Citation Nr: 21002905 Decision Date: 01/19/21 Archive Date: 01/19/21 DOCKET NO. 16-32 998 DATE: January 19, 2021 REMANDED Service connection for sleep apnea is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1965 to August 1967. In November 2018, the Board of Veterans’ Appeals (Board) remanded the issues of service connection for sleep apnea and sinusitis to the agency of original jurisdiction (AOJ) for VA examinations. On remand, the AOJ granted service connection for chronic sinusitis and allergic rhinitis. The sinusitis/rhinitis issue is no longer before the Board. Grantham v. Brown, 114 F.3d 1156, 1158 (Fed. Cir. 1997). The Board finds that another remand is necessary with respect to the sleep apnea issue. In July 2019, a VA examiner determined that the Veteran’s sleep apnea was less likely than not incurred in or caused by service. The examiner reasoned that the claims file is “silent for complaint, diagnosis and therapy of obstructive sleep apnea during active service,” and he was not diagnosed until 2012. The examiner offered no other rationale. The July 2019 opinion is inadequate for at least three reasons. First, it is based solely on the absence of documented sleep apnea in the Veteran’s service treatment records. Dalton v. Nicholson, 21 Vet. App. 23, 39-40 (2007). Second, the opinion does not appear to comply with the Board’s specific remand instruction to consider the August 1967 service treatment record noting a history of ear, nose, or throat trouble. Stegall v. West, 11 Vet. App. 268, 271 (1998). Lastly, because the Veteran has asserted that his sleep apnea may be secondary to his now service-connected chronic sinusitis and/or allergic rhinitis, an addendum opinion on secondary service connection is warranted. See El Amin v. Shinseki, 26 Vet. App. 136, 140 (2013) (VA medical opinions on secondary service connection must sufficiently address both causation and aggravation). The Board by this remand makes no determination, expressed or implied, concerning the credibility of any statements on file. The matter is REMANDED for the following action: 1. Obtain an addendum opinion on the etiology of the Veteran’s sleep apnea. After reviewing the claims file, including this remand, the examiner must address the following: (a.) Is it at least as likely as not (50 percent or greater probability) that the Veteran’s sleep apnea had its onset in or is otherwise etiologically related to service? (b.) Is it at least as likely as not (50 percent or greater probability) that the Veteran’s sleep apnea is proximately due to his service-connected chronic sinusitis and/or allergic rhinitis? (c.) Is it at least as likely as not (50 percent or greater probability) that the Veteran’s sleep apnea is aggravated beyond its natural clinical course by his service-connected chronic sinusitis and/or allergic rhinitis? At a minimum, the examiner’s opinion must reflect consideration of the November 1967 service treatment record noting a history of ear, nose or throat trouble. 2. Review the medical opinion above to ensure substantial compliance with the Board’s directives. Take any necessary corrective action. 3. Readjudicate the Veteran’s claim. If it remains denied, issue a supplemental statement of the case and allow the Veteran and his representative the opportunity to respond. Then return to the Board for further appellate review. KELLI A. KORDICH Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D.Z. Wall, 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.