Citation Nr: 21041550
Decision Date: 07/09/21	Archive Date: 07/09/21

DOCKET NO. 18-00 983
DATE: July 9, 2021

REMANDED

Entitlement to service connection for acute myeloid leukemia is remanded.

Entitlement to service connection for the Veteran's cause of death is remanded.

REASONS FOR REMAND

The Veteran served on active duty from June 1971 to August 1976. 

This case comes before the Board of Veterans' Appeals (Board) on appeal of a July 2015 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran died on October [REDACTED], 2013. The Appellant, the Veteran's wife, and the Veteran's brother testified before the undersigned Veterans Law Judge (VLJ) on March 9, 2021. On July 2, 2021, the RO sent a letter to the Appellant informing her that it accepted the November 2013 Application for DIC, Death Pension, and/or Accrued Benefits as a request for substitution. The RO granted the request. 

The Appellant contends that the Veteran is entitled to service connection for leukemia, a disease also linked to the cause of death, due to contaminated water exposure during service at Camp Lejeune. The Veteran was afforded a VA opinion in June 2014. The examiner reviewed the record and opined that it was not at least as likely as not that the Veteran's leukemia was due to exposure to contaminated water at Camp Lejeune. The examiner stated that the Veteran did not serve at Camp Lejeune. The examiner cited the Agency for Toxic Substances and Disease Registry (ATSDR) study and found that it was is too early to be conclusive but Camp Lejeune veterans with leukemias were those exposed to greater total amounts of contaminated water. 

The Board finds that the VA opinion is inadequate. In the June 2014 and July 2015 rating decisions, the RO conceded exposure to contaminated water at Camp Lejeune. The Board agrees with the RO that the Veteran was exposed to contaminated water at Camp Lejeune. Additionally, the examiner failed to cite any medical literature and only discredited the ATSDR in the opinion. The Board finds that the examiner provided an inadequate rationale in his negative nexus opinion. Thus, a remand is warranted for a new VA opinion. See Barr v. Nicholson, 21 Vet. App. 303, 312 (2007).

These matters are REMANDED for the following action:

Arrange for an appropriate VA medical expert, preferably in the specialty of Camp Lejeune water contamination, to provide an opinion as to the cause of the Veteran's death. The entire claims file, including a copy of this remand, must be made available to, and be reviewed by, the medical expert. The medical expert must indicate that the claims file was reviewed in conjunction with the report. The medical expert should determine:

Whether it is at least as likely as not (50 percent or greater probability) that the Veteran's diagnosed leukemia was caused by, or etiologically related to, his active duty service, to include the conceded exposure to Camp Lejeune contaminated water. The examiner is requested to discuss Camp Lejeune contaminated water in the rationale. 

In reaching the opinion, please review and discuss the Veteran's private doctor letter from July 2013 and all of the Veteran's and Appellant's statements, including but not limited to, the June 2016 VA Form 21-4138 Statement in Support of Claim and the March 2021 hearing testimony. The examiner should reconcile any contrary medical evidence of record, specifically the VA opinion from June 2014. The examiner should also directly address any other relevant evidence in the Veteran's claim file. All opinions must be supported by a rationale.

 

 

A. C. MACKENZIE

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	D. Hetman

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.