Citation Nr: 20021040 Decision Date: 03/24/20 Archive Date: 03/24/20 DOCKET NO. 16-53 703 DATE: March 24, 2020 REMANDED Service connection for obstructive sleep apnea is remanded. REASONS FOR REMAND The Veteran had active duty service in the United States Navy from July 1984 to October 1984 and April 1987 to September 1988. The issue is on appeal from a February 2015 rating decision. Service connection for obstructive sleep apnea (OSA) is remanded. This issue was previously remanded by the Board of Veterans’ Appeals (Board) in November 2019 where, in pertinent part, the regional office (RO) was instructed to schedule a VA examination to discuss the etiology of the Veteran’s OSA. In February 2020, the Veteran’s representative submitted a statement that the Veteran had reached out to reschedule a Board mandated VA examination. The Veteran was subsequently rescheduled. However, the Veteran then received a telephone call from the RO that further development was needed so he would again need to be rescheduled. Rather than receiving notice of his next rescheduled VA examination appointment, the Veteran received a supplemental statement of the case (SSOC) in December 2019, continuing the denial of service connection for OSA because he had not shown up for his VA examination. In light of this statement, the Board finds another remand is necessary so that the Veteran may be afforded a VA examination for his OSA service connection claim. The Board notes that VA’s duty to assist includes providing a medical examination when it is necessary to make a decision on a claim. 38 U.S.C. § 5103A (d); 38 C.F.R. § 3.159. Such development is necessary if the information and evidence of record does not contain sufficient competent medical evidence to decide the claim, but (1) contains competent evidence of diagnosed disability or symptoms of disability, (2) establishes that the Veteran suffered an event, injury or disease in service, or has a presumptive disease during the pertinent presumptive period, and (3) indicates that the claimed disability may be associated with the in-service event, injury, or disease, or with another service-connected disability. 38 C.F.R. § 3.159 (c)(4); McLendon v. Nicholson, 20 Vet. App. 79, 83-86 (2006). The threshold for finding a link between a current disability and service so as to require medical examination is low. See generally Locklear v. Nicholson, 20 Vet. App. 410 (2006); McLendon, 20 Vet. App. at 83. The Board also notes that the duty to assist is not a one-way street; a claimant cannot stand idle and fail to cooperate. Wood v. Derwinski, 1 Board. App. 190 (1991). A VA examination is needed as private medical records reveal the Veteran was diagnosed with depression in February 2012 and OSA in February 2014. During the Veteran’s July 2019 hearing, his representative submitted medical articles regarding a link between OSA and comorbid psychiatric conditions including mood disorders and anxiety disorders. The Board notes that the Veteran is service-connected for adjustment disorder with mixed disturbance of emotions and conduct. Therefore, a VA examination should be scheduled for the etiology of the Veteran’s OSA. The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA examination. The examiner is asked to opine on whether the Veteran’s OSA was caused or aggravated (permanently increased in severity beyond the natural progress of the condition) by the service-connected adjustment disorder with mixed disturbance of emotions and conduct. If aggravation is found, the examiner should identify the baseline level of severity of the nonservice-connected disability to the best extent possible. The examiner is asked to consider and address the two medical articles submitted by the Veteran’s representative: (1) “Obstructive Sleep Apnea and Posttraumatic Stress Disorder among OEF/OIF/OND Veterans” and (2) “Treatment of OSA with CPAP is Associated with Improvement in PTSD symptoms among Veterans.” The examiner should submit complete rationale for any opinions reached. 2. Readjudicate the appeal. L. M. BARNARD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Lee 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.