Citation Nr: 18141949
Decision Date: 10/12/18	Archive Date: 10/12/18

DOCKET NO. 16-24 298
DATE:	October 12, 2018
REMANDED
Entitlement to service connection for coronary artery disease is remanded.
Entitlement to service connection for sleep apnea is remanded.
REASONS FOR REMAND
The Veteran had active military service from November 1980 to June 1991, including service in Southwest Asia from September 24, 1990 to April 17, 1991. 
The RO previously denied the Veteran’s service connection claim for heart disease in a June 2009 rating decision that was not appealed. The June 2009 rating decision noted that the Veteran’s service treatment records at that time were incomplete. Along with a June 2012 petition to reopen service connection for heart disease, the Veteran submitted additional service treatment records that had not been in the record, including a complaint of chest pain during the Veteran’s reserve service in 2003. Even though the June 2009 rating decision is final, the provisions of 38 C.F.R. § 3.156(c) apply in that relevant service treatment records that existed and had not been associate in the claims file at the time of the previous rating decision, have been added to the record. Thus, rather than addressing the preliminary issue of whether new and material evidence to reopen the claim of service connection for coronary artery disease, the claim will be reconsidered on the merits.
1. Entitlement to service connection for coronary artery disease is remanded.
The Veteran indicated that his coronary artery disease may have begun during his active duty service. However, a review of the claims file does not find that his complete service treatment records have been obtained. 
The Board also cannot make a fully-informed decision on the issue of service connection for coronary artery disease because no VA examiner has opined whether the heart disease is related to his military service. The record shows the Veteran had complaints of chest pain during his reserve service in 2003. He was later diagnosed with coronary artery disease in 2007.
2. Entitlement to service connection for sleep apnea is remanded.
The Board cannot make a fully-informed decision on the issue of service connection for sleep apnea because no VA examiner has opined whether it is related to his service-connected posttraumatic stress disorder (PTSD). On his VA-Form 9, the Veteran referred to an article from the American Academy of Sleep Medicine noting that there was a high risk of sleep apnea in young veterans with PTSD. Science Daily, May 19, 2015.
The matters are REMANDED for the following action:
1. Obtain the Veteran’s complete service treatment records. 
2.  Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of his coronary artery disease.  The examiner must opine whether it at least as likely as not (1) began during active service or a period of qualifying service, (2) manifested within one year after discharge from active duty service, or (3) was noted during active service with continuity of the same symptomatology since active service.
3. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of his sleep apnea. The examiner must opine whether it is at least as likely as not (1) proximately due to service-connected PTSD, or (2) aggravated beyond its natural progression by service-connected PTSD. Please consider the article referenced by the Veteran from the American Academy of Sleep Medicine, “High risk of sleep apnea in young veterans with PTSD.” Science Daily May 19, 2015.
 
S. L. Kennedy
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	Sarah B. Richmond