Citation Nr: 18155276 Decision Date: 12/04/18 Archive Date: 12/03/18 DOCKET NO. 16-37 466 DATE: December 4, 2018 REMANDED Entitlement to service connection for obstructive sleep apnea is remanded. Entitlement to service connection for endometriosis is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force Reserve from February to April 2007. Although the Board regrets the delay, remand is necessary to ensure that there is a complete record on which to decide the Veteran’s claim. Specifically, the Board finds that VA examinations are needed to assess the Veteran’s claims. VA has a duty to assist claimants to obtain evidence needed to substantiate a claim. 38 U.S.C. § 5103A (2012); 38 C.F.R. § 3.159 (2017). VA’s duty to assist includes providing a medical examination when is necessary to make a decision on a claim. 38 U.S.C. § 5103A(d); 38 C.F.R. § 3.159(c)(4). Such development is necessary if the information and evidence of record does not contain sufficient competent medical evidence to decide the claim, but (1) contains competent evidence of diagnosed disability or recurrent symptoms of disability, (2) establishes that the Veteran suffered an event, injury or disease in service, or has a presumptive disease during the pertinent presumptive period, and (3) indicates that the claimed disability may be associated with the in-service event, injury, or disease, or with another service-connected disability. 38 C.F.R. § 3.159(c)(4); McLendon v. Nicholson, 20 Vet. App. 79, 83-86 (2006) (noting that the third element establishes a low threshold and requires only that the evidence “indicates” that there “may” be a nexus between the current disability or symptoms and active service, including equivocal or non-specific medical evidence or credible lay evidence of continuity of symptomatology). 1. Entitlement to service connection for obstructive sleep apnea The Veteran alleges that her obstructive sleep apnea began during service and has existed since that time. See November 2014 Notice of Disagreement. Here, the veteran has a current diagnosis of obstructive sleep apnea. Additionally, the Veteran asserts that her obstructive sleep apnea began in service and she provided a buddy statement which notes that the Veteran had trouble sleeping in service. Because there is evidence of a currently diagnosed disability, a possible in-service incurrence, and an indication that the current disability may be associated with service, remand for a VA examination is required. 2. Entitlement to service connection for endometriosis The Veteran alleges that her endometriosis began during service and has existed since that time. See November 2014 Notice of Disagreement. Here, the veteran has a current diagnosis of endometriosis. Additionally, the Veteran asserts that her endometriosis began in service and she provided a buddy statement which notes that the Veteran complained of severe pain from endometriosis during service. Because there is evidence of a currently diagnosed disability, a possible in-service incurrence, and an indication that the current disability may be associated with service, remand for a VA examination is required. This matter is REMANDED for the following actions: 1. Contact the Veteran and afford her the opportunity to identify by name, address, and dates of treatment or examination any relevant medical records. Subsequently, and after securing the proper authorizations where necessary, make arrangements to obtain all the records of treatment or examination from all sources listed by the Veteran which are not already on file. Associate with the claims file all VA records, if not already associated with the claims file. 2. After any additional records are associated with the claims file, schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of obstructive sleep apnea. The examiner should offer comments, an opinion and a supporting rationale that addresses whether it is at least as likely as not (a 50 percent probability or greater) that the Veteran’s currently diagnosed obstructive sleep apnea disorder had its onset in, was aggravated by, or is otherwise etiologically related to the Veteran’s active duty service. (Continued on the next page)   3. After any additional records are associated with the claims file, schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of endometriosis. The examiner should offer comments, an opinion and a supporting rationale that addresses whether it is at least as likely as not (a 50 percent probability or greater) that the Veteran’s currently diagnosed endometriosis disorder had its onset in, was aggravated by, or is otherwise etiologically related to the Veteran’s active duty service. A. S. CARACCIOLO Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD G. DEEMER, ASSOCIATE COUNSEL