Citation Nr: 20003513 Decision Date: 01/16/20 Archive Date: 01/15/20 DOCKET NO. 11-14 075 DATE: January 16, 2020 REMANDED Entitlement to service connection for a sleep disorder is remanded. REASONS FOR REMAND The Veteran served on active duty in the Navy from September 1993 to August 1997. This matter is before the Board of Veterans’ Appeals (Board) on appeal from a February 2009 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In August 2015, the Veteran testified at a Travel Board hearing conducted by a Veterans Law Judge. A transcript of the August 2015 hearing has been associated with the claims file. The VLJ who conducted the August 2015 hearing subsequently left the Board, and, in May 2017, the Veteran was sent a notice regarding the departure and her opportunity to have a new hearing with a different judge who would decide her case. The Veteran did not ask for a new hearing within 30 days of the notice. As such, pursuant to the terms of the May 2017 letter, the Board assumes the Veteran does not want to appear at another hearing and will proceed with adjudication of the appeal.  In October 2015, June 2016, and September 2017, the Board remanded the Veteran’s appeal to the RO for further evidentiary development. Entitlement to service connection for a sleep disorder is remanded. As noted above, this claim was most recently before the Board in September 2017. At that time, the Board directed the RO to obtain the Veteran’s service personnel records as there was an indication the Veteran served aboard an aircraft carrier that traveled the Persian Gulf. If the development determined that the Veteran had qualifying service in the Southwest Asia theater of operations, to include the Persian Gulf, the RO was directed to schedule the Veteran for a Gulf War General Medical Examination. The Veteran’s personnel records indicate that she served on the USS NIMITZ from May 1996 to November 1996. It remains unclear from the evidence of record whether this ship was in the Southwest Asia theater of operations while the Veteran was aboard. For purposes of 38 C.F.R. § 3.317(e), the Southwest Asia theater of operations includes the Gulf of Aden, the Gulf of Oman, the Persian Gulf, the Arabian Sea, and the Red Sea. Therefore, if the USS NIMITZ was in any of these bodies of water while the Veteran was aboard, her service would qualify under § 3.317. The Board finds that further development is needed to determine whether the USS Nimitz was in any of these bodies of water while the Veteran was aboard. If it is determined that the USS NIMITZ was in the Southwest Asia theater of operations while the Veteran was aboard, then a Gulf War General Medical Examination should be scheduled to ensure substantial compliance with the September 2017 Board remand directives. The matters are REMANDED for the following actions: 1. Complete any development necessary to determine whether the USS NIMITZ was in the Southwest Asia theater of operations, as defined in 38 C.F.R. § 3.317(e), while the Veteran was aboard from May 9, 1996 to November 27, 1996. 2. If it is determined pursuant to the development completed in item 1 that the Veteran had qualifying service under 38 C.F.R. § 3.317(e), then schedule the Veteran for a Gulf War General Medical Examination regarding the Veteran’s sleep disturbances and daytime fatigue. The examiner should respond to the following: (a.) Opine as to whether the Veteran has objective indications, as established by history, physical examination, and laboratory tests, of an undiagnosed illness or a medically unexplained chronic multi-symptom illness, manifested by sleep-related symptoms, including sleep disturbances and daytime fatigue, that has existed for six months or more or exhibited intermittent episodes of improvement and worsening over a six-month period. A “medically unexplained chronic multi-symptom illness” is defined as a diagnosed illness without conclusive pathophysiology or etiology that is characterized by overlapping symptoms and signs and has features such as fatigue, pain, disability out of proportion to physical findings, and inconsistent demonstration of laboratory abnormalities. A complete rationale for all opinions must be provided. If the clinician cannot provide a requested opinion without resorting to speculation, it must be so stated, and the clinician must provide the reasons why an opinion would require speculation. The clinician must indicate whether there was any further need for information or testing necessary to make a determination.   Additionally, the clinician must indicate whether any opinion could not be rendered due to limitations of knowledge in the medical community at large and not those of the particular examiner. M. SORISIO Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board R. Dean 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.