Citation Nr: 18157172 Decision Date: 12/12/18 Archive Date: 12/11/18 DOCKET NO. 16-60 522 DATE: December 12, 2018 REMANDED Entitlement to service connection, to include on a secondary basis, for obstructive sleep apnea is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1998 to September 2006. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2015 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). Entitlement to service connection, to include on a secondary basis, for obstructive sleep apnea is remanded. The Veteran contends that his diagnosed obstructive sleep apnea is secondary to his service-connected PTSD, and/or in the alternative, due to his environmental hazardous exposure to burn pits during his active Gulf War military service. A review of the record shows that the Veteran served in Iraq from April 2003 to March 2004 and from February 2005 to January 2006. See DD Form 214. The Veteran was provided a VA examination in August 2017. The VA examiner opined that the Veteran’s obstructive sleep apnea was not secondary to a mental health condition. The examiner noted that research was mixed and inconclusive about whether sleep apnea can be caused by PTSD or other mental health disorders. The Board highlights the July 2018 appellate brief in which the Veteran’s representative asserted aggravation theory of entitlement and the August 2017 correspondence in which the Veteran reiterated his exposure to burn pits. The Board notes that the August 2017 VA examiner did not address whether the Veteran’s sleep apnea was aggravated by the service-connected PTSD and did not provide a direct etiological opinion as to whether the Veteran’s sleep apnea was related to active service, to include the claimed exposure to burn pits. Thus, a remand is warranted to obtain such opinions. Moreover, the Board notes that a September 2015 Social Security Administration (SSA) Inquiry shows the Veteran had Title II status. A review of the record does not show that attempts have been conducted to retrieve SSA records. The Board also notes that in the August 2017 correspondence, the Veteran indicated that he had filled out a burn pit registry but that the record has not been associated with the claims file. As such, on remand, any pertinent records from SSA and any additional treatment records pertaining to the Veteran’s service, to include burn pit registry should be obtained. The matter is REMANDED for the following action: 1. Take all appropriate steps to obtain all outstanding service personnel and service treatment records, to include records related to any burn pit registry, if available. 2. Contact the SSA and request any relevant records from that agency that pertain to any claim for disability benefits filed by the Veteran, to include copies of any reports of examinations arranged by that agency, medical records considered and any decisions rendered with respect to the Veteran. 3. After completion of the above, schedule the Veteran for a VA examination with an appropriate examiner to determine the nature and etiology of his obstructive sleep apnea. The claims folder should be made available to the examiner for review in connection with the examination and the examiner should acknowledge such review in the examination report or in an addendum. All necessary tests and studies should be accomplished, and complaints and clinical manifestations should be reported in detail. The examiner should provide an opinion as to the following: (a) Whether it is at least as likely as not (50 percent or greater probability) that the obstructive sleep apnea is etiologically related to the Veteran’s active service, including exposure to environment hazards in Southwest Asia, such as burn pits. (b) Whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s obstructive sleep apnea is proximately due to or caused by his service-connected PTSD. (c) Whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s obstructive sleep apnea is aggravated (permanently increased in severity beyond the natural progress of the disorder) by his service-connected PTSD. The examiner should provide a complete rationale for all opinions expressed and conclusions reached. If the examiner is unable to answer any question without resort to speculation, then he or she should so indicate and provide a rationale for why an answer could not be provided. S. HENEKS Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J. Cheng, Associate Counsel