Citation Nr: 21024176 Decision Date: 04/22/21 Archive Date: 04/22/21 DOCKET NO. 16-27 466A DATE: April 22, 2021 REMANDED The claim of entitlement to service connection for a cerebrovascular accident (CVA) (claimed as stroke and paralyzed left side) is remanded. The claim of entitlement to service connection for a seizure disorder is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1984 to May 1989. These issues come before the Board of Veterans’ Appeals (Board) on appeal from an April 2015 rating decision issued by a U.S. Department of Veterans Affairs (VA) Regional Office (RO). In January 2020, the Board remanded the claims on appeal for additional development. The case is again before the Board for appellate review. Another remand is warranted for issuance of an addendum opinion. The Veteran contends that his cerebrovascular accident and seizure disorder are the result of exposure to contaminated water at Camp Lejeune, North Carolina. In the January 2020 remand, the Board requested medical examination into the claims on appeal, stated that exposure to contaminated water at Camp Lejeune should be presumed, and requested a review of information submitted into evidence by the Veteran in June 2016, which highlighted studies connecting contaminated water exposure and neurobehavioral effects. The Veteran underwent VA examination into his claims in June 2020. The examiner found it unlikely that stroke and seizures related to service. However, the examiner did not address the June 2016 submission of evidence by the Veteran. On remand, an addendum opinion should be obtained. The matters are REMANDED for the following action: Return the case to the VA examiner who conducted the June 2020 VA examination, or to a suitable substitute, for issuance of an addendum opinion addressing the claims of entitlement to service connection for a CVA and a seizure disorder. After reviewing the claims file, the examiner should again address the following question: Is it at least as likely as not (a 50 percent or greater probability) that the Veteran’s CVA and/or seizure disorder was incurred in, or is otherwise related to, active service to include presumed exposure to contaminated water at Camp Lejeune? In answering this question, the examiner must consider and discuss the Veteran’s June 2016 submission of a printout from the VA.gov website and from Review of VA Clinical Guidance for the Health Conditions Identified by the Camp Lejeune Legislation; Committee on the Review of Clinical Guidance for the Care of Health Conditions Identified by the Camp Lejeune Legislation; Board on the Health of Select Populations; Institute of Medicine. Washington (DC): National Academies Press (US); 2015 Mar 26 (available at https://www.ncbi.nlm.nih.gov/books/NBK284982/). The articles include discussion of medical studies which found limited/suggestive evidence of an association between exposure to mixed solvents and neurobehavioral effects. Please explain in detail any opinion provided and the supporting rationale. C. J. McEntee Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J.T. Massey, 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.