Citation Nr: 21003451 Decision Date: 01/21/21 Archive Date: 01/21/21 DOCKET NO. 17-25 144 DATE: January 21, 2021 REMANDED Entitlement to service connection for sleep apnea is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from January 1967 to January 1970. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a May 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). As a preliminary matter, the Board notes that the Veteran testified during a video-conference hearing before the undersigned Veterans Law Judge on March 4, 2020. Unfortunately, due to technical difficulties, the recording of the hearing was lost, and a transcript of the hearing is unavailable. The Veteran initially expressed his desire for another hearing, but ultimately waived his hearing request in an October 2020 correspondence. Regrettably, additional development is necessary before the Veteran's claim for entitlement to service connection for sleep apnea can be adjudicated. The Veteran contends that his currently diagnosed sleep apnea had its onset during service or is otherwise related to active service. The Veteran has reported symptoms of sleep apnea since service. The Veteran’s service treatment records include reports of fatigue and a diagnosis for psychosomatic fatigue. The Veteran was also treated for pharyngalgia and other throat issues. The Veteran post-service records show diagnoses for obstructive sleep apnea and complex sleep apnea, as confirmed by several sleep studies. In January 2000, a uvulopalatoplasty, septoplasty, and turbinoplasty were performed in an effort to treat his sleep apnea. The Veteran was not provided a VA examination for his sleep apnea. A medical examination or medical opinion is necessary if the information and evidence of record does not contain sufficient competent medical evidence to decide the claim, but: (1) contains competent evidence of a current diagnosed disability or persistent or recurrent symptoms of a disability; (2) establishes that an event, injury, or disease occurred in service or certain diseases manifested during an applicable presumptive period for which the claimant qualifies; and (3) indicates that the disability or symptoms may be associated with the established event, injury or disease in service or with another service-connected disability. McLendon v. Nicholson, 20 Vet. App. 79 (2006). Here, the Veteran has a current diagnosis, in-service symptoms that may be associated with sleep apnea, and a significant treatment history that suggests his condition may be related to service. Accordingly, the Board finds that a remand is warranted for an examination and medical opinion addressing the nature and etiology of the Veteran's sleep apnea. The matters are REMANDED for the following action: 1. Obtain the Veteran's updated VA treatment records and associate them with the evidence of record. If possible, the Veteran himself should submit these records (if any), and any other new treatment for this problem, himself, to expedite the case. Any assistance on this issue would be appreciated. 2. Obtain an opinion from an appropriate clinician to determine the nature and etiology of the Veteran's sleep apnea. Specifically, the examiner should opine whether it is at least as likely as not (a 50 percent or greater probability) that the Veteran's sleep apnea had its onset during or is otherwise related to active service. A complete rationale for any opinions expressed should be provided. The report should set forth all complaints, findings, and diagnoses relating to the Veteran's sleep apnea and provide a rationale for all conclusions reached. If the requested opinion cannot be rendered without resorting to speculation, the examiner must state whether the need to speculate is caused by a deficiency in the state of general medical knowledge, i.e., no one could respond given medical science and the known facts, or by a deficiency in the record or the examiner, i.e., additional facts are required, or the examiner does not have the needed knowledge or training. (Continued on the next page)   3. After completion of the aforementioned, the AOJ should readjudicate the issues on appeal. If the benefit sought on appeal is not granted, then the AOJ should provide the Veteran with a supplemental statement of the case and afford him the appropriate opportunity to respond thereto. Thereafter, the case must be returned to the Board for further appellate review. John J. Crowley 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.