Citation Nr: 18151013 Decision Date: 11/19/18 Archive Date: 11/16/18 DOCKET NO. 15-07 004 DATE: November 19, 2018 REMANDED Entitlement to service connection for obstructive sleep apnea (OSA) is remanded. Entitlement to an increased rating in excess of 10 percent for deep vein thrombosis (DVT) of the right lower extremity is remanded. Entitlement to an increased rating in excess of 10 percent for DVT of the left lower extremity is remanded. REASONS FOR REMAND The Veteran, who is the appellant, served on active duty from May 1991 to September 1998 and from January 1999 to December 2004. In October 2018, a videoconference board hearing was held before the undersigned. A transcript of the hearing is associated with the Veteran’s claims file. 1. Entitlement to service connection for OSA is remanded. The Veteran claims service connection for OSA. During the hearing before the undersigned, he and his wife testified regarding the onset of his symptom during service. Specifically, he stated that during service he snored a great deal, and was tired and irritable from lack of sleep. The Veteran has not been afforded a compensation examination to ascertain whether the symptoms of which they testified could mark the onset of his now diagnosed OSA. After considering the statements in the record, the Board finds that a medical examination is warranted. See McLendon v. Nicholson, 20 Vet. App. 79 (2006). 2. Entitlement to an increased rating in excess of 10 percent for DVT of the right and left lower extremities is remanded. Regarding the Veteran’s claims for increased evaluations for the DVT of his lower extremities, it is noted that, while he did have a compensation examination in January 2018, during the hearing on appeal, he stated that he had eczema on the legs, swelling of the vein on the back of his right foot that resulted in severe pain, and persistent blood clots that necessitated stent insertion into both his legs. The Veteran attributed these symptoms to his DVT of the lower extremities, which was not addressed by the January 2018 VA examination. The Board finds that the nature and extent of any of these additional symptoms may be attributed to DVT would be helpful in the determination of the proper rating to be assigned. As such, an additional examination is warranted. The matters are REMANDED for the following actions: 1. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any OSA. The examiner must opine whether it is at least as likely as not related to an in-service injury, event, or disease. The examiner should specifically address the testimony provided by the Veteran and his spouse during the October 2018 Board hearing. 2. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected DVT. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran’s disability under the rating criteria. The examiner must attempt to elicit information regarding the severity, frequency, and duration of any flare-ups, and the degree of functional loss during flare-ups. To the extent possible, the examiner should identify any symptoms and functional impairments due to the bilateral DVT alone and discuss the testimony adduced at the October 2018 Board hearing, including contentions related to eczema and persistent blood clots resulting from the DVT, as well as the effect of the Veteran’s DVT on any occupational functioning and activities of daily living. If it is not possible to provide a specific measurement, or an opinion regarding flare-ups, symptoms, or functional impairment without speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training). A. ISHIZAWAR Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Joseph P. Gervasio