or working at Camp Lejeune from August 1953 through December 1987 were potentially exposed to drinking water contaminated from two on-base water wells with the volatile organic compounds (VOCs) trichloroethylene (TCE), a metal degreaser, perchloroethylene (PCE), a dry-cleaning agent, Benzene, vinyl chloride (VC), and other compounds. 38 U.S.C. § 3.307 (a)(7); see also VA's Camp Lejeune Veteran and family health & disability benefits brochure available at https://www.publichealth.va.gov/docs/exposures/camp_lejeune_brochure.pdf. The following diseases are considered service-connected in exposed Veterans even though there is no record of such disease during service, subject to the rebuttable presumption provisions of 38 C.F.R. § 3.307 (d): kidney cancer; liver cancer; Non-Hodgkin's lymphoma; adult leukemia; multiple myeloma; Parkinson's disease; aplastic anemia and other myelodysplastic syndromes; and bladder cancer. 38 C.F.R. § 3.309 (f). The Veteran's current diagnosed disorders are not identified among the conditions presumptively caused by exposure to contaminated water at Camp Lejeune. However, the Veteran is entitled to benefits on a direct basis if there is sufficient evidence that the contaminated water at Camp Lejeune caused his claimed conditions. See generally 38 U.S.C. § 1110; 38 C.F.R. § 3.303 (d); see also Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994). The Veteran's personnel records document that the Veteran served at Camp Lejeune from July 29, 1981 to September 25, 1981. Therefore, exposure to contaminated water at Camp Lejeune is conceded. See 38 C.F.R. § 3.307 (a)(7)(iii). In November 2018, the Veteran submitted a private medical opinion. The physician noted that the Veteran has had low testosterone levels for years and has been on testosterone replacement since 2003. The physician noted numerous medical studies and literature indicating a relationship between exposure to trichloroethylene and low testosterone levels. Therefore, the physician opined that the Veteran's low testosterone levels are related to his exposure to trichloroethylene in service. The examiner included references to several scientific studies indicating that exposure to chemicals such as TCE can cause decreased testosterone levels. The Board notes that April 2019 VA medical opinions regarding the Veteran's hypogonadism and low testosterone were obtained. The examiner opined that these conditions are less likely than not related to the Veteran's military service, to include his service at Camp Lejeune. However, the examiner did not discuss the November 2018 private opinion and did not discuss the Veteran's low testosterone levels following his military service. Therefore, the Board finds the April 2019 VA opinion to be inadequate as it did not provide an adequate rationale for the opinion given. In addition, the VA examiner indicated that the Veteran was only at Camp Lejeune for 30 days when the personnel records indicate a longer period from July 29, 1981 to September 16, 1981. The Veteran credibly testified that he was there for a total of fifty days. Therefore, the Board affords more weight to the November 2018 private medical opinion and finds that entitlement to service connection for hypogonadism, to include low testosterone, is warranted. MICHAEL MARTIN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Mountford, 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.