Citation Nr: 18155701 Decision Date: 12/06/18 Archive Date: 12/04/18 DOCKET NO. 16-49 395 DATE: December 6, 2018 REMANDED Entitlement to service connection for obstructive sleep apnea, to include as secondary to service-connected posttraumatic stress disorder is remanded. REASONS FOR REMAND The Veteran served on active duty from September 2008 through September 2013. 1. Entitlement to service connection for obstructive sleep apnea, to include as secondary to service-connected PTSD is remanded. The Veteran asserts his obstructive sleep apnea is either directly related to his active duty service, or secondary to his service-connected PTSD. He was afforded a VA examination to determine the etiology of his sleep apnea in December 2013. He reported snoring loudly after returning from deployment. The examiner opined it was less likely than not that the Veteran’s sleep apnea was related to his active duty service because he did not have a current diagnosis of sleep apnea, and he did not report symptoms consistent with sleep apnea. The Board does not find the December 2013 VA examination to be adequate for rating purposes. The Veteran underwent a sleep study consultation in March 2014 and reported daytime hypersomnia and witnessed apneas. He reported a medical history of hypersomnia, hypnic jerks, and witnessed apneas since returning from Afghanistan. He also reported that the onset of these symptoms was 12 months prior. In July 2014 the Veteran underwent a sleep study and was diagnosed with moderate obstructive sleep apnea. As the Veteran has a current diagnosis of sleep apnea, and there is credible, competent evidence that he experienced symptoms such as snoring while on active duty service, he should be afforded a VA examination to determine the etiology of his obstructive sleep apnea. The matter is REMANDED for the following action: 1. Obtain the Veteran’s VA treatment records for the period from January 2015 to the present. 2. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of his obstructive sleep apnea. The examiner is to review the claims file. The examiner must opine whether it is at least as likely as not related to an in-service injury, event, or disease. In doing so, the examiner should consider the Veteran’s report of hypersomnia, hypnic jerks, and apneas during active duty referenced in the March 2014 sleep study. If the examiner determines the Veteran’s obstructive sleep apnea is not directly related to his active duty service, opine as to whether it is at least as likely as not (1) proximately due to service-connected PTSD, or (2) aggravated beyond its natural progression by service-connected PTSD. (Continued on the next page)   A rationale must be provided for any opinion offered. D. JOHNSON Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Parsons, Associate Counsel