Citation Nr: 18156854 Decision Date: 12/11/18 Archive Date: 12/11/18 DOCKET NO. 16-61 696 DATE: December 11, 2018 REMANDED Entitlement to service connection for left eye scar is remanded. Entitlement to service connection for sleep apnea, to include as due to exposure of environmental hazards, is remanded. REASONS FOR REMAND The Veteran served in the Marine Corps from February 1, 1973, to January 31, 1977 and from March 26, 1977, to March 29, 1995. This matter is before the Board of Veterans’ Appeals (Board) on appeal from an August 2015 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in St. Louis, Missouri. Although the Board regrets the additional delay, a remand is required for further development and adjudicative action. 1. Entitlement to service connection for left eye scar is remanded. The Board cannot make a fully-informed decision on the issue of whether the Veteran’s left eye scar should be service-connected because no VA examiner has opined regarding the etiology, nature, or current state of the Veteran’s scar. A remand for 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 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). Here, the Veteran has reported symptoms of a left eye scar. See Layno v. Brown, 6 Vet. App. 465, 470 (1994) (a Veteran is competent to report on that of which he or she has personal knowledge). Additionally, in service, the Veteran was hit in the face and lost consciousness. See April 1974 Service Treatment Records. Thereafter, he had “trauma” to his “head and face”. See June 1974 Service Treatment Records. Thus, the Veteran’s claimed left eye scar may be associated with the in-service injury, and a remand is necessary. The Board finds that the evidence in this case is sufficient to indicate that the Veteran’s left eye scar may be related to his service, but is not sufficient to decide the case. 2. Entitlement to service connection for sleep apnea, to include as due to exposure of environmental hazards, is remanded. The Veteran also contends that he is entitled to service connection for sleep apnea. The Veteran’s service treatment records contain complaints of the Veteran having “difficulty in breathing through [his] nose” after incurring a deviated septum in the same altercation discussed above. See December 1975 Service Treatment Records. Post-service treatment records and examinations indicate that the Veteran complained of having fatigue after sleeping and he underwent a sleep study in March of 2014. See April 2014 VA Treatment Records. The Board cannot make a fully-informed decision on the issue of whether the Veteran’s sleep apnea should be service-connected because no VA examiner has opined regarding the etiology and nature of the Veteran’s sleep apnea. Therefore, the Board finds that the low McClendon threshold has been met and this claim must also be remanded for a VA examination. See McClendon, 20 Vet. App. 79, 81. The record also indicates that VA has not received any VA treatment records since December 2017. Any outstanding VA treatment records should also be obtained on remand. The matter is REMANDED for the following actions: 1. Associate with the claims file any outstanding VA treatment records from December 2017 through the present. 2. Following completion of step one, schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of the Veteran’s sleep apnea and left eye scar. The examiner must be provided with and review the entire claims file, to include a copy of this remand AND any outstanding treatment records. Following a review of the evidence of record, to include the Veteran’s lay statements, the examiner should opine: (a.) Whether the Veteran has any current left eye scar. If the Veteran is diagnosed with left eye scar disability, is it at least as likely as not (50 percent probability or higher), caused by or aggravated (worsened) by the Veteran’s service? The examiner is asked to reconcile, to the extent possible, the incident where the Veteran was hit in the face. (b.) Whether the Veteran’s diagnosed sleep apnea is at least as likely as not (50 percent probability or higher), caused by or aggravated (worsened) by the Veteran’s service? The examiner is asked to reconcile, to the extent possible, the Veteran’s in-service complaints of difficulty in breathing through his nose. 3. Thereafter, if the benefits sought on appeal remain denied, the Veteran and his representative should be provided a supplemental statement of the case (SSOC). After the Veteran and his representative have been given the applicable time to submit additional argument, the claims should be returned to the Board for further review. MICHAEL MARTIN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD K.Smith, Law Clerk