Citation Nr: 18150891
Decision Date: 11/16/18	Archive Date: 11/15/18

DOCKET NO. 17-59 135
DATE:	November 16, 2018
REMANDED
Service connection for obstructive sleep apnea is remanded.
REASONS FOR REMAND
The Veteran served on active duty from July 1982 to August 2005.
The Veteran contends that he reported sleep problems and disturbances immediately after military retirement in 2005. He further contends that a proper diagnosis of sleep apnea was warranted in 2005 and that his prior sleep studies are inaccurate. The Veteran further indicated that these symptoms have continued to present, and only improved upon being issued a CPAP machine.
In addition, he contends in his substantive appeal (VA Form 9), that his wife reported a change in his snoring and nighttime breathing when he returned from Okinawa in 2004. A statement from his wife reported a change in his sleeping and nighttime breathing while in Okinawa. A fellow Marine also submitted a statement indicating that while they were stationed in Camp Lejeune, the Veteran reported a change in his sleeping and increased problems with breathing and snoring.
The Board cannot make a fully-informed decision on the issue of sleep apnea because no VA examiner has opined whether the Veteran’s sleep apnea either occurred in service, in close proximity to military retirement, or is otherwise etiologically related to service. The record indicates that the Veteran has a current diagnosis of sleep apnea. Accordingly, the Board finds that a VA examination for an opinion as to the etiology of the Veteran’s sleep apnea is warranted. See McLendon v. Nicholson, 20 Vet. App. 79 (2006). The examiner should further address the contentions in the Veteran’s April 2017 Correspondence and VA Form 9, along with the third-party statements he has submitted in furtherance of this claim.
Moreover, a complete set of VA treatment records have not been obtained for this Veteran from 2005 to present. Therefore, the Board has no basis upon which to evaluate the Veteran’s contentions that he reported sleep problems upon his retirement in 2005. On remand, the AOJ should obtain VA treatment records from 2005 to present.
The matter is REMANDED for the following action:
1. Obtain VA treatment records from 2005 to present.
2. Thereafter, schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of 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 whether sleep apnea had its onset during active duty.  
The examiner is to address the Veteran’s statements. The examiner should further address the “Buddy Statements” submitted by the Veteran in December 2017.
The examiner must provide a complete rationale on which his/her opinion is based, and must include a discussion of the medical principles as applied to the medical evidence and facts used in establishing his/her opinion.
The term “at least as likely as not” does not mean within the realm of medical possibility, but rather that the medical evidence both for and against a conclusion is so evenly divided that it is as medically sound to find in favor of a conclusion as it is to find against it.
If the examiner finds that he/she cannot provide an opinion without resorting to speculation, he/she should explain the inability to provide an opinion.
 
Nathaniel J. Doan
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	A. Dellarco, Associate Counsel