Citation Nr: 21014853 Decision Date: 03/15/21 Archive Date: 03/15/21 DOCKET NO. 15-43 312 DATE: March 15, 2021 REMANDED Entitlement to service connection for a brain disability, to include as due to exposure to Camp Lejeune Contaminated Water (CLCW) and/or jet fuel is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1993 to August 1997. This case is before the Board of Veterans’ Appeals (Board) on appeal from a July 2014 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). In September 2018 and July 2020, the Board remanded the matter for additional development. The matter is now returned to the Board. The Veteran is seeking service connection for brain lesions. Unfortunately, the Board finds that another remand is necessary prior to final adjudication of the matter. The Board notes that a medical opinion regarding the causal link between the Veteran’s current brain lesions and his exposure to CLCW was obtained in October 2020. The October 2020 VA examiner found that the Veteran’s disability was not related to exposure to contaminated water, but indicated that the most likely causes of the Veteran’s claimed condition include hypertension, smoking, type 2 diabetes, and obesity. In that regard, the examiner also pointed out the Veteran’s neurologist’s previous suggestion that the Veteran’s condition may be secondary to longstanding history of hypertension, history of migraines with aura, and history of smoking in the past. Importantly, the Veteran is currently service-connected for hypertension. As such, a medical opinion as to the possible secondary service connection is necessary in order to make a fully informed decision. Moreover, as the October 2020 examiner did not address whether the Veteran’s disability was related to exposure to jet fuel as requested by the Board, another opinion was obtained in November 2020 by a different examiner. However, while the examiner found that the Veteran’s brain disability was not related to exposure to jet fuel, the examiner offered no rationale for this opinion except to say that the claims file was reviewed. Thus, this opinion is inadequate. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 301 (2008). As such, in order to comply with the Board’s prior remand, another opinion must be obtained concerning whether the disability is due to in-service exposure to jet fuel. See Stegall v. West, 11 Vet. App. 268, 271 (1998). Accordingly, the matter is REMANDED for the following action: Obtain an addendum opinion from the October 2020 VA examiner regarding the Veteran’s service connection claim for a brain disability. If the October 2020 VA examiner is not available, the requested opinion with rationale should be rendered by another appropriate medical professional. The need for another examination is left to the discretion of the examiner. The examiner should review the Veteran’s claims file and a copy of this REMAND order before rendering the requested addendum opinion. (a.) The examiner must opine whether the Veteran’s current brain condition is at least as likely as not (50 percent or greater probability) related to an in-service injury, event, or disease, including exposure to jet fuel. (b.) The examiner must opine whether the Veteran’s current brain condition is at least as likely as not (50 percent or greater probability) caused (in whole or in part) by his service-connected hypertension. (c.) The examiner must opine whether the Veteran’s current brain condition is at least as likely as not (50 percent or greater probability) aggravated (any incremental increase in disability or any additional impairment of earning capacity regardless of its permanence) by his service-connected hypertension. The examiner is asked to provide a complete written rationale for any opinion offered. J.N. MOATS Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. E. Kim, 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.