Revised July 24, 2023
VIII.iii.8.B.1.aPresumptive SC Based on Exposure to Contaminated Water Supply on the Marine Corps Base at Camp Lejeune, North Carolina
On March 14, 2017, 38 CFR 3.307(a)(7) effectuated a presumption of service connection (SC) for specific disabilities based on exposure to contaminants present in the U.S. Marine Corps Base Camp Lejeune, North Carolina, water supply. In order to qualify for presumptive SC under these provisions, there must be evidence of
- a diagnosis of a condition listed in 38 CFR 3.309(f), if manifest to a degree of 10 percent or more at any time after service, and
- service of at least 30 days (consecutive or nonconsecutive) at Camp Lejeune during the period beginning on August 1, 1953, and ending on December 31, 1987.
Important: Follow the guidelines in M21-1, Part VIII, Subpart iii, 8.A.1.c regarding processing jurisdiction of claims based on contaminated drinking water at Camp Lejeune. Note: Consider SC on a direct basis under the toxic exposure risk activity (TERA) procedures for any other disease not listed in 38 CFR 3.309(f) if there is
- evidence of a current disease or disability
- evidence of exposure to the contaminated water at Camp Lejeune while on active duty, and
- a medical nexus between the two, supported by a sufficient scientific explanation.
Exception: Direct SC based on exposure to contaminants does not apply if the only service at Camp Lejeune was with a National Guard or Reserve unit while on active duty for training (ADT) or inactive duty for training. References: For more information on
- direct SC, see
- TERA procedures, see the PACT Act Implementation SOP
- establishing Veteran status based on a period of training, see M21-1, Part III, Subpart i, 1.A.2, and
- developing Camp Lejeune claims, see M21-1, Part VIII, Subpart iii, 8.A.
VIII.iii.8.B.1.bService at Camp Lejeune
Under 38 CFR 3.307(a)(7)(iii), service at Camp Lejeune is service of no less than 30 days (consecutive or nonconsecutive) within the borders of the entirety of the United States Marine Corps Base Camp Lejeune and Marine Corps Air Station New River (MCAS), North Carolina, during the period beginning on August 1, 1953, and ending on December 31, 1987. Important: Qualifying service must be established by military orders or other official service department records. Note: The borders of the Camp Lejeune base include, but are not limited to, all of the following areas which may be claimed or reflected in military records:
- MCAS New River
- Camp Geiger
- Camp Johnson
- Naval Hospital Camp Lejeune
- Tarawa Terrace
- Camp Knox
- Montford Point
- Stone Bay/Rifle Range
- Holcomb Boulevard, and
- Hadnot Point.
Exception: Camp Lejeune service does not include service at MCAS Cherry Point. Reference: For more information on obtaining records of Camp Lejeune service, see M21-1, Part VIII, Subpart iii, 8.A.2.c.
VIII.iii.8.B.1.cPresumptive Disabilities Associated With Exposure to Contaminants in the Camp Lejeune Water Supply
Under 38 CFR 3.309(f), the Department of Veterans Affairs (VA) acknowledges the following disabilities to have a relationship with exposure to contaminants in the Camp Lejeune water supply during the period beginning on August 1, 1953, and ending on December 31, 1987:
- kidney cancer
- liver cancer
- Non-Hodgkin’s lymphoma (NHL)
- adult leukemia
- multiple myeloma
- Parkinson’s disease
- aplastic anemia and other myelodysplastic syndromes, and
- bladder cancer.
Note: A presumption of SC based on exposure to contaminants in the water supply at Camp Lejeune is not warranted for any other condition, but may be established on a direct basis, if warranted by the facts of the case. Follow TERA procedures for all non-presumptive claims involving at least one day of qualifying Camp Lejeune service. References: For more information on
- qualifying Camp Lejeune service, see M21-1, Part VIII, Subpart iii, 8.A.2.b, and
- actions required for a non-presumptive disability, see
- M21-1, Part VIII, Subpart iii, 8.A.2
- M21-1, Part VIII, Subpart iii, 8.B.1.e, and
- the PACT Act Implementation SOP.
VIII.iii.8.B.1.dCamp Lejeune Effective Date Considerations
The presumption established in 38 CFR 3.307(a)(7) became effective on March 14, 2017. Decision makers must evaluate the facts of each claim to determine the most advantageous effective date allowed. Important: If awarding a claim
- based on exposure to contaminants in the Camp Lejeune water supply on a direct basis under 38 CFR 3.303, apply the
- regular effective date provisions of 38 CFR 3.400, or
- liberalizing effective date rules based on the Promise to Address Comprehensive Toxics (PACT) Act, or
- presumptively under 38 CFR 3.307(a)(7), consider the provisions of 38 CFR 3.114(a).
References: For more information on effective date assignment in claims involving
- direct SC, see M21-1, Part V, Subpart ii, 4.A.3, and
- a liberalizing law or VA issue, see
VIII.iii.8.B.1.eConsidering Claims for Disabilities Not Recognized Under 38 CFR 3.309(f)
As discussed in M21-1, Part VIII, Subpart iii, 8.A.3.b, the centralized processing RO will refer some claims for disabilities not recognized under 38 CFR 3.309(f) for a medical opinion. Decision makers must weigh the specific facts of these claims and determine if direct SC is warranted and assign an appropriate effective date. References: For more information on
- direct SC, see
- Camp Lejeune effective date considerations, see M21-1, Part VIII, Subpart iii, 8.B.1.d
- considering pre-regulation Camp Lejeune subject matter expert review opinions, see the attachment, Historical_M21-1VIII_iii_8_SecB_7-29-21.docx , and
- considering claims for former National Guard or Reserve members, see M21-1, Part VIII, Subpart iii, 8.B.1.f.
VIII.iii.8.B.1.fConsidering Camp Lejeune Claims From Former National Guard or Reserve Members
Under 38 CFR 3.307(a)(7), former reservists and National Guard members are presumed to have been exposed to contaminants in the Camp Lejeune water supply, if their military personnel record includes orders or other records of no less than 30 days service (consecutive or nonconsecutive) at Camp Lejeune between August 1, 1953, and December 31, 1987. This presumption applies even if the only qualifying service at Camp Lejeune occurred during a period of training. Once presumption of exposure is established, it provides Veteran status to former National Guard or Reserve members by presuming that a covered disability was incurred in the line of duty and arose during the qualifying period of service. Important: If the claimant’s service at Camp Lejeune does not meet the requirements under 38 CFR 3.307(a)(7)(iii), there is no presumption of exposure; therefore, Veteran status is not conferred. Example 1: A former National Guard member files a claim for SC for Parkinson’s disease. His military records establish he was assigned to Camp Lejeune for ADT from June 20, 1977, to July 31, 1977. Result: The RO awards SC under 38 CFR 3.307(a)(7) and awards Veteran status for the period of qualifying service at Camp Lejeune. Example 2: A former National Guard member files a claim for SC for Parkinson’s disease. His military records establish he was assigned to Camp Lejeune for ADT from June 20, 1977, to June 28, 1977. No other Camp Lejeune service is shown. Result: The RO denies the claim as the requirements of presumptive SC are not established. The claimant does not have qualifying service, and therefore, Veteran status is not established. Reference: For more information on establishing Veteran status based on a period of training, see M21-1, Part III, Subpart i, 1.A.2.
VIII.iii.8.B.1.gRating Requirements for Camp Lejeune Claims
In order to properly identify and track disabilities for which SC is awarded or denied under 38 CFR 3.307(a)(7), ROs must properly code the disabilities in the Veterans Benefits Management System - Rating (VBMS-R). When awarding or denying a claim due to exposure to contaminants in the Camp Lejeune water supply users must
- select the appropriate reason(s) for awarding or denying the claim in the DECISION BASIS drop-down menu
- affix the Environmental Hazard-Camp Lejeune special issue in VBMS-R, and
- follow the PACT Act Implementation SOP requirements if deciding the claim under TERA procedures.
Notes:
- More than one denial reason may apply to a claim. Decision makers must ensure that all reasons for deciding the claim are included in the rating decision document and notice to the claimant.
- When needed to explain the full basis of the decision, decision makers should add free text to supplement any system-generated language.
References: For more information on
- assigning a special issue in VBMS-R, see the VBMS Rating User Guide
- rating decision narrative requirements, see M21-1, Part V, Subpart iv, 1.A, and
- decision notice requirements, see
End of Part VIII, Subpart iii, Chapter 8, Section B