Citation Nr: 18150303
Decision Date: 11/14/18	Archive Date: 11/14/18

DOCKET NO. 16-30 952
DATE:	November 14, 2018
REMANDED
Service connection for lumbar spine disability, claimed as degenerative changes of the lumbar spine, is remanded.
Service connection for obstructive sleep apnea is remanded.
Service connection for gastroesophageal reflux disease (GERD) is remanded.
REASONS FOR REMAND
The Veteran served on active duty from January 1964 to July 1968, and from September 1968 to June 1990.
This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a March 2014 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Roanoke, Virginia.
1. Service connection for lumbar spine disability is remanded.
The Board cannot make a fully-informed decision on the issue of service connection for degenerative changes of the lumbar spine because no VA examiner has opined whether this condition was caused or aggravated by his service connected right knee degenerative joint disease.  As the Veteran has reported that this condition began in 1986, during service, this examiner should also provide opinions on the issues of direct and presumptive service connection.
2. Service connection for obstructive sleep apnea is remanded.
The Board cannot make a fully-informed decision on the issue of service connection for obstructive sleep apnea because no VA examiner has opined whether the Veteran’s reported loud snoring during service between 1988 and 1990 shows an in-service onset of this disability.
3. Service connection for gastroesophageal reflux disease (GERD) is remanded.
The Board cannot make a fully-informed decision on the issue of service connection for GERD because no VA examiner has opined whether the Veteran’s reported repeated heartburn during service shows an in-service onset of this disability.
The matters are REMANDED for the following action:
1. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any lumbar spine disability.  The examiner must provide opinions on the following:
(a.) If the Veteran currently has arthritis of the lumbar spine, is it at least as likely as not that any arthritis of the lumbar spine (1) began during active service, (2) manifested within one year after discharge from service, or (3) was noted during service with continuity of the same symptomatology since service?
(b.) Is any current lumbar spine disability at least as likely as not related to an in-service injury, event, or disease?
(c.) Is any current lumbar spine disability at least as likely as not (1) proximately due to service-connected disability, or (2) aggravated beyond its natural progression by service-connected disability?
2. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any 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 his reports of snoring during service.
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3. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any GERD.  The examiner must opine whether it is at least as likely as not related to an in-service injury, event, or disease, including his reports of heartburn during service.
 
Thomas H. O'Shay
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	B. Houbeck, Counsel