Citation Nr: 21030971 Decision Date: 05/20/21 Archive Date: 05/20/21 DOCKET NO. 15-11 300 DATE: May 20, 2021 REMANDED Entitlement to service connection for kidney disease, to include as secondary to secondary to in-service exposure to herbicide agents, exposure to contaminated water at Camp Lejeune, and service-connected myelodysplastic syndrome, is remanded. REASONS FOR REMAND The Veteran served on active duty from May 1972 to November 1972, from December 1972 to December 1974, and from August 1975 to September 1978. In April 2019, the Veteran died. In November 2019, the appellant was recognized as the surviving spouse and her claim for substitution was granted. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an October 2011 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In a November 2018 decision, the Board denied entitlement to service connection for kidney disease. The Veteran appealed to the United States Court of Appeals for Veterans Claims (the Court). In October 2020, the Court granted a motion for partial remand. In March 2021, the Board remanded the claim for further development. In his March 2011 claim, the Veteran reported that his kidney disease was secondary to "blue water." In the October 2011 rating decision, the RO considered whether the disability was secondary to exposure to herbicide agents. The Veteran's service records reflect that in March 1973 he was advised of the legal implications of service in Okinawa and that he started his overseas tour. His DD Form 214 for the period from December 1972 to December 1974 shows that he had 11 months and 23 days of foreign and/or sea service. The RO should ask the appellant whether the Veteran, during his service as a Marine, served on a ship that was offshore of the Republic of Vietnam. VA treatment records reveal that in May 2011 the Veteran reported that he stopped working in part due to kidney disease. In March 2012, the RO requested records regarding his claim for Social Security disability benefits but the Social Security Administration did not respond. The RO should again attempt to obtain those records. In October 2017, the Veteran submitted some records from Kaiser Permanente. The RO should obtain all records from that provider. VA treatment records reveal that the Veteran had kidney-related anemia. Service connection is in effect for myelodysplastic syndrome. Pursuant to Schroeder v. West, 212 F.3d 1265, 1271 (Fed. Cir. 2000), the Board will consider whether the kidney disease is secondary to myelodysplastic syndrome. An addendum to a March 2021 VA medical opinion is necessary to address that theory of entitlement. The matters are REMANDED for the following action: 1. Ask the appellant to identify all treatment for the Veteran's kidney disease and myelodysplastic syndrome, and obtain any identified records. Ask the appellant to complete a VA Form 21-4142 for Kaiser Permanente. Make two requests for the authorized records from Kaiser Permanente, unless it is clear after the first request that a second request would be futile. 2. Obtain the Veteran's federal records from the Social Security Administration pertaining to his claim for disability benefits. Document all requests for information as well as all responses in the claims file. 3. Ask the appellant whether the Veteran served on a ship was offshore of the Republic of Vietnam and, unless she verifies that he did not serve offshore of the Republic of Vietnam, attempt to verify the Veteran's asserted in-service exposure to herbicide agents. If there is still insufficient information to verify exposure to herbicide agents, issue a Formal Finding outlining the steps taken to assist the appellant and notify the appellant of VA's inability to verify the in-service herbicide agent exposure. 4. After the development in 1 through 3 is completed, the RO should arrange for the Veteran's electronic claims file to be reviewed by the VA doctor who prepared the March 2021 VA medical opinion for the preparation of an addendum regarding any relationship between kidney disease and myelodysplastic syndrome. If that doctor is unavailable, arrange for the claims file to be reviewed by another medical professional. The clinician must opine on whether it is at least as likely as not that the chronic kidney disease, to include focal segmental glomerulosclerosis, was (1) caused by or (2) aggravated by myelodysplastic syndrome. If the clinician finds that the chronic kidney disease, to include focal segmental glomerulosclerosis, was aggravated by myelodysplastic syndrome, then the clinician should quantify the degree of aggravation. If and only if the RO verifies that the Veteran served on a ship was offshore of the Republic of Vietnam, the clinician must opine whether it is at least as likely as not that chronic kidney disease, to include focal segmental glomerulosclerosis, is related to in-service herbicide-agent exposure while serving on a ship was offshore of the Republic of Vietnam. The clinician should be advised that simply stating that chronic kidney disease, to include focal segmental glomerulosclerosis, is not a presumptive disorder under the regulations is not a medical rationale and that the clinician must give a rationale on whether chronic kidney disease, to include focal segmental glomerulosclerosis, is related to in-service herbicide-agent exposure. 5. After development above has been completed, the RO should readjudicate the appellant's claim. If the claim remains denied, the appellant should be issued a supplemental statement of the case and afforded an opportunity to respond. MICHAEL LANE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D. Cherry, 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.