Citation Nr: 18154269
Decision Date: 11/29/18	Archive Date: 11/29/18

DOCKET NO. 16-57 776
DATE:	November 29, 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 Army from January 1979 to December 2000.
This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a January 2015 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO).  
Entitlement to service connection for obstructive sleep apnea is remanded.
The Veteran asserts that his obstructive sleep apnea was incurred during service due to duties of his military occupational specialty (MOS) as a Combat Engineer, which caused him to be deprived of adequate sleeping conditions, and that symptoms of his disorder have been continuous ever since.  See March 2015 Notice of Disagreement (NOD) and November 2016 VA Form 9.  The Veteran has a current diagnosis of obstructive sleep apnea and a lay statement from his wife indicating she witnessed his difficulty sleeping, snoring, and choking while in service that has continued post-service.  See April 2014 VA treatment record and March 2015 Disability Benefit Questionnaire (DBQ) and March 2015 Buddy Statement.  Thus, the Board finds that the low standard detailed in McLendon v. Nicholson, 20 Vet. App. 79, 83 (2006) is met and a VA examination and medical nexus opinion are warranted and should be obtained on remand.  See also 38 U.S.C. § 5103A(d); 38 C.F.R. § 3.159 (c)(4).  Any outstanding treatment records should also be secured.
The matter is REMANDED for the following action:
1. Obtain any outstanding VA treatment records.
2. With any necessary assistance from the Veteran, obtain any outstanding relevant private treatment records.
3. Then schedule the Veteran for a VA examination to determine the nature and etiology of his obstructive sleep apnea.  The claims file, including a copy of this remand, must be provided to the examiner in conjunction with the requested opinion.  All indicated tests and studies should be conducted, and all findings reported in detail.
The examiner should address the following:
For diagnosed obstructive sleep apnea (see April 2014 VA treatment record and March 2015 DBQ), please opine on whether it is at least likely as not (a 50 percent or greater probability) that such disability had its onset in service or is otherwise related to service, to include as a result of duties of the Veteran’s MOS where he asserts he was “deprived of adequate sleeping conditions.”  In addressing this question, the examiner should comment on the Veteran’s lay statements that fellow servicemembers and his wife witnessed him snoring, stop breathing, and choking while on active duty, which is corroborated in his wife’s March 2015 statement.
If a diagnosis of obstructive sleep apnea is not found, please reconcile your finding with the above cited VA treatment record and DBQ and diagnosis of the same.
4. A complete rationale must be provided for all opinions expressed.  If unable to provide a medical opinion, provide a statement as to whether there is any additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge.


 
S. BUSH
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	R. Asante, Associate Counsel