Citation Nr: 18149784
Decision Date: 11/13/18	Archive Date: 11/13/18

DOCKET NO. 16-28 533
DATE:	November 13, 2018
REMANDED
Entitlement to service connection for obstructive sleep apnea is remanded.
REASONS FOR REMAND
The complete dates of the Veteran’s active duty, active duty for training (ACDUTRA) and inactive duty for training (INACDUTRA) are not clear from the record. These dates are pertinent in order to determine whether the Veteran’s claimed obstructive sleep apnea had its onset during a qualifying period of service or is the result of injuries incurred or aggravated in active duty, in the line of duty during INACDUTRA, and/or diseases or injuries incurred or aggravated in the line of duty during ACDUTRA. 
The record reflects that the Veteran’s obstructive sleep apnea was diagnosed following a June 2014 diagnostic polysomnogram. A statement from the Veteran’s private doctor dated April 2015, and received June 2015, indicates the Veteran’s symptoms started while he was on active duty. However, it is unclear when, specifically, the doctor believes the Veteran’s symptoms began and why he believes they began at that time. As it stands, the record does not reflect the Veteran was on active duty in June 2014. In his VA Form 9 substantive appeal, the Veteran indicated that two private doctors had stated his sleep apnea was related to his 30-year membership in the United States Army Reserves. He explained that while he was diagnosed in 2014, his symptoms had been occurring for much longer. 
Remand is necessary to determine the specific dates of the Veteran’s qualifying periods of service and to obtain a medical opinion with sufficient rationale explaining whether it is more likely than not that the Veteran’s obstructive sleep apnea is related to his military service. 
The matter is REMANDED for the following actions:
1. Contact all appropriate sources for records showing all of the periods of active duty, ACDUTRA and INACDUTRA served by the Veteran. All records requests and responses received must be documented in the claims file and all pertinent follow-up should be undertaken.
2. After completing the above-requested development, refer the Veteran’s claims file to an appropriate VA clinician. A complete copy of this remand must be made available to, and reviewed by, the examiner. Provide the clinician with all of the Veteran’s verified dates of active duty, ACDUTRA and INACDUTRA service. The clinician is then asked to provide answers to the following questions. If the clinician determines that an examination is necessary to arrive at any requested opinion, an examination should be scheduled. 
a)	Is the Veteran’s obstructive sleep apnea at least as likely as not related to an in-service injury, event, or disease?
b)	If not, is at least as likely as not (1) proximately due to a service-connected disability, or (2) aggravated beyond its natural progression by a service-connected disability, including exercise induced asthma?
c)	If the answer to the above two questions is no, opine as to whether, subsequent to June 2014, the Veteran’s obstructive sleep apnea was at least as likely as not aggravated (non-temporary increase in severity) by service and, if so, whether any increase in severity was clearly and unmistakably (undebatable) due to its natural progress.
A clear explanation for all opinions would be helpful and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. If the clinician is unable to provide an opinion he or she should explain why.
 
A. ISHIZAWAR
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	R.Vemulapalli, Associate Counsel