Citation Nr: 18151044 Decision Date: 11/19/18 Archive Date: 11/16/18 DOCKET NO. 11-14 422 DATE: November 19, 2018 REMANDED Entitlement to service connection for a sleep disorder, to include as secondary to a service connected spine disability is remanded. Entitlement to service connection for benign prostatic hypertrophy (BPH), to include as secondary to a service connected spine disability is remanded. REASONS FOR REMAND Entitlement to service connection for a sleep disorder and BPH, to include as secondary to a service connected spine disability are remanded. The Board remanded these claims in September 2016, in part so that the Veteran could undergo VA examinations. These were performed in June 2018. However, the findings made are deemed inadequate because the VA examiner failed to take into consideration the lay statements of the Veteran. At his April 2016 Board hearing, the Veteran testified that during training exercises he would spend 48 hours in an armored vehicle (tank). He testified that there were times when he would hold urine to avoid having to get out of the tank. He also testified that he would have to sleep while sitting up in the tank. He stated that he found it hard to breathe and that he would wake up gasping. He also had been told by his ex-wife that he has been snoring for 30 years. The Veteran is considered competent to report the observable manifestations of his claimed disability. See Charles v. Principi, 16 Vet. App. 370, 374 (2002) (“ringing in the ears is capable of lay observation”); Layno v. Brown, 6 Vet. App. 465, 469-70 (1994) (lay testimony iterating knowledge and personal observations of witness are competent to prove that claimant exhibited certain symptoms at particular time following service). The Board finds that a remand is necessary in order to obtain an addendum opinion that addresses the Veteran’s lay statements. The matters are REMANDED for the following action: 1. Obtain an addendum opinion from the September 2016 VA examiner or other appropriate clinician regarding whether it is at least as likely as not that the Veteran’s BPH began during or is causally related to service, to include as due to spending lengthy periods of time holding in urine. The examiner should render an additional opinion addressing: (a) whether BPH clearly and unmistakably preexisted the Veteran’s entrance into service; if so, (b) whether any such disorder increased in severity during service; and, if so, (c) whether such increase in severity represented the natural progression of the condition, or was beyond the natural progress of the condition (representing a permanent worsening of such disorder). The examiner is advised that the Veteran is competent to report injuries and symptoms and that his reports must be considered in formulating the requested opinion. 2. Obtain an addendum opinion from the September 2016 VA examiner or other appropriate clinician regarding whether it is at least as likely as not that the Veteran’s sleep disability began during or is causally related to service, to include as due to spending nights in a tank, sleeping in a sitting position, having difficulty breathing, and waking up gasping. The examiner should also address the veteran’s reported 30-year history of snoring. The examiner should render an additional opinion addressing: (a) whether any sleep disability clearly and unmistakably preexisted the Veteran’s entrance into service; if so, (b) whether any such disorder increased in severity during service; and, if so, (c) whether such increase in severity represented the natural progression of the condition, or was beyond the natural progress of the condition (representing a permanent worsening of such disorder). The examiner is advised that the Veteran is competent to report injuries and symptoms and that his reports must be considered in formulating the requested opinion. ERIC S. LEBOFF Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. Prem, Counsel