Citation Nr: 21068974 Decision Date: 11/17/21 Archive Date: 11/17/21 DOCKET NO. 15-17 989 DATE: November 17, 2021 REMANDED Entitlement to service connection for a heart disability to include as due to contaminated drinking water at Camp Lejeune is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1973 to April 1974. The Veteran also had reserve service and periods of active duty of training (ACDUTRA) and inactive duty for training (INACDUTRA). This matter is before the Board of Veterans' Appeals (Board) on appeal of an October 2013 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). In October 2017, the Veteran appeared at a hearing before the undersigned Veterans Law Judge. A transcript of the hearing is in the record. In February 2018 and May 2021, the Board remanded the case to the RO for additional development. The appeal of the Veteran originally included a claim for service connection for left hand arthritis. In a September 2021rating decision, the RO granted service connection for arthritis of the left hand and loss of motion in the left thumb (combined with service- connected residuals of a gunshot wound), and separate service connection awards for loss of motion in the left index finger, loss of motion in the left long finger, loss of motion in the left ring finger, and loss of motion in the left little finger. This is considered a full grant of the benefit sought on the appeal for the claim of service connection for the claim for service connection for left hand arthritis. Holland v. Gober, 10 Vet. App. 433, 436 (1997). Because the evidence indicates that the Veteran may have different conditions or diagnoses for ¬¬¬his heart disability claim, the Board is expanding the scope of the claim to encompass any diagnosis raised by the record. Clemons v. Shinseki, 23 Vet. App. 1, 5 (2009). With apologies to the Veteran, a remand is necessary to ensure that due process is followed and that there is a complete record upon which to decide the Veteran's claims for service connection. The Board's prior remands directed VA examinations with opinions and rationale to address whether the Veteran has a heart disability related to service. Such opinions and rationale will allow the Board's decision to be a fully informed one. See D'Aries v. Peake, 22 Vet. App. 97, 104 (2008). Compliance with remand directives is not optional or discretionary, and the Board errs as a matter of law when it fails to ensure remand compliance. Stegall v. West, 11 Vet. App. 268 (1998). The Veteran strongly asserts that he has a current heart disability because of his military service, to include as due to contaminated drinking water at Camp Lejeune. The record reflects that the Veteran served at Camp Lejeune in 1973 and 1974 for the requisite amount of time during the requisite period to be considered for presumptive service connection. 38 C.F.R. § 3.307 (a)(7). However, heart disorders are not listed among the disabilities presumptively linked to contaminated water at Camp Lejeune. 38 C.F.R. § 3.309 (f). The Veteran may still establish service connection with proof of direct causation. Combee v. Brown, 34 F.3d 1039, 1042 (Fed. Cir. 1994). Neither the August 2018 nor the May 2021 VA examination reports include opinions as to whether the Veteran's exposure to the Camp Lejeune drinking water resulted in his heart disability. Therefore, the Veteran's claim is remanded for a VA opinion to address the claim he has a heart disability because of his service at Camp Lejeune. Ongoing medical records should first be obtained before the VA examiner reviews the file. The matters are REMANDED for the following action: 1. Ask the Veteran to identify all outstanding treatment records relevant to his heart disability claim. All identified VA records should be added to the claims file. All other properly identified records should be obtained if the necessary authorization to obtain the records is provided by the Veteran. If any records are not available, or the Veteran identifies sources of treatment but does not provide authorization to obtain records, appropriate action should be taken (see 38 C.F.R. § 3.159(c)-(e)), to include notifying the Veteran of the unavailability of the records. 2. After records development is completed, the claims file should be sent to an appropriate examiner to offer an opinion as to whether it is at least as likely as not (50 percent probability or greater) that the current heart disability had its onset during service or is otherwise related to an in-service injury, event, or disease, to include exposure to contaminated water at Camp Lejeune. The examiner is specifically asked to provide an opinion as to whether it is at least as likely as not (50 percent probability or more) that any heart disability began in service or is causally related to service due to exposure to contaminated drinking water at Camp Lejeune. The examiner is advised that the law does not require a medical principle be established to the point of being generally accepted in the scientific community or reach the level of scientific or medical consensus. Instead, the literature need only establish that the evidence for and against that the question is in approximate balance The need for an examination is left to the discretion of the examiner. A rationale for all opinions offered is requested as adjudicators are precluded from making any medical findings. L. M. BARNARD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Russell P. Veldenz, 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.