Citation Nr: 25005280 Decision Date: 04/17/25 Archive Date: 04/17/25 DOCKET NO. 18-13 370 DATE: April 17, 2025 REMANDED Entitlement to service connection for a brain tumor with memory loss, to include as due to exposure to contaminated water at Camp LeJeune, is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1969 to June 1971. The Board thanks the Veteran for his service. This matter comes to the Board of Veterans' Appeals (Board) on appeal from a rating decision issued in March 2015 by a Department of Veterans Affairs (VA) Regional Office (RO). The claims currently before the Board were most recently remanded in a November 2024 decision for further development. The claims now return to the Board. 1. Entitlement to service connection for a brain tumor with memory loss, to include as due to exposure to contaminated water at Camp LeJeune, is remanded. After review, the Board concludes that further development is required. The Board apologizes for further delay in adjudication. The Veteran has consistently argued that his brain tumor is the result of exposure to toxins while in service. He also argues that his brain tumor was the result of a head injury while in service. The Veteran was provided a new medical opinion for his tumor in January 2025 that specifically addressed his contention that his tumor was due to a head injury during service. However, the Veteran's other claim, that his tumor is due to Camp Lejeune water exposure, still needs development. On August 10, 2022, the President of the United States signed into law the Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 (PACT Act). 38 U.S.C. § 1168 requires a medical nexus opinion and examination for claimed disabilities with a possible nexus to toxic exposure risk activities (TERA). A review of the claims file indicates that the Veteran participated in a TERA: his exposure to Camp Lejeune water. The June 2024 VA memorandum did not find participation in any other TERAs. The Board notes that the Veteran has not received a TERA examination, despite qualifying service. Thus, a remand is necessary to ensure that due process is followed and that there is a complete record upon which to decide the Veteran's claim so that he is afforded every possible consideration for his brain tumor claim. 38 U.S.C. § 5103A; 38 C.F.R. § 3.159. The Board notes that while the Veteran has already received an opinion with regards to whether the Veteran's Camp Lejeune water exposure is related to his brain tumor. However, the PACT Act mandates that if the Veteran participated in a TERA, then a TERA opinion must be provided. As such, the Board is requesting the additional opinion. The matters are REMANDED for the following action: 1. Return the claims file to a VA examiner of appropriate expertise in order to determine the etiology of the Veteran's brain tumor, specifically with regards to TERA exposure. The VA examiner must answer whether it is at least as likely as not (i.e. the likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's disorders are related to or otherwise caused by a TERA. In providing this opinion, the VA examiner is requested to determine and consider the total potential exposure through all applicable military deployments and service, as well as the synergistic and combined effect of all TERA. A complete rationale for any opinion expressed should be provided in a report. Melanie J. Mann Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Jonah Nelson 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.