Citation Nr: 18140927
Decision Date: 10/09/18	Archive Date: 10/09/18

DOCKET NO. 15-42 679
DATE:	October 9, 2018
REMANDED
Entitlement to service connection for obstructive sleep apnea (OSA), to include as secondary to service-connected post-traumatic stress disorder (PTSD), is remanded.
REASONS FOR REMAND
The Veteran served on active duty from June 1969 to January 1971.
In September 2018, the Veteran appeared at a hearing before the undersigned Veterans Law Judge (VLJ) at a videoconference hearing.
Entitlement to service connection for OSA, to include as secondary to service-connected PTSD, is remanded.
The Board finds that additional development is needed prior to final adjudication of the issue on appeal.  Specifically, the Board finds that a new examination is needed.  The April 2015 examiner declined to find a positive nexus between the Veteran’s claimed condition and service, because snoring does not indicate sleep apnea and the Veteran had gained weight since separation.  
The Board finds this opinion to be inadequate for several reasons.  First, in September 2018, the Veteran appeared at a hearing before the undersigned VLJ, and it was noted that the Veteran is not overweight.  The Veteran also reported that his weight has been essentially consistent except for losing 20 pounds at one point which did not change the diagnosis or severity of his OSA.  In addition, the Veteran’s wife, before her passing, submitted a statement in March 2015 indicating that shortly after the Veteran left service, she noticed that not only did he snore at night, but he would stop breathing at times.  This was not addressed in the VA opinion.  Finally, there is some indication that the Veteran’s service-connected PTSD might aggravate his OSA.  Therefore, due to the inadequacies of the former opinion, and the new secondary service-connection argument, the Board will remand to afford the Veteran a new VA examination.
Accordingly, the matter is REMANDED for the following action:
1. Schedule the Veteran for a new VA examination to address the etiology of his claimed OSA.  The examiner is asked to provide an opinion that addresses whether it is at least as likely as not (i.e., a 50 percent or greater probability) that his claimed OSA was caused by the Veteran’s active duty service or, if preexisting service, was aggravated therein.  The examiner is asked to specifically address: (a) the Veteran’s supposed weight-gain and his report that his weight has been consistent except for losing 20 pounds at one point which did not change the diagnosis or severity of his OSA; and (b) the Veteran’s wife’s March 2015 statements that shortly after the Veteran left service, not only did he snore at night, but he would stop breathing at times.
In addition, the examiner should provide an opinion as to whether it is at least as likely as not (i.e., a 50 percent or greater probability) that the claimed OSA is proximately due to, or the result of, or aggravated (permanently worsened) beyond normal progression by, the Veteran’s service-connected PTSD. 
2. If upon completion of the above action the issue is denied, the case should be returned to the Board after compliance with appellate procedures.
 
E. I. VELEZ
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	K. Foster, Associate Counsel