Citation Nr: 21009305 Decision Date: 02/22/21 Archive Date: 02/22/21 DOCKET NO. 19-23 364 DATE: February 22, 2021 REMANDED Entitlement to service connection for lupus is remanded. Entitlement to service connection for fibromyalgia is remanded. Entitlement to service connection for a left hip disability is remanded. Entitlement to service connection for a right hip disability is remanded. Entitlement to service connection for a sinus disability is remanded. Entitlement to service connection for right upper extremity neuropathy is remanded. Entitlement to service connection for left upper extremity neuropathy is remanded. Entitlement to service connection for hypertension is remanded. Entitlement to service connection for a kidney disability is remanded. REASONS FOR REMAND The Veteran had active duty service from June 1984 to November 1984. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from July 2018 and January 2019 rating decisions by a Department of Veterans Affairs (VA) Regional Office (RO). The Board acknowledges that the Veteran’s claims for lupus, hypertension, and kidney disease were originally denied in May 2018. The Veteran submitted a new claim in June 2018, a new rating decision was issued in July 2018, and a notice of disagreement (NOD) to that decision was submitted in November 2018. The Board notes that the NOD was submitted within the one-year appeal period. Additionally, the Veteran submitted new and material evidence within one year of the original decision. As such, the July 2018 rating decision incorrectly denied reopening the Veteran’s claims. The May 2018 rating decision was not final, and the Board need not address whether the Veteran’s claim is reopened. In September 2019 the Board denied entitlement to service connection for fibromyalgia, a sinus disability, a bilateral hip disability, and bilateral upper extremity neuropathy. The Veteran appealed that decision to the Court of Appeals for Veterans Claims (Court). In an August 2020 Joint Motion for Remand (JMR) the parties agreed that the Board’s decision should be vacated. In August 2020, the Court vacated the Board’s decision, and remanded the issue to the Board for action consistent with the JMR. The claims have been returned to the Board for appellate review. The Board notes that the August 2020 JMR specifically abandoned the denial of service connection for fibromyalgia, left and right hip conditions, sinusitis, left and right upper extremity neuropathy, based on a theory that they are directly related to service. 1. Entitlement to service connection for lupus is remanded. The Board cannot make a fully-informed decision on the issue of entitlement to service connection for lupus because no VA examiner has opined whether his lupus is causally related to his exposure to contaminated water at Camp Lejeune. 2. Entitlement to service connection for fibromyalgia is remanded. The Veteran’s claim of service connection for lupus affects the remaining claimed disabilities as the Veteran is asserting that the additional disabilities may be causally related to or aggravated by his lupus; therefore, the service connection claims are inextricably intertwined. Thus, a decision by the Board on the remaining service connection claims would, at this point, be premature. 3. Entitlement to service connection for a left hip disability is remanded. Please see the analysis in section 2, above. 4. Entitlement to service connection for a right hip disability is remanded. Please see the analysis in section 2, above. 5. Entitlement to service connection for a sinus disability is remanded. Please see the analysis in section 2, above. 6. Entitlement to service connection for right upper extremity neuropathy is remanded. Please see the analysis in section 2, above. 7. Entitlement to service connection for left upper extremity neuropathy is remanded. Please see the analysis in section 2, above. 8. Entitlement to service connection for hypertension is remanded. Please see the analysis in section 2, above. 9. Entitlement to service connection for a kidney disability is remanded. Please see the analysis in section 2, above. The matters are REMANDED for the following action: 1. Following a complete review of the evidence of record and with consideration of the Veteran’s lay statements, assuming the statements are credible for the limited purpose of the request herein, a medical professional is requested to provide the following opinions: a.) Given the Veteran’s exposure to contaminated water during his period of time at Camp Lejeune, is the Veteran’s lupus at least as likely as not causally related to service? The examiner should address the October 2018 private nexus opinion, as well as the studies submitted by the Veteran including the Agency for Toxic Substances and Disease Registry statement that TCE, PCE, vinyl chloride, and benzene are associated with lupus. b.) Is the Veteran’s hypertension or kidney disease at least as likely as not related to service, to include the Veteran’s exposure to contaminated water during his period of time at Camp Lejeune? c.) Is the Veteran’s fibromyalgia, sinus disability, neuropathy of the upper extremities, bilateral hips, hypertension, or kidney disease at least as likely as not causally related to or aggravated by his lupus? d.) Is the Veteran’s hypertension causally related to or aggravated by his kidney disease? The examiner is advised that a negative opinion cannot be based solely 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. A complete rationale must be provided for all opinions offered. If any opinion cannot be offered without resort to mere speculation, the examiner must fully explain why this is the case and identify what, if any, additional evidence would potentially allow for a more definitive opinion. If an additional examination is required for the examiner to sufficiently address the above questions, then a new examination should be afforded. 2. After undertaking the development above and any additional development deemed necessary, the Veteran’s claims should be readjudicated. If the benefits sought on appeal remain denied, the appellant and his representative should be furnished a supplemental statement of the case and be given an appropriate period to respond thereto before the case is returned to the Board, if in order. Jennifer White Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Patricia Veresink, Associate 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.