The claim of entitlement to service connection for gastroesophageal reflux disease (GERD), to include nausea and dizzy spells, claimed as due to exposure to contaminated water at Camp Lejeune, is remanded.

Citation Nr: 26001425 Decision Date: 01/30/26 Archive Date: 01/30/26 DOCKET NO. 14-35 420A DATE: January 30, 2026 REMANDED The claim of entitlement to service connection for gastroesophageal reflux disease (GERD), to include nausea and dizzy spells, claimed as due to exposure to contaminated water at Camp Lejeune, is remanded. The claim of entitlement to service connection for a foot skin disorder, claimed as jungle rot of the bilateral feet, is remanded. The claim of entitlement to service connection for a respiratory disorder, claimed as emphysema, is remanded. The claim of entitlement to service connection for a respiratory disorder, claimed as asthma, is remanded. REASONS FOR REMAND The Veteran had active service in the United States Marine Corps from July 1977 to December 1978. These matters come before the Board of Veterans' Appeals (Board) on appeal from a June 2011 rating decision of the Department of Veterans Affairs (VA) Regional Office, which is the Agency of Original Jurisdiction (AOJ). As determined by the Board in its April 2022 remand, the Veteran's prior request for a hearing before the Board has been deemed withdrawn. 38 C.F.R. § 20.603(d). The Board observes that, since the issuance of the most recent supplemental statement of the case (SSOC) in July 2024, additional evidence consisting of relevant VA treatment records has been associated with the claims file and the Veteran has not waived AOJ consideration of such evidence. 38 C.F.R. § 20.1305(c). However, as the claims are being remanded, the AOJ will have an opportunity to review the newly received evidence so that no prejudice will result to the Veteran in the Board considering the evidence for the limited purpose of issuing a comprehensive and thorough remand. 1. The claim of entitlement to service connection for GERD, to include nausea and dizzy spells, claimed as due to exposure to contaminated water at Camp Lejeune, is remanded. See section four below. 2. The claim of entitlement to service connection for a foot skin disorder, claimed as jungle rot of the bilateral feet, is remanded. See section four below. 3. The claim of entitlement to service connection for a respiratory disorder, claimed as emphysema, is remanded. See section four below. 4. The claim of entitlement to service connection for a respiratory disorder, claimed as asthma, is remanded. The Veteran seeks service connection for the above conditions. Although regrettable, additional remand is required to ensure that VA has met its duty to assist the Veteran in developing his claims and to obtain substantial compliance with the Board's previous remand instructions. See Stegall v. West, 11 Vet. App. 268, 270-71 (1998); 38 C.F.R. § 3.159(c). First, the Board finds that the AOJ has not fulfilled its duty to assist the Veteran in obtaining potentially relevant records in the custody of a federal department or agency. 38 C.F.R. § 3.159(c)(2). Specifically, the Veteran's claim application indicated that he spent time in a federal penitentiary, and he signed an authorization for VA to obtain medical records from his period of incarceration. See April 2009 VA 21-526 Veterans Application for Compensation; April 2009 VA 21-4142 Authorization for Release of Information. According to lay evidence of record, the Veteran was incarcerated for over 30 years after his service. See June 2016 VA medical treatment records (recovery treatment plan note). In the case of federal records, VA's duty to assist requires it to make as many requests as necessary to secure relevant federal records. See 38 U.S.C. § 5103A(c)(2); 38 C.F.R. § 3.159(c)(2). Initial development by the AOJ prior to the issuance of the June 2011 rating decision shows that the AOJ made approximately two requests for records from the federal prison where the Veteran reported he had been incarcerated but did not clearly conclude that the records did not exist or that further efforts to obtain them would be futile. 38 C.F.R. § 3.159(e)(1). Therefore, remand is necessary to allow the AOJ to make additional attempts to obtain the outstanding federal prison medical records that may be relevant to the issues on appeal. Second, regarding Stegall compliance, the Board acknowledges that development of this appeal has been significantly complicated by the Veteran's chronic lack of stable housing and contact information. In his February 2011 VA 21-526b Supplemental Claim application, the Veteran reported that he resided in shelters. The Veteran's recent VA treatment records continue to indicate that the Veteran is typically without stable address for months at a time. See, e.g., July 2022 Mental Health Telephone Encounter (Veteran's next of kin, W.S., reporting that it can be up to eight months in between contact with the Veteran); August 2024 Post Discharge Contact Note (contact with W.S., reporting she had not seen the Veteran in three months and had no contact number for him). The evidence currently of record shows that the AOJ has regularly attempted to locate current or viable addresses for the Veteran without success, as mail is routinely returned as undeliverable and attempts to contact the Veteran on telephone numbers associated with his file are unsuccessful. Despite efforts by the AOJ, the Veteran has not attended a VA medical examination for the claims on appeal and he has not kept VA apprised of his whereabouts for VA to reschedule missed examinations. The Board thus finds that the AOJ substantially complied with its April 2022 directive to attempt to locate the Veteran's current mailing address and that the AOJ notified the Veteran's representative of its inability to contact the Veteran. See, e.g., August 2022 VA 27-0820 Report of General Information. Nevertheless, the Board finds remand unavoidable in this case because the AOJ did not comply with the Board's directive that even "if the Veteran fails to report for the scheduled examinations, medical opinions should still be obtained." The AOJ obtained a medical nexus opinion only as to the GERD condition, an opinion that was made without access to potentially relevant federal prison medical records (as discussed above). As for the remaining claimed conditions, review of the Veteran's service treatment records (STRs) shows that he complained of asthma, shortness of breath, and foot trouble (described as athlete's foot) at separation from service. See December 1978 Report of Medical History. Accordingly, the Board finds remand required to obtain medical opinions as to whether the Veteran's in-service complaints can be linked to current conditions of the feet and/or respiratory system. Additionally, the Board observes that the Veteran provided a new address to VA in July 2025, when he filed a VA 21-0966 Intent to File. Where mail sent to a Veteran is undeliverable and a Veteran's claims file discloses other "possible and plausible addresses, VA must attempt to locate the veteran at the alternative known addresses." Davis v. Principi, 17 Vet. App. 29 (2003). Because the Board is remanding these matters, the Board finds that the AOJ should make an additional attempt to contact and schedule the Veteran for in-person examinations. If the Veteran again fails to attend without good cause and/or fails to keep the AOJ apprised of his whereabouts, the AOJ should continue to obtain medical nexus opinions based on the evidence of record and evidence obtained on remand. The Board again emphasizes to the Veteran that while VA has a duty to assist him in obtaining information, the Veteran has a duty on his part to cooperate with VA in developing his claims. See Wood v. Derwinski, 1 Vet. App. 190, 193 (1991) (noting that "[t]he duty to assist is not always a one-way street"). Normally, it is the Veteran's burden to inform VA of his whereabouts and "if he does not do so, there is no burden on the part of the VA to turn up heaven and earth to find him." Hyson v. Brown, 5 Vet. App. 262, 265 (1993). The Veteran is hereby notified that failure to keep VA apprised of his whereabouts and to comply with VA's efforts to develop his claims may result in the denial of benefits. Lastly, the Board acknowledges that in its April 2022 remand, it directed that a clinician opine whether the Veteran's claimed respiratory conditions were due to service, "to include [the Veteran's] claimed in-service exposure to asbestos." However, in the Veteran's April 2009 VA 21-526 Application for Compensation, he expressly stated that his exposure to asbestos occurred post-service at a "Community Correctional Facility" in Indiana between 1989 and 1996. In April 2024, the AOJ obtained a Toxic Exposure Risk Activity (TERA) Memorandum, that conceded only the Veteran's TERA Participation based on Camp Lejeune Water Contamination and did not identify or concede asbestos exposure. The Board has revised its remand directives accordingly. The matters are REMANDED for the following action: 1. Obtain the Veteran's federal medical records from the Bureau of Prisons (BOP). See April 2009 VA 21-526 Veterans Application for Compensation; April 2009 VA 21-4142 Authorization for Release of Information (identifying United States Penitentiary Coleman II). The AOJ should document all requests for information as well as all responses in the claims file. If the records cannot be located or no such records exist, the Veteran and his representative should be so notified pursuant to 38 C.F.R. § 3.159(e). 2. Obtain updated VA medical treatment records. 3. Make additional attempts to verify the Veteran's current mailing address and other contact information, and update VA contact systems if an accurate address is located. See July 2025 Intent to File (new address provided by Veteran). The AOJ is encouraged to review VA medical records to obtain contact information for the Veteran's aunt, W.S., to determine if she knows how to reach the Veteran. See August 2024 VA Post Discharge Contact Note. 4. Ensure that, on an ongoing basis, the Veteran's current representative is provided with copies of written correspondence mailed to the Veteran and copies of any relevant VA 27-0820 Reports of General Information regarding outreach to the Veteran. 5. Ask the Veteran to complete a VA Form 21-4142 for state prison medical records from the Community Correctional Facility in Westville, Indiana, (via the Indiana Department of Administration) as identified on his April 2009 VA 21-526 (page 2, listing incarceration dates between 1989 and 1996). Make two requests for the authorized records unless it is clear after the first request that a second request would be futile. 6. Attempt to schedule the Veteran for VA examinations with appropriate clinicians regarding his claims for service connection for respiratory disorders, a foot skin disorder, and GERD (claimed to include nausea and dizziness). The opining clinicians must be provided access to all relevant evidence of record, including all relevant medical records from the BOP, all VA treatment records, and any past VA medical opinions. 7. If the examination scheduling requests are cancelled or attempts to contact the Veteran are unsuccessful, a report of contact or report of general information explaining the failed attempt(s) to schedule an examination or contact the Veteran, or his authorized representative, should be placed in the Veteran's electronic file. 8. EVEN IF THE VETERAN DOES NOT ATTEND AN IN-PERSON EXAMINATION, THE AOJ MUST OBTAIN MEDICAL NEXUS OPINIONS FOR EACH OF THE CLAIMED CONDITIONS, TO INCLUDE AS DUE TO EXPOSURE TO CAMP LEJEUNE CONTAMINATED WATER. Specifically: (a.) Regarding GERD (claimed to include nausea and dizziness): the opining clinician should review any additional medical records or lay evidence obtained on remand and provide an addendum to the September 2022 opinion. The addendum should address whether there is any revision needed to the September 2022 opinion. In other words, the clinician is encouraged to address whether there are additional diagnoses related to the Veteran's claim of GERD, and whether the additional evidence supports a change in the nexus opinion provided in September 2022. See, e.g., July 2024 VA hospital follow up note (regarding differential diagnoses after report of chest pain). (b.) Regarding respiratory conditions, including claimed as asthma and emphysema: the opining clinician should identify all current respiratory disorders ("current" meaning present at any point pertinent to the Veteran's February 2011 claim, even if currently asymptomatic or since resolved). The clinician should opine whether it is at least as likely as not that any currently diagnosed condition is related to the Veteran's service, to include his exposure to contaminated water at Camp Lejeune. The clinician is encouraged to consider and address STRs relating to breathing trouble and his December 1978 Report of Medical History at separation (showing complaint of asthma and shortness of breath). (c.) Regarding bilateral foot skin conditions, claimed as jungle rot: the opining clinician should identify all current skin disorders of the feet ("current" meaning present at any point pertinent to the Veteran's February 2011 claim, even if currently asymptomatic or since resolved). The clinician should opine whether it is at least as likely as not that any foot skin disorder, to include jungle rot, had its onset in, or is otherwise related, to the Veteran's military service, to include as due to his conceded exposure to contaminated water at Camp Lejeune. The clinician is encouraged to consider and address the Veteran's April 2009 lay statement (describing issues with his service socks and "jungle rot"), the July 1977 STR (regarding treatment for blisters), and December 1978 Report of Medical History at separation (reporting foot trouble and athlete's foot). (Continued on the next page) ? A complete rationale must be given for all requested opinions. (d.) Following completion of the above, the AOJ should review the record, ensure adequacy of the examination opinions and development, and readjudicate the claims on appeal. If any claim remains denied, the AOJ should issue an appropriate SSOC, afford the Veteran and their representative an opportunity to respond, and return the case to the Board. B. MULLINS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. Hart, 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.