Section A – Developing Claims Based on Exposure to Contaminants in the Water Supply at Camp Lejeune

Updated Jan 25, 2024

In This Section

This section contains the following topics:

Topic	Topic Name
1	General Information and Jurisdiction for Claims Based on Exposure to Contaminants in the Water Supply at Camp Lejeune
2	Regional Office (RO) of Jurisdiction (ROJ) Actions to Complete on Camp Lejeune Claims
3	Centralized Processing RO Actions on Exposure Claims

1. General Information and Jurisdiction for Claims Based on Exposure to Contaminants in the Water Supply at Camp Lejeune

Introduction

This topic contains contains general information and jurisdiction for claims based on exposure to contaminants in the water supply at Camp Lejeune, including

Change Date

July 24, 2023

VIII.iii.8.A.1.a. Presumption of SC Based on Exposure to Contaminated Water at Camp Lejeune

On March 14, 2017, 38 CFR 3.307(a)(7) effectuated a presumption of service connection (SC) for specific disabilities for Veterans who served no less than 30 days (consecutive or nonconsecutive) at the U.S. Marine Corps Base Camp Lejeune, North Carolina, between August 1, 1953, and December 31, 1987, based on exposure to contaminants present in the base’s water supply.

Important: This presumption also applies to former reservists and National Guard members if their military record includes orders or other records of no less than 30 days service (consecutive or nonconsecutive) at Camp Lejeune during the contamination period.

References: For more information on

service at Camp Lejeune, see 38 CFR 3.307(a)(7)(iii)
rating claims based on Camp Lejeune service, see M21-1, VIII, Subpart iii, 8.B, and
service in the Reserve or National Guard, see M21-1, Part III, Subpart i, 1.A.

VIII.iii.8.A.1.b. Definition: Camp Lejeune Issue

A Camp Lejeune issue, for the purpose of processing under the procedures listed in this section, is a claim for compensation for

one of the presumptive conditions listed at 38 CFR 3.309(f), or
any non-presumptive condition being processed under the toxic exposure risk activity (TERA) procedures, when service at Camp Lejeune during the contamination period is
- expressly claimed by the claimant, or
- otherwise established by the evidence of record.

References: For more information on

Camp Lejeune claims jurisdiction, see M21-1, VIII, Subpart iii, 8.A.1.c, and
TERA, see the PACT Act Implementation SOP.

VIII.iii.8.A.1.c. Processing Jurisdiction of Camp Lejeune Claims

All substantially complete claims for compensation containing at least one Camp Lejeune issue will be routed based on the table below.

Note: For the purposes of the table below, the regional office (RO) of jurisdiction (ROJ) is the next available RO in the National Work Queue (NWQ) environment.

If military records document during the contamination period …	Then the claim is decided by the …
at least one day of Camp Lejeune service	Louisville RO.
no Camp Lejeune service	ROJ.

Exception: The following types of claims qualify for other centralized processing and will not be processed by the ROJ or Louisville RO:

Veterans residing in foreign territories
original pre-discharge claims
restricted access claims, and
other specific special mission claims, as needed.

VIII.iii.8.A.1.d. ROJ Processing of Camp Lejeune Claims

Claims containing at least one Camp Lejeune issue will not be referred to the Louisville RO when

the Veteran did not serve at Camp Lejeune between August 1, 1953, and December 31, 1987
the Veteran does not identify a disability or symptom on the claim, such as claims simply stating “Camp Lejeune” or “exposure at Camp Lejeune”
Veteran status needs to be established, such as through a character-of-discharge (COD) determination, or when the only service at Camp Lejeune is in a training status with the Reserve or National Guard, or
the only claim is for a disability of a dependent, including birth defects. VA has no statutory authority to compensate a Veteran’s dependents exposed to Camp Lejeune water contamination. Follow the procedures in M21-1, Part VI, Subpart i, 1.A to administratively decide these claims.

Important: If a claim is clarified and found to be for a specific disability, or if Veteran status is established, such as by administrative decision, then follow the procedures in M21-1, Part VIII, Subpart iii, 8.A.2.a to ensure proper routing of the claim.

References: For more information on

action to take when the Veteran only claims exposure, see M21-1, Part VIII, Subpart iii, 8.A.2.d
clarifying claims, see M21-1, Part III, Subpart i, 2.D.1.c, and
COD decisions, see M21-1, Part X, Subpart iv, 1.

2. ROJ Actions to Complete on Camp Lejeune Claims

Introduction

This topic contains information on ROJ actions to complete on Camp Lejeune claims, including

Change Date

January 25, 2024

VIII.iii.8.A.2.a. Initial Actions to Take on Camp Lejeune Claims

The table below describes the initial actions to take upon receipt of a substantially complete claim containing at least one Camp Lejeune issue as defined in M21-1, Part VIII, Subpart iii, 8.A.1.b.

Step	Action
1	Receive the claim.
2	Establish the appropriate end product (EP), and affix the Environmental Hazard – Camp Lejeune special issue indicator to the relevant contention(s), and PACT special issue, when relevant. Reference: For more information on the PACT special issue, see the PACT Act Implementation SOP.
3	Resolve any COD issues. *Note: If service is dishonorable for Department of Veterans Affairs (VA) purposes, no further action in this table is necessary. Reference*: For more information on COD, see M21-1, Part X, Subpart iv, 1.
4	Follow the procedures in M21-1, Part VIII, Subpart iii, 8.A.2.b to verify and document service at Camp Lejeune, and for non-presumptive claims, the PACT Act Implementation SOP to verify and document any additional TERA participation.
5	Verify a diagnosis for the claimed condition, including requesting identified medical records relevant to the claim.
6	Affix the Environmental Hazard – Camp Lejeune – Louisville special issue indicator to the relevant contention(s) when the claim involves at least one day of service at Camp Lejeune during the contamination period. *Note*: The attachment of this second special issue indicator triggers assignment of the claim for centralized processing in the NWQ.

Important: The Louisville RO has jurisdiction for any legacy appeals received on Camp Lejeune claims and all other inextricably intertwined non-Camp Lejeune legacy appeals. The ROJ must affix the Environmental Hazard – Camp Lejeune – Louisville special issue indicator to the relevant contention(s) and transfer the legacy appeal EP to the Louisville RO as well as transferring the Veterans Appeals Control and Locator System (VACOLS) record to RO70.

References: For more information on

Camp Lejeune service for the purposes of presumptive SC, see
- 38 CFR 3.307(a)(7)(iii), and
- M21-1, Part VIII, Subpart iii, 8.B, and
inextricably intertwined non-Camp Lejeune legacy appeals, see M21-1, Part VIII, Subpart iii, 8.A.3.c, and
inextricably intertwined legacy appeals, see
- M21-5, Chapter 7, Section A.1.g, and
- M21-5, Chapter 7, Section E.3.c and d.

VIII.iii.8.A.2.b. ROJ’s Actions to Verify Service at Camp Lejeune

Before referring the claim for centralized processing, the ROJ must

verify the Veteran had at least one day of service at Camp Lejeune between August 1, 1953, and December 31, 1987, and
review all available service records to determine the number of days the Veteran served at Camp Lejeune during the contamination period.

Important:

When calculating the 30-day service requirement, consider the number of cumulative days a Veteran served at Camp Lejeune. The 30 days of Camp Lejeune service do not have to be consecutive.
Regardless of the disability claimed, ROJs must retain jurisdiction of all claims where there is no qualifying service at Camp Lejeune during the contamination period. This includes when the only service was active duty for training (ADT) or inactive duty for training (IADT) with the National Guard or the Reserve.
If service treatment records (STRs) document an official visit, such as for medical treatment, within the defined borders of Camp Lejeune, the days associated with the visit count as service at Camp Lejeune, even if personnel records indicate the Veteran had a different official duty station.

Example: A Veteran’s official service personnel records list his official duty station as Marine Corps Air Station Cherry Point, North Carolina, but STRs indicate he received medical treatment at Camp Lejeune on June 1, 1983. This episode of treatment counts as a day served at Camp Lejeune for the purposes of processing a claim for SC based on exposure to contaminants in the water supply at Camp Lejeune.

Follow the procedures in the table below to verify service at Camp Lejeune.

Step	Action
1	Do service records establish at least one day of service at Camp Lejeune between August 1, 1953, and December 31, 1987? If yes, go to the next step. If no, ensure the service records development procedures in M21-1, Part VIII, Subpart iii, 8.A.2.c were followed, and go to Step 4.
2	In the Veteran’s Veterans Benefits Management System (VBMS) electronic claims folder, edit the subject line of the relevant document(s) used to verify service at Camp Lejeune. *Example: Note: If the claim is being processed under TERA procedures, document both Camp Lejeune service in accordance with the guidance above, as well as TERA participation as outlined in the PACT Act Implementation SOP. Reference: For more information on editing document properties, see the VBMS Core User Guide*.
3	Calculate the cumulative number of days the Veteran served at Camp Lejeune between August 1, 1953, and December 31, 1987, and record them in a VBMS note.
4	Did the service records requested in Step 1 provide additional evidence sufficient to establish at least one day of service at Camp Lejeune between August 1, 1953, and December 31, 1987? If yes, return to Step 2. If no, undertake normal claims processing without routing the claim for centralized processing.

Reference: For more information on Camp Lejeune service, see

VIII.iii.8.A.2.c. Obtaining Records of Camp Lejeune Service

Follow the procedures in the table below to obtain records of Camp Lejeune service during the contamination period. These records may verify Camp Lejeune service through temporary duty (TDY) orders, performance evaluations, or in the case of National Guard or the Reserve, orders for ADT or IADT.

Note: It is important the ROJ

verify that the Veteran’s service at Camp Lejeune occurred during the period of water contamination, August 1, 1953, to December 31, 1987
establish the number of days of Camp Lejeune service during this time frame, and
annotate the service records that verify service at Camp Lejeune and TERA participation, when applicable.

Step

Action

1

Does VA already possess the Veteran’s service records (STRs and service personnel records)?

If yes, no additional service records development is needed.
If no, go to the next step.

2

Request service records that are not already in VA’s possession through normal channels.

When initially requesting service personnel records through

Personnel Information Exchange System (PIES), use request code O50, or
Defense Personnel Records Information Retrieval System (DPRIS), select the records identified on the OMPF REQUEST FORM as
- SC1 – DD-214/215
- SC6 – Disch/Sep/Ret
- SC8 – Orders/Endorsements
- PG2 – Commendatory Items, and
- PH5 – Chron Assignment History.

Exception: Do not submit the request if VA has previously submitted and received a response under request code O50.

3

Do service personnel records obtained through an initial request through PIES or DPRIS contain proof of the Veteran’s service at Camp Lejeune between August 1, 1953, and December 31, 1987?

If yes, service development procedures are complete.
If no, follow the instructions in the table below.

If the request used in Step 2 was …	Then …
PIES request code O50	no additional service records development is needed.
made through DPRIS	select the remainder of the records on DPRIS’s OMPF REQUEST FORM that were not selected under Step 2.

References: For more information on

requesting service records, see M21-1, Part III, Subpart ii, 2
verifying service based on service with the National Guard or the Reserve, see M21-1, Part III, Subpart i, 1.A.2.k, and
TERA participation, see the PACT Act Implementation SOP.

VIII.iii.8.A.2.d. Action to Take When the Veteran Claims Exposure to Contaminants but Does Not Claim a Disability

A claim is not substantially complete if a Veteran alleges exposure to contaminants in the Camp Lejeune water supply but does not claim SC for a specific disability. In cases such as these, the receiving RO must follow the procedures for handling an incomplete application at M21-1, Part II, Subpart iii, 1.C.2.b and c.

Important: If the receiving RO is able to obtain clarification under M21-1, Part II, Subpart iii, 1.C.2.b, follow the procedures at M21-1, Part VIII, Subpart iii, 8.A.2.a.

3. Centralized Processing RO Actions on Exposure Claims

Introduction

This topic contains information on developing claims based on exposure to contaminants in the water supply at Camp Lejeune, including

Change Date

July 24, 2023

VIII.iii.8.A.3.a. Actions Taken by Centralized Processing RO on Camp Lejeune Claims

Once a claim has been transferred for centralized processing, the centralized processing RO is responsible for all additional development, rating, authorization, and legacy appeal activity.

The table below describes the stages of claims processing handled by the centralized processing RO.

Stage	Description
1	Ensures Camp Lejeune service information is verified and accurate.
2	Requests a medical opinion, when needed.
3	Decides all claimed issues and sends notice of the decision to the claimant.
4	Retains jurisdiction for any legacy appeals received on decisions on Camp Lejeune claims, and all other inextricably intertwined non-Camp Lejeune legacy appeals.

References: For more information on

Camp Lejeune claims jurisdiction, see M21-1, Part VIII, Subpart iii, 8.A.1.c
Camp Lejeune legacy appeals jurisdiction, see M21-1, Part VIII, Subpart iii, 8.A.2.a, and
inextricably intertwined Camp Lejeune legacy appeals, see M21-1, Part VIII, Subpart iii, 8.A.3.c.

VIII.iii.8.A.3.b. Determining the Need for Medical Opinions

Camp Lejeune issues, as defined in M21-1, Part VIII, Subpart iii, 8.A.1.a, may require direct SC medical opinions when the claim does not qualify for presumptive SC.

Historically, VA obtained these opinions through a subject matter expert (SME) review process. As of August 10, 2022, non-presumptive disability claims involving exposure to contaminants in the Camp Lejeune water supply are processed under the Promise to Address Comprehensive Toxics (PACT) Act TERA procedures. Use the table below to determine which medical opinion procedures to apply to a claim.

Exception: Direct SC based on exposure to contaminants does not apply if the only service at Camp Lejeune was with the National Guard or the Reserve while on ADT or IADT. If the only service at Camp Lejeune was with a National Guard or Reserve unit while on ADT or IADT, do not request a medical opinion.

If …	Then …
the claim was filed prior to August 10, 2022, or the Veteran passed away prior to August 10, 2022	consider whether the claim met requirements for medical SME review under historical M21-1, Part VIII, Subpart iii, 8.A procedures.
the claim was filed on or after August 10, 2022	follow the TERA procedures outlined in the PACT Act Implementation SOP.

References: For more information on

considering Camp Lejeune claims from former National Guard or Reserve members, see M21-1, Part VIII, Subpart iii, 8.B.1.f, and
historical guidance on Camp Lejeune SME review, see the attachment, Historical_M21-1VIII_iii_8_SecA_7-29-21.docx.

VIII.iii.8.A.3.c. Inextricably Intertwined Non-Camp Lejeune Legacy Appeals

For non-Camp Lejeune legacy appeals that are inextricably intertwined with a Camp Lejeune legacy appeal, the ROJ will take the actions indicated in M21-1, Part VIII, Subpart iii, 8.A.2.a.

Upon receipt of a non-Camp Lejeune claim or legacy appeal, the Louisville RO will review to determine whether the non-Camp Lejeune legacy appeal or claim is inextricably intertwined with the Camp Lejeune legacy appeal. If not inextricably intertwined, the Louisville RO will

annotate the decision in VACOLS and VBMS
remove any special issue indicators, and
return the legacy appeal to the originating ROJ.

References: For more information on

inextricably intertwined legacy appeals, see
- M21-5, Chapter 7, Section A.1.g, and
- M21-5, Chapter 7, Section E.3.c and d
VACOLS, see the VACOLS User Guide, and
transferring EPs, see the VBMS Core User Guide.

38 CFR Part 3 (Click to Open)

38 CFR Part 4 (Click to Open)

VA Disability Codes [Click to Expand]

M21-1 Table of Contents

M21-5 Table of Contents

In This Section

1. General Information and Jurisdiction for Claims Based on Exposure to Contaminants in the Water Supply at Camp Lejeune

Introduction

Change Date

VIII.iii.8.A.1.a. Presumption of SC Based on Exposure to Contaminated Water at Camp Lejeune

VIII.iii.8.A.1.b. Definition: Camp Lejeune Issue

VIII.iii.8.A.1.c. Processing Jurisdiction of Camp Lejeune Claims

VIII.iii.8.A.1.d. ROJ Processing of Camp Lejeune Claims

2. ROJ Actions to Complete on Camp Lejeune Claims

Introduction

Change Date

VIII.iii.8.A.2.a. Initial Actions to Take on Camp Lejeune Claims

VIII.iii.8.A.2.b. ROJ’s Actions to Verify Service at Camp Lejeune

VIII.iii.8.A.2.c. Obtaining Records of Camp Lejeune Service

VIII.iii.8.A.2.d. Action to Take When the Veteran Claims Exposure to Contaminants but Does Not Claim a Disability

3. Centralized Processing RO Actions on Exposure Claims

Introduction

Change Date

VIII.iii.8.A.3.a. Actions Taken by Centralized Processing RO on Camp Lejeune Claims

VIII.iii.8.A.3.b. Determining the Need for Medical Opinions

VIII.iii.8.A.3.c. Inextricably Intertwined Non-Camp Lejeune Legacy Appeals

Related M21 References

M21-1 Table of Contents

M21-5 Table of Contents