Citation Nr: 18152512 Decision Date: 11/23/18 Archive Date: 11/23/18 DOCKET NO. 16-37 142 DATE: November 23, 2018 REMANDED Entitlement to service connection for a sleep disorder, to include insomnia and sleep apnea, to include secondary to service connected disability is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1984 to June 2008. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an April 2011 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Pittsburgh, Pennsylvania. A review of the service treatment records shows that in June 2007, the Veteran reported a 5 to 15-year history of disrupted sleep. He reported no problems falling asleep but stated that he would wake up five hours later without any external stimulus. He denied snoring and no apneic reports were offered by any partner. The Veteran was referred for screening with a sleep study, but one was never administered. In February and April 2008, the appellant reported that he was not sleeping well, and that sometimes he felt tired during the day. Problems concentrating and staying on task were also noted. Postservice records note that in January 2010 the appellant was using Trazadone to help with sleep. In April 2010, the Veteran was diagnosed with a chronic lumbar syndrome with disc degeneration. Concurrent with that diagnosis, the Veteran filed a claim of entitlement to service connection for a sleep disturbance describing insomnia, and sleep deprivation due to his back condition and associated pain. The Board finds that the evidence of sleeping problems extending back to the Veteran’s active duty service, together with continued symptoms postservice triggers VA’s duty to provide the claimant with an examination. See McLendon v. Nicholson, 20 Vet. App. 79 (2006). The issue is therefore remanded so that the Veteran can be afforded appropriate VA examination prior to adjudication. The matter is REMANDED for the following action: 1. Obtain any outstanding, pertinent private, military and VA treatment records dated since June 2008. If any such records cannot be located, specifically document the attempts that were made to locate them, and explain in writing why further attempts to locate or obtain any government records would be futile. Then: (a) notify the claimant of the specific records that it is unable to obtain; (b) explain the efforts VA has made to obtain that evidence; and (c) describe any further action it will take with respect to the claims. The claimant must then be given an opportunity to respond. The Board notes that the Veteran currently resides in Germany and that postservice he used military medical facilities. 2. Following completion of the above, schedule the Veteran for a VA examination to address the nature and etiology of any diagnosed sleep disorder including, but not limited to, sleep apnea and insomnia. The examiner must specify in the report that all VBMS and Virtual VA/Legacy records have been reviewed. Any indicated evaluations or studies should be conducted. If the examiner determines that a sleep study is required, that study must be conducted. The examiner must discuss the Veteran’s allegation that his back disorder causes a loss of sleep. Following the examination the examiner must opine whether it is at least as likely as not (50 percent or greater probability) that the Veteran suffers from any sleep disorder that had its onset during, or is otherwise related to any event or injury during the appellant’s active military service. The examiner must also opine whether it is at least as likely as not (50 percent or greater probability) that any diagnosed sleep disorder is caused or aggravated by his chronic lumbar syndrome with disc degeneration. A complete and fully explanatory rationale must be provided for any opinion offered. If any opinion cannot be rendered without resorting to speculation, the examiner must state whether the need to speculate is caused by a deficiency in the state of general medical knowledge, i.e., no one could respond given medical science and the known facts, or by a deficiency in the   record or the examiner, i.e., additional facts are required, or the examiner does not have the needed knowledge or training. DEREK R. BROWN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Allen M. Kerpan, Associate Counsel