Citation Nr: 18154000
Decision Date: 11/28/18	Archive Date: 11/28/18

DOCKET NO. 16-53 251A
DATE:	November 28, 2018
REMANDED
Entitlement to service connection for obstructive sleep apnea is remanded.
REASONS FOR REMAND
The Veteran served on active duty in the United States Marine Corps from February 1969 to February 1995.
The Veteran filed a claim for “snoring” in his December 2010 VA Form 21-526, indicating the condition began in November 1982.  He was diagnosed with obstructive sleep apnea with associated arterial oxygen desaturation and loud snoring in April 2011.  See April 2011 polysomnographic report.  The Veteran contends his symptoms of obstructive sleep apnea began in service, but that it went undiagnosed due to a lack of awareness of the condition.  See February 2013 notice of disagreement, November 2016 VA Form 9, and December 2016 correspondence from the Veteran. 
Although no limb movement disorder was noted on the April 2011 polysomnographic report, the Board observes that the Veteran reported a history of arm and leg jerks during sleep.  The Veteran specifically noted an incident in service where his foot broke through a window near his bed while he was sleeping resulting in a laceration to his heel.  See November 2016 VA Form 9; see also July 1969 service treatment records.  In the November 2016 VA Form 9, he also reported that during his time in service he experienced frequent episodes of waking from sleep while kicking, flailing, or breathing heavily.  His spouse has attested to observing several years of loud snoring with stopped breathing while the Veteran sleeps.  See a March 6, 2011 statement.  To ensure VA has met its duty to assist, the Board finds it necessary to obtain a medical opinion in this matter.  
The matter is REMANDED for the following action:
1. Schedule the Veteran for an examination with a physician with appropriate expertise, to determine whether it is at least as likely as not (i.e. 50 percent or greater probability) that the Veteran’s currently diagnosed obstructive sleep apnea had its onset in, or is otherwise related to his active service.  The examiner should review the Veteran’s claims file, and take a history from the Veteran as to the progression of his claimed disability.  The examiner must consider the Veteran’s competent lay statements concerning symptoms he experienced in service, such as loud snoring and frequent episodes of waking from sleep while kicking, flailing, or breathing heavily.  Any opinion expressed should be supplemented with a supporting medical explanation.




(Continued on Next Page)
2. Readjudicate the issue on appeal with consideration of all evidence of record.  If the claim remains denied, issue a supplemental statement of the case to the Veteran and his representative. 
 
V. Chiappetta
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	B. Mask, Associate Counsel