Citation Nr: 18152719
Decision Date: 11/27/18	Archive Date: 11/23/18

DOCKET NO. 16-20 297
DATE:	November 27, 2018
REMANDED
Entitlement to service connection for obstructive sleep apnea (OSA), to include as secondary to the service-connected psychiatric disability, is remanded.
REASONS FOR REMAND
The Veteran had active duty service from October 1965 to October 1968, from January 1983 to May 1983, from March 1991 to January 1992, from November 1997 to March 1998, and from August 1998 to January 2003.
This matter comes before the Board of Veterans’ Appeals (Board) on appeal from the December 2014 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO).
The Veteran maintains that his OSA was either directly incurred in service or, alternatively, is secondary to his service-connected psychiatric disability.  
Evidence from the Crestwood Medical Center, dated in June 2014, includes a polysomnography test showing that the Veteran was diagnosed with OSA.
In a November 2018 brief, submitted by the Veteran’s representative, medical literature was referenced that suggested some relationship between OSA and major depressive disorder and posttraumatic stress disorder (PTSD).  The Veteran is currently service-connected for adjustment disorder with depressed mood (also claimed as PTSD).  Further, the Veteran submitted statements from fellow servicemembers which indicate that they witnessed the Veteran’s loud snoring in service.  
The Veteran has not been afforded a VA examination regarding the etiology of his OSA.  As such, a remand is required. 
The matter is REMANDED for the following actions:
1. Schedule the Veteran for a VA examination to determine the nature and etiology of his currently diagnosed obstructive sleep apnea.  The examiner must review the Veteran’s claims file.  All clinical findings must be reported in detail and correlated to a specific diagnosis.  The examiner should then address the following:
(a.) State whether it is at least as likely as not (50 percent or greater probability) that the currently diagnosed sleep apnea is related to service.  (NOTE: the examiner should discuss lay statements provided by the Veteran’s fellow servicemembers indicating that they witnessed the Veteran’s loud snoring during service).
(b.) State whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s sleep apnea is either caused or aggravated by the Veteran’s service-connected psychiatric or physical disabilities.
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The VA examiner is requested to provide a rationale for any opinion provided.
 
LAURA E. COLLINS
Acting Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	R. Casadei, Counsel