Citation Nr: 18147527
Decision Date: 11/05/18	Archive Date: 11/05/18

DOCKET NO. 17-24 583
DATE:	November 5, 2018
REMANDED
Entitlement to service connection for obstructive sleep apnea is remanded.
REASONS FOR REMAND
The Veteran, who is the appellant in this case, had service from February 1989 to February 1995.

The Board notes that the Veteran’s Notice of Disagreement for issues of a rating reduction for a right knee disability and service connection for tinea pedis was received by VA in October 2018 and is awaiting issuance of a Statement of the Case from the regional office.  As a result, these issues are not on appeal to the Board at this time.
1. Entitlement to service connection for obstructive sleep apnea is remanded.
The Veteran contends that his obstructive sleep apnea is related to service.  The issue was initially denied entitlement to service connection for obstructive sleep apnea via a November 2014 rating decision and January 2015 notification letter due to no evidence of a current diagnosis; however, the Veteran’s April 2015 private treatment records confirm the presence of severe obstructive sleep apnea on a sleep study and subsequent VA treatment records reflect the Veteran was issued a CPAP.  As a result, a VA examination is necessary to determine whether the Veteran’s sleep apnea is related to service.  In disability compensation claims, VA must provide a medical examination and medical opinion when there is (1) competent evidence of a current disability or persistent or recurrent symptoms of a disability, and (2) evidence establishing that an event, injury, or disease occurred in service or establishing certain diseases manifesting during an applicable presumptive period for which the claimant qualifies, and (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the veteran’s service or with another service-connected disability, but (4) insufficient competent evidence on file for the VA to make a decision on the claim.  McLendon v. Nicholson, 20 Vet. App. 79 (2006).
The matter is REMANDED for the following action:
1. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any obstructive sleep apnea.  The examiner must opine on the following:
(a.) whether it is at least as likely as not related to an in-service injury, event, or disease, including any continuity of sleep apnea symptoms described by the Veteran as having started during his service.
(b.) whether it is at least as likely as not proximately due to a service-connected disability.  The examiner should discuss the relationship, if any, between his service-connected disabilities and increased weight-gain due to inability to exercise as well as its impact, if any, on his obstructive sleep apnea.
(c.) whether it is at least as likely as not aggravated beyond its natural progression by a service-connected disability.  The examiner should discuss the relationship, if any, between his service-connected disabilities and increased weight-gain due to inability to exercise as well as its impact, if any, on his obstructive sleep apnea.
 
H. SEESEL
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	R. Connally, Counsel