Citation Nr: 18158012
Decision Date: 12/14/18	Archive Date: 12/13/18

DOCKET NO. 16 60-586
DATE:	December 14, 2018
REMAND
Entitlement to service connection for sleep apnea, to include as secondary to service connected posttraumatic stress disorder (PTSD), is remanded.
REASONS FOR REMAND
The appellant is a Veteran who served on active duty from June 2009 to June 2013.  This matter is before the Board of Veterans’ Appeals (Board) on appeal from a December 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO).
Entitlement to service connection for sleep apnea to include as secondary to service connected PTSD is remanded
The Veteran has asserted that he suffers from sleep apnea due to service, to include as secondary to the service connected PTSD.   
Service treatment records are negative for any evidence of any complaints or treatment for sleep apnea.   
VAMC treatment records document reports of difficulty sleeping.  At a March 2015 visit the Veteran reported waking up at night due to breathing issues, and reported having had this issue since 2012.  A sleep study in August 2015 confirming mild obstructive sleep apnea. 
In June 2016, a VA medical opinion was rendered.  The VA examiner opined the sleep apnea was less likely than not proximately due to or the result of PTSD.  
The June 2016 opinion did not adequately address secondary service connection.  A supplemental opinion is required.  
The matter is REMANDED for the following action:
1. Obtain any outstanding VA and private medical records and associate these records with the claims folder.
2. Forward the Veteran’s claims file to an appropriate examiner for a supplemental opinion on the etiology of the claimed sleep apnea.  It is left to the examiner’s discretion whether to examine the Veteran.  The examiner is asked to answer the following: 
(a)	Is it at least as likely as not that the Veteran’s sleep apnea is related to his service?
(b)	Is it at least as likely as not that the Veteran’s sleep apnea was caused OR aggravated (worsened beyond its natural progression) by the service-connected PTSD? 
(c)	If aggravation is found, please identify to the extent possible the baseline level of disability prior to the aggravation and determine what degree of additional impairment is attributable to aggravation of sleep apnea, by the service-connected disability. 
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The examiner is asked to address medical records and the Veteran’s contentions, and to provide a rationale for all opinions reached.
 
H.M. WALKER
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	E. Skiouris, Associate Counsel