Citation Nr: 21072625 Decision Date: 12/03/21 Archive Date: 12/03/21 DOCKET NO. 16-54 578 DATE: December 3, 2021 ORDER Entitlement to service connection for a colon disability, to include as related to exposure to contaminated water at Camp Lejeune, is denied. FINDING OF FACT The Veteran's colon disabilities are not etiologically related to active service, and are not presumed to be related to his exposure to contaminated water at Camp Lejeune. CONCLUSION OF LAW The criteria for service connection for a colon disability have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113 (2018); 38 C.F.R. §§ 3.303, 3.307, 3.309 (2020). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service in the United States Marine Corps (USMC) from June 1969 to March 1970. This case comes before the Board of Veterans' Appeals (Board) on appeal from a July 2015 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). This matter was previously before the Board in December 2018 at which time the case was remanded for additional development; namely, to afford the Veteran a VA examination. There has been substantial compliance with the Board's remand directives. See Stegall v. West, 11 Vet. App. 268 (1998). The Board notes that the issue of entitlement to service connection for neurobehavioral effects was also remanded for additional development in December 2018. However, in a June 2021 rating decision, the Veteran was granted entitlement to service connection for major depressive disorder with anxious distress (claimed as neurobehavioral effects, anger issues). That decision constitutes a full grant of the benefit sought on appeal and the Board has limited its consideration accordingly. The Veteran contends that he has a colon disability as a result of his exposure to contaminated water at Camp Lejeune. Additionally, the Veteran has reported that his colon disabilities are related to exposure to parasites from well-water at Camp Lejeune. While VA has conceded the Veteran's service at Camp Lejeune, for the following reasons, the Board concludes that service connection is not warranted. At the outset, the Veteran's service treatment records (STRs) do not show, and the Veteran does not assert, that he sustained or developed any colon disability during service. Rather, the Veteran asserts that he was exposed to contaminated water at Camp Lejeune, which resulted in that disability later developing. The Veteran was afforded a VA examination for his claimed colon disabilities in May 2020. At that time, the examiner noted the Veteran's diagnoses of colon polyps and diverticulosis. The examiner stated that the Agency for Toxic Substances and Disease registry has not found that colon polyps and diverticulosis are related to the contaminants found in the drinking water at Camp Lejeune. Further, that there have been no reports or literature linking organic solvents to colonic polyps or diverticulosis. Ultimately, the examiner opined that the Veteran's diagnoses of colon polyps and diverticulosis were less likely as not caused or a result of the Veteran's exposure to contaminants found in the drinking water at Camp Lejeune. In so finding, the examiner stated that colon polyps and diverticulosis are mainly due to older age and lifestyle factors. Moreover, the examiner stated that it would be unlikely that the Veteran would have developed colon polyps and diverticulosis from low exposure to solvents over a short period of time at Camp Lejeune. VA obtained an addendum opinion from another VA examiner in March 2021. At that time, the examiner noted the Veteran's assertion that he was diagnosed with polyps in the 1990s, but that the earliest diagnosis of record was in October 2003. Again, the examiner opined that the Veteran's claimed conditions were less likely than not incurred in or caused by the claimed in-service injury, event, or illness. In so finding, the examiner stated that at the time of the Veteran's diagnosis he was 54 with a family history of colon cancer. The examiner noted that the Veteran met the strong causative criteria of colon polyps. Notably, the examiner stated that contrary to the Veteran's doctor's opinion parasites were not known to be causative factors for colon polyps. VA obtained an additional opinion in July 2021. The examiner noted that the Veteran was informed by his doctor that his colon problems were related to exposure to parasites in well-water while stationed in Camp Lejeune. However, the examiner opined that the Veteran's claimed conditions were less likely than not incurred in or caused by the claimed in-service injury, event, or illness. In so finding, the examiner noted that diverticulosis is associated with a diet low in fiber, age, a diet rich in salt, sugar, and meat, obesity, and non-steroidal anti-inflammatory drugs (NSAID) use. The examiner stated that diverticulosis was not associated with parasites or exposure to contaminants in the water supply of Camp Lejeune and that there was no evidence that the Veteran had diverticulosis during service. The Board notes that on his November 2015 notice of disagreement, the Veteran stated that his doctor explained to him that his colon problems were caused by parasites from well-water that he was exposed to while stationed at Camp Lejeune. While the Veteran is competent to report what his physician explained to him, the Board finds that the May 2020, March 2021, and July 2021 VA opinions, when taken together, are the most probative evidence of record. The May 2020 examiner reviewed the Veteran's medical and service records, while the March 2021 and July 2021 examiner examined the Veteran and reviewed the Veteran's medical and service records. They discussed the relevant evidence, considered the contentions of the Veteran, and provided a thorough supporting rationale for the conclusions reached. Further they relied on their own expertise, knowledge, and training when drafting their reports. Barr v. Nicholson, 21 Vet. App. 303 (2007); Stefl v. Nicholson, 21 Vet. App. 120 (2007); Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). Further, as the Veteran has not submitted any contradictory medical evidence, the VA medical opinions are the most probative evidence of record as to the etiology of the Veteran's colon disabilities. The Board acknowledges that the Veteran has continuously indicated that his colon disability is related to his exposure to contaminated water and parasites at Camp Lejeune. The Veteran is competent to report observable symptomatology of his condition and to relate a contemporaneous medical diagnosis. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). However, to the extent that the Veteran has attempted to establish a nexus through his own lay assertions, laypersons are not competent to offer opinions as to the etiology of the Veteran's colon disability. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); Woehlaert v. Nicholson, 21 Vet. App. 456, 462 (2007). The Veteran's colon disabilities require specialized training for determinations as to diagnosis and causation, and is therefore not susceptible to lay opinions on etiology. Thus, a layperson is not competent to render such a nexus opinion or attempt to present lay assertions to establish a nexus between the current diagnosis and service. Accordingly, the Board finds that the preponderance of the evidence is against the claim and entitlement to service connection for the Veteran's colon disabilities are not warranted. 38 U.S.C. § 5107(b) (2018); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Sonja A. Mishalanie Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board I. Cannaday, 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.