Citation Nr: 18155031
Decision Date: 12/04/18	Archive Date: 12/03/18

DOCKET NO. 16-47 027
DATE:	December 4, 2018
REMANDED
Entitlement to service connection for insomnia to include as secondary to medications taken for treatment of service connected conditions is remanded.
REASONS FOR REMAND
The Veteran served on active duty from September 2004 to September 2008.  This matter comes to the Board of Veterans’ Appeals (Board) from a Department of Veterans Affairs (VA) Regional Office (RO) in St. Paul, Minnesota.
The Veteran has been treated for a sleep disorder since 2015.  In May 2016, a VA examiner rejected a diagnosis of insomnia, and instead diagnosed the Veteran with an “other specified sleep-wake disorder” under the DSM-V criteria.  
The Veteran has stated in lay statements that his sleep troubles began during service but that he did not report them at that time.  However, in the same opinion, the VA examiner stated that it was less likely than not that the Veteran’s condition was related to service because there was no sleep disorder diagnosed during service and because there was no diagnosis of insomnia present.
In the Appellant’s brief to the Board, the Veteran argues that he should be entitled to service connection on a secondary basis from the Veteran’s service-connected disabilities and medications taken to treat those disabilities.  No VA or private medical examination on record has addressed secondary service connection.  In order to fully adjudicate the claim, the Board requires a medical opinion regarding secondary service connection, including aggravation.  Therefore, this matter is remanded to obtain a VA examination to include an opinion on secondary service connection.
The matter is REMANDED for the following action:
1. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any sleep disorder, to include insomnia.  The examiner must opine whether it is at least as likely as not related to an in-service injury, event, or disease including secondary service connection.  
a. The examiner must address whether it is at least as likely as not that the Veteran has a sleep disorder that is (1) proximately due to any service-connected disability, or (2) aggravated beyond its natural progression by a service-connected disability.
b. The examiner must also address whether it is at least as likely as not that the Veteran’s sleep disorder is (1) proximately due to any medication taken by the Veteran to treat a service-connected disability, or (2) aggravated beyond its natural progression by any medication taken by the Veteran to treat a service-connected disability.
2. Once this is completed, the issue on appeal should be readjudicated.  If the benefit sought on appeal is denied, 
 
issue a Supplemental Statement of the Case (SSOC) to the Veteran and his representative.  

 
MICHAEL LANE
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	M. Hebert, Law Clerk