Citation Nr: 20005263 Decision Date: 01/23/20 Archive Date: 01/22/20 DOCKET NO. 13-24 983A DATE: January 23, 2020 REMANDED Entitlement to service connection obstructive sleep apnea is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from February 1986 to February 2006. The Veteran testified at a Travel Board hearing before the undersigned Veterans Law Judge in October 2017. A transcript of the hearing is associated with the record. The Board previously remanded this case for further development in March 2018. Entitlement to service connection obstructive sleep apnea is remanded. The Board previously remanded this case to obtain a VA medical opinion on the etiology of the Veteran’s sleep apnea. The examiner was directed to consider the Veteran’s and others' lay statements, including the letter from B.B, who served with the Veteran and slept in the same tent as the Veteran while serving in Afghanistan and Iraq. These statements essentially indicated that while in service, the Veteran snored, choked and made gasping and gurgling sounds while sleeping. A medical opinion was obtained in September 2019. The examiner found that it was less likely than not that the Veteran’s sleep apnea was due to military service. However, the examiner never discussed the lay statements as directed by the Board. The Board errs when it fails to ensure substantial compliance with a Board remand. See Stegall v. West, 11 Vet. App. 268, 271 (1998). Thus, in order to comply with the Board’s remand, this case must be returned for another VA opinion. The VA examiner also stated that excessive weight and obesity are the most common cause for sleep apnea. However, the examiner did not discuss the Veteran’s weight in relation to his sleep apnea, especially given that post-service clinical records do not appear to indicate that the Veteran is excessively overweight. The matters are REMANDED for the following action: Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s sleep apnea is at least as likely as not related to service. The examiner must address whether the Veteran’s reported memory issues in service were actually manifestations of his sleep apnea due to being tired. The examiner is specifically requested to review the June 2005 EEG; the January 2007 polysomnogram; and the January 2010 sleepy study from the Sleep Disorders Center of Alabama. The examiner should discuss the Veteran’s and others’ lay statements describing his inservice symptoms, including the letter from B.B, who served with the Veteran and slept in the same tent as the Veteran while serving in Afghanistan and Iraq. The examiner should also address the indication that the Veteran’s weight is the cause of his sleep apnea.   The examiner should review the Veteran’s claims file, to include a copy of this remand, in conjunction with the opinion. Any opinions offered should be accompanied by supporting rationales L. M. BARNARD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J.N. Moats 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.