Citation Nr: 21000341 Decision Date: 01/05/21 Archive Date: 01/05/21 DOCKET NO. 16-09 872 DATE: January 5, 2021 REMANDED The claim for service connection for a right shoulder disability is remanded. The claim for service connection for a right knee disability is remanded. The claim for service connection for sleep apnea to include as secondary to tinnitus is remanded. The claim for service connection for chronic headaches to include migraine to include as secondary to tinnitus is remanded. REASONS FOR REMAND The Veteran had active service from January 1986 to July 1989. These matters come before the Board of Veterans’ Appeals (Board) on appeal from July 2015, September 2015 and April 2017 rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO). A video conference was held before the undersigned Veterans Law Judge (VLJ) in February 2019. In July 2019, the Board remanded the issues for further development. Regrettably, the Board’s review of the electronic claims file indicates that the RO did not substantially comply with the February 2019 remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998) (holding veterans are entitled to compliance with Board remand instructions). Accordingly, the claims are remanded to the RO for corrective action, as set forth below. 1. Service connection for a right shoulder disability The Veteran seeks service connection for residuals of a right shoulder injury. The Veteran underwent a QTC examination in February 2020; however, the examiner’s opinion relies exclusively on a lack of records showing a diagnosis or treatment during the Veteran’s service. In addition, the examiner did not consider the Veteran’s contentions. A negative opinion based solely on the lack of evidence in service treatment records is inadequate. See generally, Dalton v. Nicholson, 21 Vet. App. 23 (2007). As the opinions of record are inadequate, an addendum opinion should be obtained. 2. Service connection for a right knee disability The Veteran seeks service connection for residuals of a right knee injury. The Veteran underwent a QTC examination in February 2020; however, the examiner’s opinion relies exclusively on a lack of records showing a diagnosis or treatment during the Veteran’s service. In addition, the examiner did not consider the Veteran’s contentions. As the opinions of record are inadequate, an addendum opinion should be obtained. 3. Service connection for chronic headaches to include as secondary to tinnitus The Veteran seeks service connection for chronic headaches, to include as secondary to his service-connected tinnitus. The Veteran underwent a QTC examination in February 2020; however, the examiner’s opinion relies exclusively on a lack of records showing a diagnosis or treatment during the Veteran’s service. In addition, the examiner did not consider the Veteran’s contentions. Regarding whether the Veteran’s headaches are proximately due to or aggravated by his service-connected tinnitus, the examiner indicated that headaches would not be aggravated because they are idiopathic in nature. The Board finds this statement conclusive, as no rationale was provided. It is not clear as to why the headaches being idiopathic cannot be aggravated by tinnitus. As the opinions of record are inadequate, an addendum opinion should be obtained. 4. Service connection for sleep apnea to include as secondary to tinnitus The Veteran seeks service connection for sleep apnea, to include as secondary to his service-connected tinnitus. The Veteran underwent a QTC examination in February 2020; however, the examiner’s opinion relies exclusively on a lack of records showing a diagnosis or treatment during the Veteran’s service. In addition, the examiner did not consider the Veteran’s contentions. Regarding whether the Veteran’s sleep apnea proximately due to or aggravated by his service-connected tinnitus, the examiner did not address this contention. As the opinions of record are inadequate, an addendum opinion should be obtained. The matters are REMANDED for the following action: 1. Updated VA treatment records should be obtained and associated with the claims file/e-folder. 2. Obtain an addendum opinion from an appropriate clinician regarding whether either the Veteran’s right shoulder arthritis, right knee strain, sleep apnea or headaches is/are at least as likely as not related to an in service injury, event, or disease. See Service treatment records. The examiner should also opine on whether the Veteran’s either sleep apnea or headaches is/are at least as likely as not (1) proximately due to his service-connected tinnitus or (2) aggravated beyond its natural progression by his service-connected tinnitus. A complete rationale for proffered opinions must be provided. The rationale should reflect consideration of the pertinent evidence of record, to specifically include the lay statements by the Veteran describing the nature and onset of his symptoms. If the examiner is unable to render an opinion regarding etiology, he or she must provide a rationale as to why this is so and state whether there is additional evidence that would permit an opinion to be rendered. Nathaniel Doan Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A.D. Jackson, Counsel 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.