Citation Nr: 18152453
Decision Date: 11/23/18	Archive Date: 11/21/18

DOCKET NO. 16-56 785
DATE:	November 23, 2018
REMANDED
Entitlement to service connection for sleep apnea, to include as secondary to a service-connected deviated septum, is remanded.
REFERRED
The issues of entitlement to service connection for a bilateral ankle condition; entitlement to service connection for a neck condition; entitlement to a rating in excess of 20 percent for right shoulder supraspinatus partial tear; entitlement to a rating in excess of 10 percent for left shoulder tendonitis; entitlement to a rating in excess of 70 percent for lumbar strain; entitlement to a rating in excess of 10 percent for right patellofemoral syndrome; and entitlement to a compensable rating for left patellofemoral syndrome were raised in a June 2016 supplemental claim, statement in support of claim, and letter from the Veteran, and are referred to the Agency of Original Jurisdiction (AOJ) for adjudication.
REASONS FOR REMAND
The Veteran served on active duty from January 2003 to August 2011.  He revoked his previous representative in a June 2016 submission.
The Veteran contends his sleep apnea is secondary to his service-connected deviated septum.  The Veteran was afforded a VA examination in October 2016.  The examiner provided a negative nexus opinion, finding the Veteran’s sleep apnea was not caused by his deviated septum.  However, the examination did not address whether the Veteran’s sleep apnea was aggravated by his deviated septum.  The Board finds the VA examination of record inadequate to properly adjudicate the Veteran’s claim.  See Barr v. Nicholson, 21 Vet. App. 303, 312 (2007).  Therefore, a remand is necessary to provide the Veteran an addendum opinion as to the nature and etiology of the Veteran’s sleep apnea.
The matter is REMANDED for the following action:
1. Contact the Veteran and request authorization to obtain any outstanding records pertinent to the claim, including any private treatment records following proper VA procedures (38 C.F.R. § 3.159(c)).
2. After all outstanding records have been associated with the claims file, forward the Veteran’s file to a qualified VA medical professional in order to obtain an addendum opinion as to the current nature and etiology of the Veteran’s sleep apnea.  The claims file, to include a copy of this Remand, must be made available to and be reviewed by the examiner.
3. The examiner is asked to address the following:
(a.) Is it at least as likely as not (probability of 50 percent or more) that the Veteran’s current sleep apnea had its onset in or is related to service; and
(b.) Is it at least as likely as not that the Veteran’s current bilateral hearing loss was caused or aggravated (increased in severity beyond the natural progress of the disorder) by his service-connected deviated septum.

All opinions must be supported by a detailed rationale.
 
A. C. MACKENZIE
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	B. N. Quarles, Associate Counsel