Citation Nr: 20003282 Decision Date: 01/14/20 Archive Date: 01/14/20 DOCKET NO. 19-14 379 DATE: January 14, 2020 REMANDED Entitlement to service connection for sleep apnea, to include as secondary to service-connected posttraumatic stress disorder (PTSD), is remanded. REASONS FOR REMAND The Veteran had active service from September 2008 to February 2012. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an October 2017rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Nashville, Tennessee. Sleep Apnea As the Veteran’s lay statements, service treatment records, and VA treatment records indicate that the Veteran’s disability may be related to service, the Board finds that a medical examination with an opinion is necessary to decide the claim. 38 C.F.R. § 3.159(c)(4); McLendon v. Nicholson, 20 Vet. App. 70 (2006). Specifically, service treatment records as recent as early 2012 reflect complaints of poor sleeping at night, and there is a current diagnosis of obstructive sleep apnea for which the Veteran is using a CPAP machine. The Board therefore finds that a remand is warranted to afford the Veteran a VA examination so as to determine the nature and etiology of his obstructive sleep apnea. The Veteran should also be given an opportunity to provide a lay statement by a family member and/or former fellow service member who have knowledge of the Veteran’s snoring and other sleeping problems since his discharge from service to the present. The matters are REMANDED for the following action: 1. Give the Veteran an opportunity to Schedule the Veteran for a VA examination to deter provide a lay statement by a family member and/or former fellow service member who have knowledge of the Veteran’s snoring and other sleeping problems since his discharge from service to the present. 2. After the Veteran has had a reasonable period of time to obtain a lay statement in response to directive number 1, schedule the Veteran for a VA examination to determine the nature and etiology of his sleep apnea. The claims file must be made available to the examiner, and the examiner must specify in the examination report that these records have been reviewed. The examiner is asked to opine as to whether it is as least as likely as not (50 percent probability or more) that the Veteran’s sleep apnea had its onset in service or is otherwise the result of an incident in service. The examiner is also asked to opine as to whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s sleep apnea was caused or aggravated by his PTSD. Aggravation is defined for these purposes as a worsening of the underlying condition versus a temporary flare-up of symptoms. If the examiner finds that the Veteran’s sleep apnea disability has been permanently aggravated/worsened by his service-connected condition, the degree of worsening should be identified. The examiner should consider all evidence, including lay statements, medical records, and other medical opinions of record. Any opinions offered should be accompanied by a clear rationale consistent with the evidence of record. Michael J. Skaltsounis Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Daniels, Associate Attorney The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.