Citation Nr: 18144947
Decision Date: 10/25/18	Archive Date: 10/25/18

DOCKET NO. 18-38 316
DATE:	October 25, 2018
REMANDED
Entitlement to service connection for sleep apnea is remanded.
REASONS FOR REMAND
The Veteran served on active duty in the U.S. Marine Corps from September 1979 to October 1999 including service in Southwest Asia from August 1990 to April 1991.
Entitlement to Service Connection for Sleep Apnea is Remanded.
The Veteran contends that he is entitled to service connection for sleep apnea on a direct basis, asserting that the condition began in service. 
The Veteran’s DD-214 lists his primary specialty as a radio chief and recruiter. 
The Veteran’s service treatment records (STRs) are associated with the claims file.  The Veteran denied trouble sleeping or fatigability multiple times throughout service, to include during his separation examination. See May 1981, May 1983, March 1993, November 1997, and March 1999 Report of Medical History forms.  STRs do not reflect any treatment for or complaints of a sleep disorder.
The earliest treatment for a sleep disorder appears in October 2005 VA treatment records, when the Veteran requested a sleep study because of snoring and breathing issues during sleep. A sleep study was performed in December 2005, revealing that the Veteran had sleep apnea.
The Veteran believes he has suffered from sleep apnea since his separation. See April 2018 Notice of Disagreement.  He also believes that exposure to oil well fires contributed to his sleeping disorder. Id. 
The Veteran has not been afforded a VA compensation and pension examination for this condition. A medical examination or medical opinion is necessary if the information and evidence of record does not contain sufficient competent medical evidence to decide the claim, but: (1) contains competent evidence of a current diagnosed disability or persistent or recurrent symptoms of a disability; (2) establishes that an event, injury, or disease occurred in service or certain diseases manifested during an applicable presumptive period for which the claimant qualifies; and (3) indicates that the disability or symptoms may be associated with the established event, injury or disease in service or with another service-connected disability. McClendon v. Nicholson, 20 Vet. App. 79 (2006). 
An opinion regarding the relationship between any exposure to airborne contaminants and sleep apnea has not been obtained.
The Board finds that the lay evidence suggests that the current disability may be caused or aggravated by service.  Therefore, a VA examination and opinion is warranted addressing the potential relationship, if any, between sleep apnea and the Veteran’s service.
The matter is REMANDED for the following action:
1. Request the service personnel records to determine the extent of the Veteran’s duties and potential exposure to airborne contaminants during service in Southwest Asia.
2. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any sleep apnea disability.  
The examiner must opine whether a sleep apnea disability is at least as likely as not caused or aggravated by an in-service injury or disease.
The examiner is asked to address the Veteran’s contentions that sleep apnea was caused or aggravated beyond the normal progression by exposure to airborne contaminants during service in Southwest Asia.
The examiner is asked to explain the reasons behind any opinions expressed and conclusions reached.  
The examiner is reminded that the term “as likely as not” does not mean “within the realm of medical possibility,” but rather that the evidence of record is so evenly divided that, in the examiner’s expert opinion, it is as medically sound to find in favor of the proposition as it is to find against it.

 
J.W. FRANCIS
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	T. Fitzgerald, Associate Counsel