Citation Nr: 21026005 Decision Date: 04/29/21 Archive Date: 04/29/21 DOCKET NO. 20-22 567 DATE: April 29, 2021 ORDER Entitlement to service connection for prostate cancer is dismissed. Entitlement to service connection for a skin disability, to include parapsoriasis and cutaneous T-cell lymphoma, is granted. FINDINGS OF FACT 1. On February 4, 2021, during the Veteran’s hearing, prior to the promulgation of a decision in the appeal, the Board received notification from the Veteran that a withdrawal of the appeal for service connection for prostate cancer is requested. 2. The Veteran has a current diagnosis of cutaneous T-cell lymphoma, a subset of non-Hodgkin’s lymphoma, and was stationed at Camp Lejeune for at least 30 days prior to December 31, 1987. CONCLUSIONS OF LAW 1. The criteria for withdrawal of the appeal of the claim for service connection for prostate cancer by the Veteran has been met. 38 U.S.C. § 7105(b)(2), (d)(5); 38 C.F.R. § 19.55. 2. The criteria for entitlement to service connection for cutaneous T-cell lymphoma are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.303, 3.304, 3.307, 3.309. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from September 1960 to September 1964. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a July 2017 rating decision. In February 2021, the Veteran testified before the undersigned Veterans Law Judge (VLJ) at a hearing. A transcript of that hearing is of record. The Veteran initially claimed entitlement to service connection for parapsoriasis, which was denied by the Agency of Original Jurisdiction (AOJ). However, what constitutes a claim is not limited by a lay veteran’s assertion of his condition in the application, but must be construed based on the reasonable expectations of the non-expert claimant and the evidence developed in processing the claim. Clemons v. Shinseki, 23 Vet. App. 1, 4-5 (2009). The record raises the issue of service connection for a skin disability, to include parapsoriasis and cutaneous T-cell lymphoma. In particular, the Veteran’s VA treatment records demonstrate that parapsoriasis is a possible precursor to cutaneous T-cell lymphoma. Thus, the Board has recharacterized the issue more broadly. 1. Entitlement to service connection for prostate cancer is dismissed. Under applicable criteria, the Board may dismiss any appeal which fails to allege specific error of fact or law in the determination being appealed. 38 U.S.C. § 7105. An appeal as to any or all issues involved in the appeal may be withdrawn on the record at a hearing or in writing at any time before the Board promulgates a decision. 38 C.F.R. § 19.55. Withdrawal may be made by a Veteran or by his or her authorized representative. Id. During the February 4, 2021 Board hearing, the Veteran explicitly, unambiguously, and with a full understanding of the consequences, withdrew his claim for service connection for prostate cancer. The undersigned clearly identified the withdrawn issue, and the Veteran affirmed that he was requesting a withdrawal as to that appeal. The Veteran’s full understanding of the consequences is shown by his verbal confirmation that the consequences of the withdrawal were discussed and understood by him and the presence of his representative at the hearing. See Acree v. O’Rourke, 891 F.3d 1009 (Fed. Cir. 2018). The request for withdrawal was made on the record and satisfies the requirements for the withdrawal of a substantive appeal. See 38 C.F.R. § 19.55. When pending appeals are withdrawn, there are no longer allegations of factual or legal error with respect to the issues that had been previously appealed. In such an instance, dismissal of the pending claim is appropriate. See 38 U.S.C. § 7105(d). Accordingly, further action by the Board on this issue is not appropriate and it is dismissed. Id. 2. Entitlement to service connection for a skin disability, to include parapsoriasis and cutaneous T-cell lymphoma, is granted. The Veteran maintains that his cutaneous T-cell lymphoma is due to his exposure to contaminated water while stationed at Camp Lejeune, North Carolina. For the reasons discussed below, the Board finds that service connection is warranted. Service connection means that a veteran has a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Service connection may be granted for any disease diagnosed after discharge when the evidence shows that the disease was incurred in service. 38 C.F.R. § 3.303(d). Entitlement to service connection is established when the following elements are satisfied: (1) the existence of a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship or “medical nexus” between the current disability and the disease or injury incurred or aggravated during service. Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004); see 38 C.F.R. § 3.303(a). Service connection may also be shown on a presumptive basis. A veteran, or former reservist or member of the National Guard, who had no less than 30 days (consecutive or nonconsecutive) of service at Camp Lejeune during the period beginning on August 1, 1953, and ending on December 31, 1987, shall be presumed to have been exposed during such service to the contaminants in the water supply, unless there is affirmative evidence to establish that the individual was not exposed to contaminants in the water supply during that service. 38 C.F.R. § 3.307(a)(7). “Contaminants in the water supply” means the volatile organic compounds trichloroethylene (TCE), perchloroethylene (PCE), benzene and vinyl chloride, that were in the on-base water-supply systems located at United States Marine Corps Base Camp Lejeune, during the period beginning on August 1, 1953, and ending on December 31, 1987. Id. If a Veteran served on Camp Lejeune during the time frame specified, certain diseases including kidney cancer, liver cancer, non-Hodgkin’s lymphoma, adult leukemia, multiple myeloma, Parkinson’s disease, aplastic anemia and other myelodysplastic syndromes, and bladder cancer shall be service-connected even though there is no record of such disease during service. 38 C.F.R. § 3.309(f). A claimant is entitled to the benefit of the doubt when there is an approximate balance of positive and negative evidence on any issue material to the claim. See 38 U.S.C. § 5107 ; 38 C.F.R. § 3.102 (providing, in pertinent part, that reasonable doubt will be resolved in favor of the claimant). When the evidence supports the claim or is in relative equipoise, the claim will be granted. See Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990); see also Wise v. Shinseki, 26 Vet. App. 517, 532 (2014). If the preponderance of the evidence weighs against the claim, it must be denied. Alemany v. Brown, 9 Vet. App. 518, 519 (1996). In this case, the Veteran states that his cutaneous T-cell lymphoma was caused by exposure to contaminated drinking water at Camp Lejeune. The Veteran’s private treatment records demonstrate that he has a current diagnosis of cutaneous T-cell lymphoma. See August 2020 Brigham Dermatology Associates Consultation Note; see also February 2021 Private Medical Opinion. The Veteran reported that he was stationed at Camp Lejeune. Specifically, the Veteran’s service treatment records show that he was stationed at Camp Lejeune from December 27, 1960 to February 7, 1961. Thus, he is presumed to have been exposed to the contaminants in the water supply at Camp Lejeune. 38 C.F.R. § 3.307(a)(7). Non-Hodgkin’s lymphoma is included in the list of presumptive diseases under 38 C.F.R. § 3.309(f) regarding contaminated water at Camp Lejeune. Evidence from the Veteran’s claims folder indicates that cutaneous T-cell lymphoma is a rare subset of Non-Hodgkin’s lymphoma. In particular, the February 2021 private medical opinion from N.R.L., MD, MPH, and Clinical Director of the Center for Cutaneous Oncology at Dana-Farber/Brigham and Women’s Cancer Center states that the Veteran is seen for management for a rare type of non-Hodgkin’s lymphoma, cutaneous T-cell lymphoma. Additionally, medical literature submitted by the Veteran in December 2020 from the Mayo Clinic provides that cutaneous T-cell lymphoma is one of several types of lymphoma collectively called non-Hodgkin’s lymphoma. Consequently, service connection is established for this disability on a presumptive basis with respect to such exposure. See 38 C.F.R. §§ 3.307, 3.309. P.M. DILORENZO Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Sean Mussey, 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.