Citation Nr: 18141382
Decision Date: 10/11/18	Archive Date: 10/10/18

DOCKET NO. 16-31 362
DATE:	October 11, 2018
REMANDED
Entitlement to service connection for sleep apnea is remanded.
REASONS FOR REMAND
The Veteran served on active duty from January 2004 to January 2008.
These matters come before the Board of Veterans’ Appeals (Board) on appeal from an October 2015 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO).
1. Entitlement to service connection for sleep apnea is remanded.
The Veteran contends that his sleep apnea is related to his service, to include his service-connected PTSD.  See February 2018 Correspondence. 
The Veteran was afforded a VA examination in April 2017.  The examiner noted that the Veteran has a diagnosis of obstructive sleep apnea.  The VA examiner offered a negative opinion as to whether the Veteran’s sleep apnea is related to his active service.  In January 2018 correspondence, the Veteran stated that his sleep apnea is secondary to his service-connected PTSD and submitted three medical studies supporting an association between PTSD and sleep apnea.  As there is no medical opinion regarding the Veteran’s contentions that his sleep apnea is secondary to his service-connected PTSD, the Board finds that an additional medical opinion is warranted to determine the etiology of the Veteran’s sleep apnea.    
The matter is REMANDED for the following action:
1. Obtain an opinion from a qualified clinician regarding the nature and etiology of the Veteran’s sleep apnea.  The claims file must be reviewed by the clinician.  If the reviewing clinician determines that physical examination of the Veteran is needed to render the requested opinion, such should be accomplished.  After reviewing the claims file and performing a physical examination of the Veteran, if necessary, the reviewing clinician should provide an opinion as to the following: 
Whether is it at least as likely as not (a 50 percent or better probability) that the Veteran’s current sleep apnea was caused by his service-connected PTSD.
Whether is it at least as likely as not (a 50 percent or better probability) that the Veteran’s current sleep apnea is aggravated by his service-connected PTSD
The examiner should review and discuss the medical studies the Veteran submitted in February 2018, to include: “Association of Psychiatric Disorders and Sleep Apnea in a Large Cohort”; “Sleep Disorders and Associated Medical Comorbidities in Active Duty Military Personnel”; and “Obstructive Sleep Apnea and Posttraumatic Stress Disorder among OEF/OIF/OND Veterans”. 
2. After the above development has been completed, readjudicate the claim.  If any benefit sought remains denied, provide the Veteran and his representative with a supplemental statement of the case, and return the case to the Board.
 
DONNIE R. HACHEY
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	K. Brandt