Citation Nr: 18148594
Decision Date: 11/08/18	Archive Date: 11/07/18

DOCKET NO. 16-21 937
DATE:	November 8, 2018
REMANDED
Service connection for sleep apnea is remanded.
REASONS FOR REMAND
The Veteran served in the United States Air Force from August 2006 to December 2009.  
This matter is before the Board of Veterans’ Appeals (Board) on appeal from a February 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). 
Service connection for sleep apnea is remanded.
The Veteran contends that his sleep problems developed while he was on active duty and have persisted to the present.  Specifically, he reported having sleep problems in 2007 or 2008 while stationed in Fort Richardson, Alaska.  He states that he was reprimanded and disciplinary action was taken against him for constantly waking up late for duty.  He also contends that he saw a physician during that time and received sleep medication, but he was not tested or treated for sleep apnea. 
The Veteran’s service treatment records do not document any treatment or complaints for sleep problems.  However, the Board notes that the records appear incomplete as they do not contain a separation examination or a post-deployment physical. 
The Board also notes that January 2015 VA examiner referenced a November 2014 VA sleep study that diagnosed the Veteran with sleep apnea and prescribed the continuous positive airway pressure (CPAP) therapy.  However, records of that sleep study have not been associated with the claims file.  Accordingly, a remand is required to obtain these potentially relevant records.  
Further, although, the Veteran was provided a VA examination in January 2015, however the examiner failed to consider or address the Veteran’s competent reports concerning the onset sleep difficulties.  Instead, the examiner relied upon the absence of documented in-service complaints in rendering the negative opinion.  This is particularly significant because some of the Veteran’s service department records appear to be missing.
Based upon the foregoing reasons, regrettably the Board must remand for additional development.
The matter is REMANDED for the following action:
1. Contact the Veteran in order to have him identify the names and addresses of all health care providers who have treated him for the issue on appeal.  The Veteran should also be notified that he may submit evidence or treatment records to support his claim. 
The Board is particularly interested the November 2014 sleep study that was referenced in the January 2015 VA examination report.  The AOJ should attempt to obtain any such records.  All efforts to obtain such records should be documented in the claims folder.  All available records should be associated with the Veteran’s VA claims folder.
2. Then, the AOJ should schedule the Veteran for a VA examination to determine the nature and likely etiology of the Veteran’s sleep apnea.  The Veteran’s claims file must be made available to the examiner.  All diagnostic testing deemed to be necessary by the examiner should be accomplished.  
The examiner should indicate whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s diagnosed sleep apnea had causal origins in service or is otherwise related to the Veteran’s active duty service.  The examiner should accept the history of symptoms provided by the Veteran as true unless the examiner provides a rationale as to why the Veteran’s recollection is affirmatively contradicted by the medical evidence. A clear rationale for all opinions must be provided and a discussion of the facts and medical principles involved would be of considerable assistance to the Board.
 
M. Donohue
Acting Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	T. Jones Council, Associate Counsel