Citation Nr: 0812120 Decision Date: 04/11/08 Archive Date: 04/23/08 DOCKET NO. 06-12 784 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Waco, Texas THE ISSUE Entitlement to service connection for obstructive sleep apnea. ATTORNEY FOR THE BOARD S. B. Mays, Counsel INTRODUCTION The veteran served on active duty from July 1988 to July 1992. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a November 2005 rating decision of the Waco, Texas Regional Office (RO) of the Department of Veterans Affairs (VA), which denied the benefit sought on appeal. The appeal is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. VA will notify the appellant if further action is required. REMAND The veteran asserts that he is entitled to service connection for obstructive sleep apnea. According to his notice of disagreement received in December 2005, he suggests that his sleep apnea is due to in-service smoke exposure. According to a service medical record dated in April 1991, it was noted that while on Operation Desert Storm, the veteran was exposed to a large amount of smoke in the Burgan Oil Fields from February 24, 1991 to February 28, 1991. The examiner noted that those oil fields are known to be high in sulfur-containing (sour) oil wells. Separation examination report dated in April 1992 shows no diagnosis of sleep apnea. Given the current diagnosis of obstructive sleep apnea, and the in-service exposure to smoke/sulfur, the Board finds that a VA examination is necessary to ascertain the etiology of pertinent disability. Review of the claims folder shows that the veteran was scheduled for a respiratory examination and a Gulf War examination in August 2005, however, those examinations were cancelled. An internal note shows that the veteran was contacted regarding the missed examinations, and he indicated that he had already been examined and felt that the examinations were duplicative. Nevertheless, while the examiner diagnosed the veteran with severe obstructive sleep apnea on March 2005 VA examination, the Board notes that during the examination, the veteran did not express his specific contention regarding in-service smoke exposure, therefore an opinion was not provided. Accordingly, the case is REMANDED for the following action: 1. The veteran's claims folder should be transferred to the VA examiner who conducted the March 2005 general medical examination. The VA examiner is specifically requested to prepare an addendum in which he addresses the etiology of the veteran's obstructive sleep apnea. Specifically, the examiner must review the entire record and render an opinion as to whether there is a 50 percent probability or greater that the veteran's obstructive sleep apnea is related to his in-service exposure to smoke containing high levels of sulfur at the Burgan Oil Fields, or any other incident of service. Any findings should be reconciled with the April 1991 service medical record, the April 1992 separation examination report, and a March 2005 polysomnography report from the William Beaumont Sleep Disorders Center. If the March 2005 examiner is no longer available, or if this examiner determines that another examination would be helpful, the veteran should be scheduled for a new C&P examination. 2. Upon completion of the above requested development, the RO should readjudicate the veteran's service connection claim for obstructive sleep apnea, taking into account any newly obtained VA examination report, and etiology opinion. All applicable laws and regulations should be considered. If the benefit sought on appeal remains denied, the veteran should be provided with a supplemental statement of the case and given the opportunity to respond thereto. Thereafter, the case is returned to the Board. The Board intimates no opinion as to the ultimate outcome of this case. The appellant has the right to submit additional evidence and argument on the matter or matters the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). This claim must be afforded expeditious treatment. The law requires that all claims that are remanded by the Board of Veterans' Appeals or by the United States Court of Appeals for Veterans Claims for additional development or other appropriate action must be handled in an expeditious manner. See 38 U.S.C.A. §§ 5109B, 7112 (West Supp. 2007). _________________________________________________ THOMAS J. DANNAHER Veterans Law Judge, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 2002), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Appeals for Veterans Claims. This remand is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (2007).