Citation Nr: 18149380
Decision Date: 11/09/18	Archive Date: 11/09/18

DOCKET NO. 16-51 586
DATE:	November 9, 2018
REMANDED
Entitlement to service connection for obstructive sleep apnea is remanded.
REASONS FOR REMAND
The Veteran had active duty service from June 1993 to June 1997.
1. Entitlement to service connection for obstructive sleep apnea is remanded.
The Veteran contends he is entitled to service connection for obstructive sleep apnea as a result of sleep issues caused by in-service treatment.  See Notice of Disagreement.  He further contends he had severe snoring in service which resulted in hazing.  See VA Form 9.
In June 2018 written argument, the Veteran’s representative also expanded on the Veteran’s contentions of in-service sleep issues to include chemical exposure in service from fire smoke, fire suppression chemicals and fuels such as jet and diesel.  
Notably, the Veteran’s service treatment records (STRs) show he had a rhinoplasty performed to fix a deviated septum in 1996, while on active duty.  Additionally, he complained of sleep difficulties on his separation examination in April 1997.  
In July 2015, the Veteran was afforded a VA examination.  The examiner found the complaints of disrupted sleep noted on the Veteran’s separation examination report to be more likely related to his mental health issues and less likely due to sleep apnea.  In support of that opinion, the examiner explained that the Veteran’s sleep apnea was not diagnosed until a positive sleep study which occurred years later in 2014, and that there was no documentation for the diagnosis of or treatment of sleep apnea in service.  However, in so finding, the examiner also indicated that obstructive sleep apnea symptoms, amongst others, included loud snoring and the examiner did not address the Veteran’s contentions that he suffered from in-service snoring issues.  Moreover, as previously indicated, the Veteran’s representative has also now raised the contention of in-service chemical exposure as being etiologically related to the Veteran’s present obstructive sleep apnea.  
In light of these issues, the Board finds an addendum medical opinion is necessary to address the Veteran’s complaints of in-service snoring, which is a symptom of obstructive sleep apnea, as well as any relationship between the Veteran’s chemical exposure and his present obstructive sleep apnea. 
The matter is REMANDED for the following action:
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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 whether it is at least as likely as not related to an in-service injury, event, or disease, including reports of in-service snoring as well as chemical exposure.
 
A. ISHIZAWAR
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	K. Churchwell, Counsel