Citation Nr: 21070543 Decision Date: 11/24/21 Archive Date: 11/24/21 DOCKET NO. 18-38 769A DATE: November 24, 2021 REMANDED Entitlement to service connection for a kidney disability, claimed as due to chemical and herbicide agent exposure, is remanded. Entitlement to service connection for a heart disability, claimed as due to chemical and herbicide agent exposure, is remanded. Entitlement to service connection for a groin disability, claimed as a blood clot, claimed as due to chemical and herbicide agent exposure, is remanded. Entitlement to service connection for a skin disability, claimed as due to chemical and herbicide agent exposure, is remanded. Entitlement to service connection for a hiatal hernia, claimed as due to chemical and herbicide agent exposure, is remanded. REASONS FOR REMAND On the substantive appeal to the Board, the Veteran requested a hearing before the Board, but withdrew that request in August 2021. The Veteran filed the claims on appeal, to include a claim for service connection for a heart disability, in March 2015. After the Agency of Original Jurisdiction (AOJ) denied the claims in a March 2015 rating decision, the Veteran appealed the claims to the Board. Subsequently, on January 16, 2021, the Veteran filed a claim for entitlement to a total rating for compensation based on individual unemployability due to service-connected disabilities (TDIU). On the application, when asked to list the service-connected disabilities that he believed caused his employment difficulties, the Veteran mentioned coronary artery disease (CAD). In March 2021, the Agency of Original Jurisdiction (AOJ) sent the Veteran a letter, stating that CAD was not service-connected and requesting that he fill out an enclosed form if he wanted to claim service connection for it. Subsequently, in an April 2021 rating decision, the AOJ granted TDIU, effective January 16, 2021, the date of the filing of the claim for entitlement to TDIU. In May 2021, the Veteran's representative sent the AOJ a letter, correctly indicating that the issue of service connection for CAD issue was included in the claim for service connection for a heart disability that is the subject of this appeal. However, the Veteran's representative also incorrectly stated that entitlement to TDIU was part of the issue of service connection for a heart disability on appeal. In keeping with the representative's contention, the AOJ subsequently included the issue of entitlement to TDIU, prior to January 16, 2021, in a June 2021 supplemental statement of the case. As a preliminary matter, the Board notes that the issue of entitlement to TDIU, prior to January 16, 2021, is not currently in appellate status and is not before the Board. The Veteran has not filed any form requesting review of the effective date assigned for entitlement to TDIU in the April 2021 rating decision, as is required by VA regulation. Additionally, the claim for entitlement to TDIU is not part and parcel of the claim for service connection for a heart disability currently under appeal. A request for entitlement to TDIU, whether expressly raised by a Veteran or reasonably raised by the record, is part and parcel of an increased rating claim, because, with few exceptions, an increased rating claim essentially seeks the maximum benefits the Veteran can receive for an already service-connected disability. Rice v. Shinseki, 22 Vet. App. 447 (2009). The Board notes that does not apply to claims for service connection, because the issue of service connection involves the relationship of the disability to the Veteran's service rather than the actual severity of the disability. If VA were to grant service connection for the claimed heart disability and the Veteran were to appeal the rating assigned, the issue of entitlement to TDIU would then become part and parcel of the claim for a higher initial rating. However, in this instance, the issue of entitlement to TDIU, prior to January 16, 2021, is not related to the claim of service connection for a heart disability. Therefore, entitlement to TDIU, prior to January 16, 2021, is not in appellate status and is not before the Board. 1. Entitlement to service connection for a kidney disability, claimed as due to chemical and herbicide agent exposure, is remanded. The Veteran served at Camp Lejeune, where the Veteran claims to have been exposed to chemicals while drinking contaminated water. The Veteran also served at Quonset Point Naval Air Station (NAS) in Kingston, Rhode Island. The Veteran has provided documentary information, indicating that Quonset Point NAS was contaminated with chemicals, necessitating a later environmental cleanup of the area. The Veteran claims that he was exposed to either chemicals and herbicide agents at that base. In a February 2018 VA medical opinion, a VA examiner, having reviewed the evidence, opined that the Veteran's claimed kidney disability was not at least as likely as not related to chemical exposure caused by drinking contaminated water at Camp Lejeune. However, the Board notes that the examiner did not offer any opinion regarding the claimed exposure to chemicals and herbicide agents at Quonset Point NAS. Remand is necessary to schedule an additional examination, and to conduct any necessary development regarding chemical or herbicide agent exposure at Quonset Point NAS. 2. Entitlement to service connection for a heart disability, claimed as due to chemical and herbicide agent exposure, is remanded. 3. Entitlement to service connection for a groin disability, claimed as a blood clot, claimed as due to chemical and herbicide agent exposure, is remanded. 4. Entitlement to service connection for a skin disability, claimed as due to chemical and herbicide agent exposure, is remanded. 5. Entitlement to service connection for a hiatal hernia, claimed as due to chemical and herbicide agent exposure, is remanded. The Board cannot make fully-informed decision on the issues fo service connection for heart, groin, skin, and hiatal hernia disabilities, because no VA examiner has opined whether they are related to service. Remand is necessary for the scheduling of an examination. The VA treatment records currently in evidence contain notations indicating that VA employees scanned medical records into a VA hospital's imaging system, but do not contain any copies of the scanned records. Any treatment records scanned into a VA hospital's imaging system are within VA's constructive possession and are considered potentially relevant to the issues on appeal. Remand is required to allow VA to obtain those records. The matters are REMANDED for the following action: 1. Obtain all outstanding VA treatment records. Specifically, obtain the most recent VA treatment records not included in the record of evidence and the records noted as having been scanned into the Vista imaging system by VA Medical Center personnel, as noted in the VA treatment records in evidence, dated April 16, 2021; April 9, 2021; November 18, 2020; October 23, 2020; April 15, 2020; December 3, 2019; April 9, 2019; December 19, 2018; October 18, 2018; and April 26, 2016. 2. Ensure that with the required procedures regarding the development of claims related to exposure to contaminated drinking water at Camp Lejeune have been adhered to in developing the claims. 3. Request that the appropriate service department agency verify claimed exposures to chemicals or herbicide agents at Quonset Point NAS in Kingston, Rhode Island. Information regarding contaminants that required any environmental cleanup should be obtained. The service agency should specifically state whether the use or contamination by herbicide agents was shown at Quonset Point NAS. 4. Schedule the Veteran for an examination with a qualified medical examiner, preferably one with experience treating diseases related to chemical exposures, to determine the natures and etiologies of the claimed disabilities. The examiner should be provided with information about the circumstances of the Veteran's service at Camp Lejeune and any exposures at Quonset Point NAS. In reviewing the record, the examiner should note the service medical records, the post-service treatment records, the lay evidence, and the treatise information regarding Quonset Point NAS provided by the Veteran. A complete rationale should be provided for all opinions and conclusions expressed. All appropriate tests or studies should be accomplished, and all clinical findings should be reported in detail. After an examination, an interview with the Veteran, and a review of the claims file, the examiner is asked to provide the following: (a.) List all kidney, heart, groin or vascular (blood clot), skin, and hiatal hernia disabilities noted during the pendency of the appeal, dating to March 2015. If the examiner finds that any diagnoses are no longer present or disagrees with any prior diagnoses, the examiner should note the diagnoses and offer clinical reasons for those findings. (b.) Opine whether it is least as likely as not (50 percent or greater probability) that any kidney disability diagnosed during the pendency of the appeal, dating to March 2015, is related to service or any incident of service, to include exposure in service to chemicals at Camp Lejeune and any corroborated exposure to chemicals or herbicide agents at Quonset Point NAS. (c.) Opine whether it is least as likely as not (50 percent or greater probability) that any heart disability diagnosed during the pendency of the appeal, dating to March 2015, is related to service or any incident of service, to include exposure in service to chemicals at Camp Lejeune and any corroborated exposure to chemicals or herbicide agents at Quonset Point NAS. (d.) Opine whether it is least as likely as not (50 percent or greater probability) that any groin disability, or vascular disability of the lower extremities, such as a blood clot, diagnosed during the pendency of the appeal, dating to March 2015, is related to service or any incident of service, to include exposure in service to chemicals at Camp Lejeune and any corroborated exposure to chemicals or herbicide agents at Quonset Point NAS. (e.) Opine whether it is least as likely as not (50 percent or greater probability) that any skin disability diagnosed during the pendency of the appeal, dating to March 2015, is related to service or any incident of service, to include exposure in service to chemicals at Camp Lejeune and any corroborated exposure to chemicals or herbicide agents at Quonset Point NAS. (f.) Opine whether it is least as likely as not (50 percent or greater probability) that any hiatal hernia disability diagnosed during the pendency of the appeal, dating to March 2015, is related to service or any incident of service, to include exposure in service to chemicals at Camp Lejeune and any corroborated exposure to chemicals or herbicide agents at Quonset Point NAS. Harvey P. Roberts Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T.M. Gillett 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.