Citation Nr: 21005166 Decision Date: 01/29/21 Archive Date: 01/29/21 DOCKET NO. 17-60 510 DATE: January 29, 2021 REMANDED Entitlement to service connection for obstructive sleep apnea (OSA), to include as secondary to service-connected disabilities is remanded. Entitlement to an evaluation in excess of 20 percent for peripheral neuropathy of the right lower extremity is remanded. Entitlement to an evaluation in excess of 10 percent for peripheral neuropathy of the left lower extremity is remanded. Entitlement to a total disability evaluation based on individual unemployability (TDIU) due to service-connected disabilities is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1965 to August 1967. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from November 2015 and November 2017 decisions. In January 2021, the Veteran presented testimony before the Board.   Entitlement to service connection for OSA, to include as secondary to service-connected disabilities The Veteran contends, through statements and testimony, that his OSA is secondary to his service-connected posttraumatic stress disorder (PTSD), diabetes mellitus, and coronary artery disease (CAD). The Veteran was afforded a VA examination in November 2015. The examiner opined the Veteran’s OSA was not the “result of” his PTSD, diabetes, or CAD; however, the examiner failed to address whether his OSA was aggravated by those conditions. Thus, the opinion is inadequate, and the matter must be remanded for an addendum opinion. Entitlement to increased evaluations for peripheral neuropathy of the bilateral lower extremities The Veteran testified that he continues to receive treatment from VA for his peripheral neuropathy, mostly recently in December 2020. The last VA outpatient treatment records associated with the file are dated in June 2018. Any VA treatment records are within VA’s constructive possession, and are considered potentially relevant to the issues on appeal. A remand is required to allow VA to obtain them. The Veteran additionally testified that his peripheral neuropathy has worsened in severity since his last VA examination in October 2017, to include difficulty walking and requiring knee braces. Accordingly, a new VA examination is necessary to assess the current level severity of the disabilities on appeal. See Snuffer v. Gober, 10 Vet. App. 400, 403 (1997). Entitlement to a TDIU The Veteran is seeking a TDIU. In a September 2017 TDIU application, in pertinent part, the Veteran reported becoming too disabled to work in 2006 as a result of his peripheral neuropathy of the bilateral lower extremities. During his Board hearing, the Veteran testified that he could no longer perform his job as an electrician as a result of physical limitations resulting from his peripheral neuropathy. A decision on the remanded issues for service connection and increased rating, could significantly impact a decision on this issue. Thus, the matters are inextricably intertwined, and a remand of the claim is required. In addition, on remand the RO should obtain an opinion to assess the functional impairments, if any, of the Veteran’s disabilities. The matters are REMANDED for the following action: 1. Obtain the Veteran’s VA treatment records for the period from June 2018 to the present. 2. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s OSA is at least as likely as not proximately due to, the result of, or aggravated beyond its natural progression by the service-connected PTSD, CAD, and diabetes mellitus. The examiner should provide a complete rationale for all opinions provided. If an opinion cannot be provided without to resorting to mere speculation, the examiner should identify all medical and lay evidence considered in this conclusion, fully explain why this is the case and identify what additional evidence (if any) would allow for a more definitive opinion. 3. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected peripheral neuropathy of the bilateral lower extremities. The examiner should provide a full description of the disabilities and report all signs and symptoms necessary for evaluating the Veteran’s disabilities under the rating criteria. 4. Obtain an opinion from an appropriate clinician regarding the functional limitations on employability caused by the Veteran’s service-connected disabilities. The need for any additional clinical evaluations is left to the discretion of the medical professional rendering the opinion. A complete copy of the claims file must be made available to the examiner and the examination report should specifically state that a review of the record was conducted. After a thorough review of the medical and lay evidence of record, the examiner should discuss the functional effects of the Veteran’s service-connected disabilities on his ability to perform the physical and mental acts, as appropriate, required to sustain substantially gainful employment consistent with his education and occupational experience. This discussion should include both sedentary and non-sedentary labor. The examiner should provide a complete rationale for all opinions provided. If an opinion cannot be provided without to resorting to mere speculation, the examiner should identify all medical and lay evidence considered in this conclusion, fully explain why this is the case and identify what additional evidence (if any) would allow for a more definitive opinion. 5. Once the development above has been completed, the RO should review the expanded record and determine (CONTINUED ON NEXT PAGE)   whether the benefits sought may be granted. If necessary, return the issues to the Board after compliance with appellate procedures. E. I. VELEZ Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K. L. Wallin, 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.