Citation Nr: 20028075 Decision Date: 04/22/20 Archive Date: 04/22/20 DOCKET NO. 17-58 618 DATE: April 22, 2020 REMANDED The claim of entitlement to service connection for obstructive sleep apnea (OSA) is remanded. The claim of entitlement to service connection for right lower extremity restless leg syndrome (RLS) is remanded. The claim of entitlement to service connection for left lower extremity RLS is remanded. REASONS FOR REMAND The Veteran died in July 2018, during the pendency of this appeal. The appellant, his surviving spouse, has been substituted as the appellant. The Veteran submitted the instant claim in December 2016. In March 2017, he asserted that his OSA was caused by abuse he experienced during his time in Germany. He also asserted that RLS was caused by his OSA, and stated his belief that he had experienced OSA and RLS since 1973. Service connection was granted for posttraumatic stress disorder (PTSD) in October 2014, based on physical and sexual abuse the Veteran experienced during service. Considering his report of OSA and RLS since 1973, an opinion should be obtained to determine whether OSA and RLS are related to service, to include abuse experienced by the Veteran therein. Additionally, an opinion should be obtained regarding whether OSA and/or RLS were caused or aggravated by the Veteran’s service-connected PTSD. The matters are REMANDED for the following action: 1. Forward the record to a qualified clinician to obtain an opinion regarding the etiology of the Veteran’s OSA and RLS. The evidentiary record, including a copy of this remand, must be made available to and reviewed by the reviewing clinician. The reviewing clinician’s report must include a notation that this record review took place. After review of the record, the reviewing clinician should provide an opinion regarding whether it is at least as likely as not that OSA had its onset during service or was otherwise related to any incident of service, to include the assaults reported by the Veteran. The reviewing clinician should also provide an opinion with respect to whether it is at least as likely as not that the Veteran’s OSA was caused OR aggravated by his service-connected PTSD. The reviewing clinician should also provide an opinion regarding whether it is at least as likely as not that right and/or left leg RLS had its onset during service or was otherwise related to any incident of service, to include the assaults reported by the Veteran. The reviewing clinician should also provide an opinion with respect to whether it is at least as likely as not that the Veteran’s right and/or left leg RLS was caused OR aggravated by his service-connected PTSD. The reviewing clinician must accept as true the Veteran’s reports of in-service assault. In rendering these opinions, the reviewing clinician is advised that a Veteran is competent to report his symptoms and history. Such reports must be acknowledged and considered in formulating any opinion. If the reviewing clinician rejects the Veteran’s reports, he or she must provide an explanation for such rejection. The reviewing clinician is not to improperly discount the Veteran’s lay statements or mistakenly rely on an absence of medical evidence in the record to support his or her conclusions. The complete rationale for all opinions should be set forth and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. If an opinion cannot be provided without resorting to mere speculation, the reviewing clinician must provide a complete explanation for why an opinion cannot be rendered. In so doing, the reviewing clinician must explain whether the inability to provide a more definitive opinion is the result of a need for additional information, or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question. 2. Then, readjudicate the appellant’s claims, with application of all appropriate laws, regulations, and case law, and consideration of any additional information obtained as a result of this remand. If the decision remains adverse to the appellant, she and her representative should be furnished a supplemental statement of the case (SSOC) and afforded an appropriate period within which to respond thereto. DONNIE R. HACHEY Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Department of Veterans Affairs 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.