Citation Nr: 21004987 Decision Date: 01/28/21 Archive Date: 01/28/21 DOCKET NO. 16-22 630 DATE: January 28, 2021 REMANDED Entitlement to service connection for sleep apnea, to include secondary to service-connected major depressive disorder is remanded. REASONS FOR REMAND The Veteran had active service from January 2009 to January 2013. In March 2019, the Veteran testified at a hearing before the undersigned Veterans Law Judge. A transcript of the hearing has been reviewed. This case was previously remanded for additional development in September 2019. 1. Entitlement to service connection for sleep apnea, to include secondary to service-connected major depressive disorder, is remanded. The Veteran testified that he had sleep problems during service. In a November 2013 written statement, he indicated that he first had sleep apnea symptoms when he joined the Marine Corps in 2009. He noted that he had guard duty in service, which contributed to interrupted sleep. At his hearing, he testified that he did fire watch or guard duty during his deployment and could never get any sleep. He testified that he experienced snoring and gasping for air. VA treatment records reflect a current diagnosis of sleep apnea. A July 2019 record noted that the Veteran reported trouble sleeping, nightmares, and waking with panic attacks. Treatment records dated in February 2020 note that the Veteran reported that he had four hours of fitful sleep and could not use CPAP. The Veteran has not been afforded a VA examination. The case is being remanded for a VA examination and medical opinion addressing the etiology of sleep apnea. The matters are REMANDED for the following action: Schedule the Veteran for a VA examination for his sleep apnea. The examiner must review the claims file. The examiner is asked to provide a response to the following: (a) Is sleep apnea at least as likely as not related to service, including the Veteran’s reported symptoms of snoring and fatigue? Provide a rationale to support the opinion. In providing the requested opinion, the examiner must consider the Veteran’s description of his in-service symptoms, including snoring and gasping for air, and interrupted sleep. See March 2019 hearing transcript. (b) Is sleep apnea at least as likely as not proximately due to service-connected major depressive disorder? Provide a rationale to support the opinion. (c) Is sleep apnea at least as likely as not aggravated (i.e., worsened beyond its natural progression) by major depressive disorder? Provide a rationale to support the opinion. In providing the requested opinion, the examiner must consider VA treatment records which show that the Veteran reported that he has nightmares and panic attacks and wakes up with bad dreams and anxiety. JENNIFER HWA Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Catherine Cykowski 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.