Citation Nr: 21076573 Decision Date: 12/27/21 Archive Date: 12/27/21 DOCKET NO. 18-54 898 DATE: December 27, 2021 REMANDED Entitlement to service connection for sarcoidosis to include as secondary to asbestos exposure and exposure to contaminated water at Camp Lejeune is remanded. Entitlement to service connection for multiple myeloma as secondary to exposure to contaminated water at Camp Lejeune is remanded. Entitlement to service connection for POEMS Syndrome as secondary to exposure to contaminated water at Camp Lejeune is remanded. Entitlement to service connection for a kidney condition as secondary to exposure to contaminated water at Camp Lejeune is remanded. Entitlement to service connection for a thyroid condition as secondary to exposure to contaminated water at Camp Lejeune is remanded. REASONS FOR REMAND The Veteran had active service from June 1989 to September 1989. The Veteran also served with the Army National Guard from March 1988 to March 1994. These matters come before the Board of Veterans' Appeals (Board) from rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO). In July 2020, the Veteran provided testimony before the undersigned Veterans Law Judge. A transcript of the hearing has been associated with the claims file. In October 2020, the Board remanded these matters for additional development. In December 2021, the Veteran submitted additional evidence pertinent to his claim. He did not submit a waiver of initial RO review, however, under 38 U.S.C. § 7105(e), for cases in which substantive appeals are received on or after February 2, 2013, if the claimant or the claimant's representative submits evidence to the RO or the Board for consideration in connection with the issues on appeal, the Board may consider such evidence in the first instance unless the claimant or representative requests in writing that the RO initially review such evidence. See 38 C.F.R. §§ 19.31, 19.37, 20.1304. The Veteran did not request that the RO review the evidence in the first instance; therefore, the Board will proceed with consideration of his claims. 1. Entitlement to service connection for sarcoidosis to include as secondary to asbestos exposure and exposure to contaminated water at Camp Lejeune is remanded. 2. Entitlement to service connection for multiple myeloma as secondary to exposure to contaminated water at Camp Lejeune is remanded. 3. Entitlement to service connection for POEMS Syndrome as secondary to exposure to contaminated water at Camp Lejeune is remanded. 4. Entitlement to service connection for a kidney condition as secondary to exposure to contaminated water at Camp Lejeune is remanded. 5. Entitlement to service connection for a thyroid condition as secondary to exposure to contaminated water at Camp Lejeune is remanded. The Veteran contends that he is entitled to service connection for sarcoidosis, multiple myeloma, POEMS syndrome, a kidney condition, and thyroid condition as a result of exposure to contaminated water at Camp Lejeune. Presumptive provisions provide that for service connection for a disease associated with exposure to contaminated water at Camp Lejeune, a claimant must show the following: (1) that the Veteran served at Camp Lejeune for no less than 30 days (either consecutive or nonconsecutive) from August 1, 1953 to December 31, 1987; (2) that the veteran suffered from a disease associated with exposure to contaminants in the water supply at Camp Lejeune enumerated under 38 C.F.R. § 3.309(f); and (3) that the disease process manifested to a degree of 10 percent or more at any time after service. 38 C.F.R. §§ 3.307(a)(7), 3.309(f). In this case, the Veteran does not contend that he served at least 30 days at Camp Lejeune during the presumptive period. He asserts that he spent three days each fall at Camp Lejeune, approximately 18 days, after the presumptive period ended. While the Veteran does not qualify for service connection for any disability on a presumptive basis, the Veteran may be entitled to service connection on a direct basis. Combee v. Brown, 34 F.3d 1039, (1994). Regarding service at Camp Lejeune, the Board finds the Veteran is competent to report that he had training weekends at Camp Lejeune. His assertions are supported by an affidavit from T.H., which was received in December 2021. In the affidavit, T.H. stated that he served with the Veteran and that their service included spending one weekend each year at Camp Lejeune for weapons qualifications. The Board finds the lay statements credible. As such, the Veteran should be given the benefit of the doubt that he served approximately 18 days at Camp Lejeune during service. Regarding exposure to contaminated water at Camp Lejeune, the Board notes that transcripts of the Congressional Subcommittee on Investigations and Oversight hearing of September 2010, the U.S. House, Committee on Science and Technology (2011), Camp Lejeune: Contamination and Compensation, Looking Back, Moving Forward, Serial No. 111-108, September 16, 2010, are of record. The transcripts indicate that documents from the Navy show there was as much as 1.1 million gallons of gasoline floating on top of the ground water at Camp Lejeune between 1988 and 1991. As such, the Board finds it likely that the Veteran was exposed to contaminated water during his stays at Camp Lejeune. As noted above, the presumptions do not apply in this case because the Veteran served less than 30 days and served after the presumptive period. As such, the question remains as to whether the Veteran's 18 days of exposure to contaminated water at Camp Lejeune after the presumptive period caused any of his claimed disabilities. The Veteran has not had an examination for any of his disabilities. On remand, examinations must be scheduled and opinions obtained indicating whether it is at least as likely as not that any of his disabilities are related to service, to include his exposure to contaminated water at Camp Lejeune. The matters are REMANDED for the following actions: 1. Schedule the Veteran for a VA examination for each of his claimed disabilities: sarcoidosis, multiple myeloma, POEMS syndrome, a kidney condition, and thyroid condition. The clinician(s) must review the electronic claims file and indicate review of the file in the examination report. The clinicians must be informed that the Veteran had 18 days of service at Camp Lejeune between 1988 and 1994. The clinicians must be informed that per the transcripts of the Congressional Subcommittee on Investigations and Oversight hearing of September 2010, the U.S. House, Committee on Science and Technology (2011), Camp Lejeune: Contamination and Compensation, Looking Back, Moving Forward, Serial No. 111-108, September 16, 2010, Navy documents show there was as much as 1.1 million gallons of gasoline floating on top of the ground water at Camp Lejeune between 1988 and 1991. After examining the Veteran, clinicians are asked to indicate whether it is at least as likely as not (50 percent or greater probability) that the Veteran's disabilities (sarcoidosis, multiple myeloma, POEMS Syndrome, kidney condition, and thyroid condition) are due to his approximately 18 days of exposure to contaminated water at Camp Lejeune between 1988 and 1994. The examiner is advised that the presumptive provisions pertinent to Camp Lejeune are not applicable and as such, a negative opinion cannot be based solely on the fact that the Veteran did not serve during the presumptive period. Further, a negative opinion cannot be based on the fact that a disability is not on the list of diseases that are presumptively associated with exposure to contaminants in the water supply at Camp Lejeune. All opinions must be supported with rationale based on medical expertise, current literature, medical evidence, and the Veteran's lay statements. 2. Then, readjudicate the Veteran's claims on appeal. If the benefits sought on appeal remain denied, provide the Veteran and his representative a supplemental statement of the case and allow an appropriate period for response. L. CHU Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. G. Alderman, 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.