Citation Nr: 21010347 Decision Date: 02/24/21 Archive Date: 02/24/21 DOCKET NO. 11-26 384A DATE: February 24, 2021 REMANDED Entitlement to service connection for lesion of the liver is remanded. Entitlement to service connection for a gall bladder disability is remanded. REASONS FOR REMAND The Veteran served on active duty from October 1962 to August 1966. This matter came before the Board of Veterans Appeals (Board) on appeal from a March 2010 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). A June 2019 Board decision remanded the issues on appeal for development. The Veteran’s October 2011 Formal Appeal requested a Travel Board hearing for the issues of service connection for liver lesions, a gall bladder disability and residuals of heart valve replacement. However, the Veteran withdrew the Travel Board request in March 2011, choosing instead to have a local RO hearing. The RO hearing was held in February 2013 and the transcript is of record. The Veteran also has a pending appeal regarding the issues of service connection for PTSD and a heart disability, including ischemic heart disease and a heart valve replacement, and has requested a Travel Board hearing regarding those issues. A February 2021 letter indicated that the hearing request was still pending. Those issues will therefore be addressed in a separate decision after the Veteran has been afforded the opportunity of a hearing. 1. Entitlement to service connection for lesion of the liver is remanded. 2. Entitlement to service connection for a gall bladder disability is remanded. The June 2019 Board decision requested development to verify the Veteran’s period of service at Camp Lejeune. The Board’s review indicates that the requested development has not yet been performed. Moreover, a February 2021 deferred rating decision issued after the appeal was returned to the Board noted that full personnel records had not yet been obtained to verify the Veteran’s period of service at Camp Lejeune. The decision noted that once the development was completed, new medical opinions shoulder also be obtained. Remand is therefore required so that the required development can be completed. Stegall v. West, 11 Vet. App. 268 (1998). The Board also finds that the December 2020 VA opinion is inadequate and new opinions are required. As noted in the June 2019 remand directives, the fact that a VA presumption has not been established for a specific disability is not dispositive of the issue of nexus and consideration must still be given to the exposure. However, in finding that the Veteran’s liver and gall bladder disabilities were not likely due to herbicide agent exposure in Vietnam, the December 2020 opinion’s discussion of herbicide agent exposure was limited to a statement that neither condition was a presumptive condition. The opinion is therefore inadequate and new opinions should be obtained upon remand. The matters are REMANDED for the following action: 1. Take all appropriate actions to verify the Veteran’s period of service a Camp Lejeune. 2. After the development in (1), obtain new VA opinions from an appropriate provider regarding the etiology of the Veteran’s current liver and gall bladder disabilities. An in-person examination is not required unless deemed necessary by the provider. The examiner should review the file and provide a complete rationale for all opinions expressed. The examiner should provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s liver and gall bladder disabilities are related to active service, to include exposure to herbicide agents in Vietnam. If service in Camp Lejeune is confirmed, the opinion should also address whether the disabilities are due to exposure to contaminated water at Camp Lejeune. In this regard, the examiner is advised that the fact that a VA presumption has not been established for a disability is not dispositive of the issue of nexus and consideration must still be given to the exposure. In providing the opinions, the examiner should consider and discuss any lay statements of record, to include the Veteran’s statements regarding the onset and persistence of his symptoms. 3. If upon completion of the above action the appeal remains denied, the case should be returned to the Board after compliance with appellate procedures. E. I. VELEZ Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Arnold 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.