Citation Nr: 21004024 Decision Date: 01/25/21 Archive Date: 01/25/21 DOCKET NO. 17-48 784 DATE: January 25, 2021 REMANDED Entitlement to service connection for obstructive sleep apnea, to include as secondary to service-connected posttraumatic sleep disorder (PTSD) is remanded. REASONS FOR REMAND The Veteran served on active duty from October 1978 to April 1988. This matter is before the Board of Veterans’ Appeals (Board) on appeal from an April 2014 rating decision from a Department of Veterans Affairs (VA) Regional Office (RO). In December 2018, the Board issued a decision which denied entitlement to service connection for sleep apnea, to include as secondary to PTSD. The Veteran appealed the Board’s decision to the United States Court of Appeals for Veterans Claims (Court). In August 2019, the Veteran and the Secretary of the Veterans Affairs (collectively, as parties) filed a Joint Motion for Remand (JMR). The Court granted the JMR in September 2019. The Board remanded the claim in April 2020. An August 2020 supplemental statement of the case was most recently issued, and the claim is once again before the Board. Entitlement to service connection for obstructive sleep apnea, to include as secondary to service-connected PTSD Pursuant to the April 2020 BVA remand, the Veteran was afforded a June 2020 examination and opinion. An additional examination and opinion were provided in August 2020. A review of the June 2020 and August 2020 opinions reflects that the VA examiners did not provide adequate opinions regarding whether the Veteran’s sleep apnea disability was aggravated by his service-connected PTSD. Because the June 2020 and August 2020 VA examiners did not substantially comply with the remand instructions, the examination reports must be returned to the examiners, or a similarly qualified medical professional, for correction. See Stegall v. West, 11 Vet. App. 268, 270-71 (1998). The matters are REMANDED for the following actions: 1. Forward the Veteran’s claims folder to an examiner for an addendum opinion regarding his sleep apnea. The examiner is requested to review the claims folder, to include this remand. Following review of the claims file the examiner must provide an opinion on the following: Whether it is at least as likely as not (a probability of 50 percent or greater) that the Veteran’s sleep apnea is aggravated by his service-connected PTSD. The term “aggravated” in the above context refers to a permanent worsening of the underlying condition, as contrasted to temporary or intermittent flare-ups of symptomatology which resolve with return to the baseline level of disability. Rationale for the requested opinion shall be provided. The examiner should also reconcile any contradictory statements contained within the August 2020 medical opinions. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation stating why this is so. In so doing, the examiner shall 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.After completing the above, and any other development deemed necessary, readjudicate the issue currently on appeal with consideration of all applicable laws and regulations. If any benefit sought on appeal remains denied, issue the Veteran and his representative a supplemental statement of the case and allow the appropriate time for response. Then, return the case to the Board. C. CRAWFORD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. M. Clark, 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.