Citation Nr: 18161092 Decision Date: 12/28/18 Archive Date: 12/28/18 DOCKET NO. 17-05 629A DATE: December 28, 2018 REMANDED Entitlement to service connection for narcolepsy is remanded. Entitlement to service connection for obstructive sleep apnea is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1987 to January 1989. 1. Entitlement to service connection for narcolepsy is remanded. In a March 2018 letter, the Veteran reported he is receiving Social Security Administration disablity benefits due to various disabilities, including disablities related to sleeping. There is no indication in the record that VA has sought these records. A remand is required to allow VA to request these records consistent with 38 C.F.R. § 3.159 (2017).   2. Entitlement to service connection for obstructive sleep apnea is remanded. In additional to the Social Security Administration records, remand is warranted for additional examination. The evidence of record indicates the Veteran attended an in-person VA sleep apnea examination in July 2017. See July 2017 VA examination report. However, the Veteran contends this was not an in-person examination, and instead was a one to two minute phone call. The Veteran further indicated he was not alone when he took the call and did not want the person he was sitting next to hear about his health issues. See March 2018 correspondence. In the July 2017 VA examination report, the examiner noted most studies have “revealed a significant association between the psychiatric disorders (specifically depression) and sleep apnea”. However, the examiner opined the Veteran’s sleep apnea is less likely than not due to his depressive disorder, because “although there is an association between sleep apnea and depression, there is no evidence of any causal relationship that would create a medical nexus between the aforementioned conditions”. However, as noted by the Veteran’s representative, the examiner did not provide an opinion on whether the Veteran’s service connected major depression aggravated the Veteran’s obstructive sleep apnea (OSA). See August 2018 brief. Furthermore, the examiner opined the Veteran’s OSA is due to his morbid obesity, but did not opine whether it is at least as likely as not the Veteran’s service-connected major depression caused the Veteran to become or remain obese. In this regard, the Board recognizes that obesity is not a disease or disability for VA compensation purposes, but that obesity can be an “intermediate step” between a service-connected disability (major depression) and a current disability (OSA) that may be service connected on a secondary basis under 38 C.F.R. § 3.310(a). See VAOPGCPREC 1-2017. In his March 2018 letter, the Veteran reported that he lost weight, “but my depression got in the way of my weight loss, and gained the weight back and then some.” Additionally, in his March 2018 letter, the Veteran stated his belief that he had sleep apnea in service and ever since. The July 2017 VA examination report notes OSA was diagnosed in 2007, but does not address the onset of symptoms. In light of the above, remand is warranted for additional examination. The matters are REMANDED for the following action: 1. Obtain the Veteran’s federal records from the Social Security Administration. Document all requests for information as well as all responses in the claims file. 2. Obtain an opinion from an appropriate clinician regarding whether it is at least as likely as not the Veteran’s service-connected major depression caused the Veteran to become or remain obese. 3. Schedule the Veteran for an in-person examination by an appropriate clinician to determine the nature and etiology of the Veteran’s obstructive sleep apnea disability. The examiner should solicit from the Veteran why he believes sleep apnea began in service. The examiner must opine whether it is at least as likely as not related to an in-service injury or disease.   The examiner must also opine whether it is at least as likely as not (1) proximately due to service-connected disease or injury, or (2) aggravated by service-connected disease or injury. The examiner should address the Veteran’s contention that his obesity is due to his service-connected depression. H. N. SCHWARTZ Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Gregory T. Shannon, Associate Counsel