Citation Nr: 20021722 Decision Date: 03/26/20 Archive Date: 03/26/20 DOCKET NO. 17-14 069A DATE: March 26, 2020 REMANDED Service connection for hypertension is remanded. Service connection for otitis externa is remanded. Service connection for headaches is remanded. Service connection for sinusitis is remanded. Service connection for sleep apnea is remanded. REASONS FOR REMAND The Veteran had active service with the U.S. Army from August 1983 to January 1990. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from September 2014 and February 2017 rating decisions from the Department of Veterans Affairs (VA) Regional Office in Denver, Colorado (RO). The Veteran testified before the undersigned Veterans Law Judge in a February 2020 Travel Board hearing. A copy of the hearing transcript has been associated with the record. Entitlement to service connection for hypertension, otitis externa, headaches, sinusitis and sleep apnea, secondary to exposure VA treatment records show the Veteran has currently diagnosed chronic otitis media, headaches, obstructive sleep apnea, hypertension, and sinusitis. The Veteran was afforded a VA examinations in August 2014 and August 2016, however, the VA examiners did not address whether diagnosed otitis externa was etiologically related to active service. A September 2016 VA-contracted addendum opinion reflects that the Veteran’s reaction to jet fuel in service in the right ear in July 1985 was an isolated incident and not-ongoing, and therefore was not chronic otitis externa. At the February 2020 Travel Board hearing, the Veteran testified that he believed all of his claimed disabilities on appeal are related to his chronic exposure to industrial solvents and other chemicals that were used during the course of his normal duties as an Aircraft Mechanic in service. While service treatment records documented a specific instance of exposure to jet fuel in his right ear in July 1985, which the September 2016 VA-contracted addendum opinion relied upon for rendering a negative nexus opinion for service connection for otitis externa, the Veteran believes that his disabilities resulted from his chronic exposure to these agents in his daily activities and duties and not just the single incident. As for his claims of service connection for headaches and sinusitis, the Veteran also believes that these disabilities could have resulted from an injury to his nose that he sustained during physical training, in which a soldier elbowed him in the nose while on a run. Furthermore, the Veteran testified that he believed diagnosed obstructive sleep apnea is secondary to sinusitis, stating that his primary physician at the VA Outpatient Clinic in Colorado Springs told him that his sleep apnea was more than likely secondary to his chronic sinusitis. The Board finds that remand is necessary to associate medical treatment records from the VA Outpatient Clinic in Colorado Springs, Colorado, and thereafter, to schedule the Veteran for VA examinations for his claims of service connection for hypertension, sleep apnea, headaches and sinusitis on appeal. McLendon v. Nicholson, 20 Vet. App. 79 (2006). The Board also believes a VA addendum opinion for the claim for service connection for otitis externa is necessary to determine if the Veteran’s exposure to chemicals as an Aircraft Mechanic played a role in the etiology of his disability. The matters are REMANDED for the following action: 1. Obtain and associate with the claims file all outstanding VA treatment records, to include all VA treatment records from the VA Outpatient Clinic in Colorado Springs, Colorado. 2. Upon completion of the above development, the AOJ should refer the case for VA examinations to determine the nature and etiology of headaches, obstructive sleep apnea, hypertension, and sinusitis. The evidence of record should be made available to the examiner for review. All indicated tests and studies should be accomplished, and all clinical findings should be reported in detail. The VA examiner is asked provide the following opinions: (a) Determine whether it is at least as likely as not (a 50 percent probability or greater) that headaches, obstructive sleep apnea, hypertension, and sinusitis were incurred in or caused by active service, to include as due to chronic exposure to industrial solvents and other chemicals that were used during the course of his normal duties as an Aircraft Mechanic; and determine whether it is at least as likely as not that hypertension manifested to a compensable level within one year of service separation. As for diagnosed headaches and sinusitis, the VA examiner should consider the Veteran’s lay statements as to an in-service injury to his nose that he sustained during physical training, in which a soldier elbowed him in the nose while on a run. (b) Determine whether it is at least as likely as not (a 50 percent probability or greater) that sleep apnea was (i) caused by, or (ii) aggravated by a service-connected disability. The examiner must provide a complete explanation for his or her opinion(s), based on his or her clinical experience, medical expertise, and established medical principles. If any of the above requested opinions cannot be made without resort to speculation, the examiner must state this and specifically explain whether there is any potentially available information that, if obtained, would allow for a non-speculative opinion to be provided. 3. After the development in step 1, the AOJ should refer the case for a VA addendum opinion to determine the nature and etiology of the Veteran’s chronic otitis externa. The evidence of record should be made available to the examiner for review. The examiner is asked to determine whether it is at least as likely as not (a 50 percent probability or greater) that otitis externa was incurred in or caused by active service, to include as due to chronic exposure to industrial solvents and other chemicals that were used during the course of his normal duties as an Aircraft Mechanic. 4. After all development has been completed, the AOJ should review the claims. If the benefits sought are not granted, the AOJ should furnish the Veteran and his representative with a Supplemental Statement of the Case, and should give the Veteran a reasonable opportunity to respond before returning the record to the Board for further review. K. Parakkal Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. R. Woodarek 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.