Citation Nr: 18147353
Decision Date: 11/06/18	Archive Date: 11/02/18

DOCKET NO. 16-01 163
DATE:	November 6, 2018
REMANDED
Entitlement to service connection for sleep apnea is remanded.
Entitlement to a rating higher than 10 percent for diplopia, status-post bilateral lateral rectus recessions for exotropia is remanded.
REASONS FOR REMAND
The Veteran served on active duty from August 1977 to December 1998. 
In October 2018, the Veteran and his spouse testified at a Board hearing at the local Regional Office before the undersigned Veterans Law Judge.
1. Entitlement to service connection for sleep apnea is remanded.
At the Board hearing, the Veteran and his spouse asserted that he began experiencing sleep apnea symptoms while on active duty.  Specifically, his wife reported witnessing the Veteran trying to catch his breath and gurgling.  In light of the above, the Board finds that a VA examination with opinion is necessary to decide this issue. 
2. Entitlement to a rating higher than 10 percent for diplopia, status-post bilateral lateral rectus recessions for exotropia is remanded.
At the Board hearing, the Veteran asserted that his eye disorder has increased in severity since he was last examined by VA in November 2013, almost five years ago.  Importantly, he also testifed that he had surgery since the last examination in March 2017.  Thus, the Veteran should be provided an opportunity to report for a VA examination to ascertain the current severity and manifestations of his diplopia, status post bilateral lateral rectus recessions for exotropia.
Again, at the Board hearing, the Veteran identified relevant outstanding private treatment records, primarily March 2017 surgical records.  A remand is required to allow VA to obtain authorization and request these records.  Further addional VA clinical records dated from Septembe 2015 to the present should also be obtained.  
The matters are REMANDED for the following action:
1. Obtain the Veteran’s VA treatment records for the period from September 2015 to the present.  
2. Ask the Veteran to complete a VA Form 21-4142 for any additional private treatment records, to specifically include records pertaining to the March 2017 eye surgery.  Make two requests for the authorized records, unless it is clear after the first request that a second request would be futile.
3. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of his diagnosed sleep apnea.  The examiner must opine whether it is at least as likely as not related to an in-service injury, event, or disease, including in-service symptoms of trying to catch his breath and gurgling.  
4.  Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected his diplopia, status post bilateral lateral rectus recessions for exotropia.  The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran’s disability under the rating criteria.  To the extent possible, the examiner should identify any symptoms and functional impairments due to his diplopia, status-post bilateral lateral rectus recessions for exotropia alone and discuss the effect of the Veteran’s eye disorder on any occupational functioning and activities of daily living.  

 
H.M. WALKER
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	J.N. Moats