Citation Nr: 21016113 Decision Date: 03/19/21 Archive Date: 03/19/21 DOCKET NO. 17-40 915 DATE: March 19, 2021 REMANDED Entitlement to service connection for renal toxicity, to include as due to exposure to contaminated water, is remanded. REASONS FOR REMAND The Veteran served on active duty from October 1958 to November 1962. This matter comes before the Board of Veterans’ Appeals (Board) from an August 2019 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO).  Entitlement to service connection for renal toxicity, claimed as a result of exposure to contaminated water at Camp Lejeune is remanded. The Veteran contends that he has developed renal toxicity as a result of exposure to the contaminated water at Camp Lejeune. Military personnel records document service at Camp LeJeune from February 1959 to March 1959, and thus exposure to contaminated water at Camp LeJeune is conceded. At the January 2021 hearing before the Board, the Veteran testified that he was diagnosed with renal toxicity in 2001. The Veteran also testified that a Dr. V.R. stated that the renal toxicity was related to exposure to contaminated water at Camp Lejeune. The Board notes that in a December 2020 private treatment record, Dr. V.R. indicated that the kidney conditions may be related to contaminated water exposure at Camp Lejeune. The Veteran asserted that if bladder cancer was service-connected based on contamination water exposure, then there may be a possibility that there is a causal relationship between the renal issues with contaminated water exposure. The Board has interpreted this to be an assertion of possible secondary service connection in addition to direct service connection based on contaminated water exposure. VA must provide the Veteran with an examination where the information and evidence of record does not contain sufficient competent medical evidence to decide the claim, but (1) contains competent evidence of diagnosed disability or symptoms of disability, (2) establishes an in-service event, injury or disease, or the presence of a presumptive disease during the pertinent period, and (3) indicates that the claimed disability may be associated with the in-service event, injury, or disease, or with another service-connected disability. McLendon v. Nicholson, 20 Vet. App. 79 (2006). The Veteran has not received a VA examination to determine the etiology of the claimed disability, whether it is related to contaminated water exposure, or whether it is secondary to a service-connected disability. Therefore, a VA examination is necessary. The matters are REMANDED for the following action: Schedule the Veteran for a VA examination conducted by an appropriate medical doctor to assist in determining the nature of the claimed renal toxicity and any relationship to active service or a service connected disability, or to exposure to contaminated water at Camp Lejeune. The examiner must review the record and should note that review in the report. A rationale for all opinions should be provided. The examiner should: (a.) Diagnose all renal disabilities found. If no renal toxicity is identified, the examiner should specifically state that fact. (b.) Opine whether it is at least as likely as not (50 percent probability or greater) that any identified renal toxicity had its onset during active service or is related to any incident of service, including resumed exposure to contaminated water at Camp Lejeune. (c.) Opine whether it is at least as likely as not (50 percent probability or greater) that any identified renal disability is due to or the result of a service-connected bladder and prostate disability. (d.) Opine whether it at least as likely as not (50 percent probability or greater) that any identified renal disability has been aggravated (increased in severity beyond the natural progression of the disorder) by a service-connected bladder and prostate disability. Harvey P. Roberts Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K. Cross, 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.