Citation Nr: A25035103 Decision Date: 04/16/25 Archive Date: 04/16/25 DOCKET NO. 240821-466531 DATE: April 16, 2025 ORDER Entitlement to service connection for eczema (originally claimed as bilateral foot calluses), to include as due to contaminated water exposure at Camp Lejeune, is granted. FINDING OF FACT Resolving any reasonable doubt in the Veteran's favor, his eczema is related to his active service, to include contaminated water at Camp Lejeune. CONCLUSION OF LAW The criteria for entitlement to service connection for eczema, to include as due to contaminated water exposure at Camp Lejeune, have been met. 38 U.S.C. §§ 1131; 38 C.F.R. §§ 3.102, 3.159, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Marine Corps from June 1975 to June 1978 and from September 1978 to September 1989. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a July 2024 higher-level review rating decision issued by a Department of Veterans Affairs (VA) regional office, the agency of original jurisdiction (AOJ). In April 2024, the Veteran submitted a VA Form 20-0996, Decision Review Request: Higher-Level Review, and requested review of a January 2024 rating decision. In July 2024, the AOJ issued the higher-level decision, which considered the evidence of record at the time of the January 2024 decision. In the August 2024 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket. Therefore, the Board may only consider the evidence of record at the time of the January 2024 AOJ decision, which was subsequently subject to higher-level review. 38 C.F.R. § 20.301. If evidence was submitted during the period after the AOJ issued the decision, which was subsequently subject to higher-level review the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.301, 20.801. If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. The Board notes that under 38 C.F.R. § 20.202(c)(2) the Veteran has one year from the date the AOJ mailed notice of the decision on appeal, or 60 days from the date that the Board receives the Notice of Disagreement, whichever is later, to change dockets, and the "Board ordinarily may not decide an appeal before this time period is up." See Williams v. McDonough, 37 Vet. App. 305 (2024). There still remains time in which the Veteran could change Board dockets. In this case, the Board is granting the appealed matter in full. Accordingly, the Veteran's due process rights are not adversely affected by not waiting until July 26, 2025, the end of the period in which to request a docket change. The Board also notes that the AOJ adjudicated the Veteran's claim as entitlement to service connection for bilateral foot calluses. The Board has expanded the scope of the claim to encompass any skin diagnosis raised by the record. See Clemons v. Shinseki, 23 Vet. App. 1, 5 (2009) (holding that the scope of claim includes any disability that may reasonably be encompassed by the claimant's description of the claim, reported symptoms, and the other information of record). Specifically, the Board has expanded the scope of the Veteran's claim to include entitlement to service connection for eczema. Entitlement to service connection for eczema, to include as due to contaminated water exposure at Camp Lejeune, is granted. The Veteran is seeking service connection for a skin condition. Based on the evidence of record and for the reasons set forth below, the Board finds that entitlement to service connection for eczema is warranted. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active military, naval, or air service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303(a). Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). As a general matter, service connection for a disability requires evidence of: (1) the existence of a current disability; (2) the existence of the disease or injury in service, and; (3) a relationship or nexus between the current disability and any injury or disease during service. Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004). Under 38 C.F.R. § 3.307(a)(7)(iii), 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. If a veteran, or former reservist or member of the National Guard, was exposed to contaminants in the water supply at Camp Lejeune during military service and the exposure meets the requirements of § 3.307(a)(7), certain diseases shall be service-connected even though there is no record of such disease during service, subject to the rebuttable presumption provisions of § 3.307(d). These diseases include kidney cancer, liver cancer, non-Hodgkin's lymphoma, adult leukemia, multiple myeloma, Parkinson's disease, aplastic anemia and other myelodysplastic syndromes, and bladder cancer. In this case, the Veteran's diagnosed skin condition is not recognized as a presumptive disease due to exposure to water contaminants at Camp Lejeune. The absence of a disease from the presumptive list does not preclude a claimant from otherwise proving that his disability resulted from exposure to contaminated water at Camp Lejeune. Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994). Accordingly, the Board must still consider whether entitlement to service connection can be granted on a direct basis for any claimed disability. In the July 2024 higher-level review decision, the AOJ determined that the Veteran has a current diagnosis of eczema. The Board is bound by this favorable finding which is consistent with the medical evidence of record. See 38 U.S.C. § 5104A; 38 C.F.R. § 3.104(c). Thus, the first element of service connection, a current disability, has been satisfied. As to the second element of service connection, an in-service incurrence, the Veteran's military personnel records reflect service at Camp Lejeune from September 1978 to July 1980, June 1985 to October 1985, and April 1987 to December 1987. See Military Personnel Record, Chronological Record. Additionally, a June 2023 VA Toxic Exposure Risk Activity (TERA) Memorandum conceded the Veteran's exposure to contaminated water at Camp Lejeune. See VA TERA Memorandum, June 2023. Therefore, the second element of service connection has also been satisfied. The remaining determination for the Board is whether a medical nexus (i.e., link) exists between the Veteran's current eczema and his service, to include exposure to contaminated water at Camp Lejeune. The Veteran underwent a VA skin diseases examination in January 2024. The VA examiner noted a 1984 diagnosis of eczema and indicated that the skin condition was active as of January 2024. See Skin Diseases Disability Benefits Questionnaire (DBQ), January 2024. The VA examiner provided a positive nexus opinion, determining that the Veteran's eczema was at least as likely as not incurred in or caused by an in-service injury, event, or illness. As rationale, the VA examiner stated that the Veteran was at Camp Lejeune during service and was exposed to toxic matter; the Veteran had no issues related to eczema prior to military service; the current diagnosis of eczema is related to the Veteran exposure to toxic matter at Camp Lejeune; there is evidence of chronicity; and a nexus has been established. See Medical Opinion DBQ, January 2024. The VA examiner provided an addendum opinion in January 2024, indicating that the Veteran's claimed bilateral foot callouses were less likely than not incurred in or caused by an in-service injury, event, or illness. The VA examiner explained that the Veteran had asymptomatic callouses on his feet in 1975; the Veteran did not have a diagnosis of bilateral feet callouses based on the objective findings of the January 2024 VA examination; the diagnosis rendered is eczema, a common inflammatory skin disorder; and therefore, the claimed bilateral foot calluses is less likely than not incurred in or caused by the bilateral foot calluses during service. See Exam Addendum, January 2024. The Board finds the VA examiner's positive nexus opinion related to eczema to have probative value. Although somewhat conclusory, the VA examiner reviewed available records, conducted an in-person examination of the Veteran, addressed the Veteran's relevant medical history, considered the Veteran's lay statements, and determined that it is at least as likely as not that the Veteran diagnosed eczema was medically linked to his conceded exposure to Camp Lejeune water contaminants. The Board notes that the VA examiner provided a negative nexus opinion regarding the Veteran's claimed bilateral foot calluses, however, there is no contradictory medical opinion of record regarding the Veteran's diagnosed eczema. Moreover, there is no sufficient basis for the Board to reject the positive nexus opinion and to further develop the claim. Cf. Mariano v. Principi, 17 Vet. App. 305, 312 (2003) (holding that, because it is not permissible for VA to undertake additional development to obtain evidence against an appellant's case, VA must provide an adequate statement of reasons or bases for its decision to pursue such development where such development could be reasonably construed as obtaining additional evidence for that purpose). After review of the evidence, the Board resolves any reasonable doubt in the Veteran's favor and finds that the third element of service connection, a nexus, has been satisfied. Thus, the Board finds that the Veteran's eczema is related to his active service, to include as due to contaminated water at Camp Lejeune. Accordingly, entitlement to service connection for eczema is granted. 38 U.S.C. § 5107(b); Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021). B. D. WATSON Veterans Law Judge Board of Veterans' Appeals Attorney for the Board P. S. Rubin, 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.