Citation Nr: 21000444 Decision Date: 01/05/21 Archive Date: 01/05/21 DOCKET NO. 16-11 759 DATE: January 5, 2021 REMANDED Entitlement to service connection for sleep apnea is remanded. REASONS FOR REMAND The Veteran served on active duty from May 1999 to December 2004. In September 2019, the Board remanded this case for additional development. The Board finds that there has been substantial compliance with the remand requests. Stegall v. West, 11 Vet. App. 268 (1998). The Veteran asserts that symptoms of obstructive sleep apnea initially manifested during service and continued after separation from service. During the April 2019 Board hearing, the Veteran testified that he snored and experienced recurrent apneic episodes during active service which continued until a post-service diagnosis of obstructive sleep apnea. The service medical records do not show any complaints of, treatments for, or diagnosis of any sleep disability. In August 2001, the Veteran reported feeling tired all of the time and in February 2003, the Veteran reported that he still felt tired after sleeping. A March 2014 medical record shows that the Veteran reported loud snoring, apneic episodes which were witnessed by his wife. In April 2014, the Veteran also reported daytime somnolence and fatigue. An April 2014 sleep study diagnosed severe obstructive sleep apnea. In August 2018, two of the Veteran’s shipmates stated that they observed loud snoring from the Veteran while in service. In a September 2018 statement, the Veteran’s brother stated that prior to service and after separation from service, he shared a bedroom with the Veteran. He stated that the Veteran did not snore prior to service, but when the Veteran returned from service, he snored loudly. A December 2019 VA examination diagnosed obstructive sleep apnea. The Veteran reported that symptoms of sleep apnea began in 2000 and included snoring and daytime sleepiness. The examiner attributed persistent daytime hypersomnolence, snoring, non-restorative sleep, and difficulty concentrating to sleep apnea. The examiner opined that a sleep disability, to include sleep apnea, was not incurred in or caused by service. As a rationale, the examiner stated that the Veteran wasn't diagnosed with obstructive sleep apnea until 2014, approximately ten years after leaving service. The Board finds that the examination did not properly consider the lay statements submitted by the Veteran and spouse regarding symptoms during and since service. The examiner also did not consider the Veteran’s complaints of feeling tired, even after sleeping, during service. Therefore, those examinations are incomplete and the claim must be remanded for further examination. The claim for service connection for sleep apnea is REMANDED for the following action: 1. Schedule the Veteran for a VA examination, conducted by a medical doctor who has not previously examined the Veteran, to determine the etiology of sleep apnea. The examiner must review the claims file and should note that review in the report. The examiner should provide the following information: (a) Confirm that the examiner is a medical doctor who has not previously examined the Veteran. (b) Opine whether it is at least as likely as not (50 percent or greater probability) that sleep apnea began in service or is related to any event, injury, or disease in service. The examiner must consider the documented complaints during service of feeling tired, even after sleep. The examiner must consider the Veteran, bother, and spouse lay statements regarding symptoms during and since service. The examiner should specifically note that sleep apnea was diagnosed as severe when first diagnosed by sleep study and should opine as to how long sleep apnea had been present prior to the diagnosis based on that severity. Harvey P. Roberts Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board E.O., Associate 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.