Citation Nr: 21062807 Decision Date: 10/12/21 Archive Date: 10/12/21 DOCKET NO. 17-39 156 DATE: October 12, 2021 REMANDED Entitlement to service connection for a respiratory disorder is remanded. Entitlement to service connection for a left knee disorder is remanded. Entitlement to service connection for a right knee disorder is remanded. Entitlement to service connection for sleep apnea is remanded. REASONS FOR REMAND The Veteran had active military service from February 1971 to February 1973, and from January to May 1991. He testified before the undersigned Veterans Law Judge during a June 2021 hearing. This matter is on appeal from a June 2015 rating decision The June 2015 rating decision, and June 2017 Statement of the Case (SOC), included the issue of service connection for posttraumatic stress disorder (PTSD). The Veteran did not include that issue in his July 2017 substantive appeal, and specifically identified that he was only appealing the issues of service connection for bilateral knee disorders, sleep apnea, and a lung disorder. Therefore, the Board of Veterans' Appeals (Board) concludes that the issue of service connection for PTSD is not before it on appeal. 1. Entitlement to service connection for a respiratory disorder is remanded. The Board cannot make a fully-informed decision on the issue of service connection for a respiratory disorder because no VA examination has been provided to the Veteran to determine what respiratory disorders he has, and whether such are related to service. VA treatment records show diagnoses of chronic obstructive pulmonry disease (COPD) and "cough variant asthma." The Veteran asserted that he has a respiratory disorder related to smoke during his service in Southwest Asia. With regards to the "cough variant asthma," VA recently amdended its adjudication regulations to establish service connection for asthma in association with presumed exposures to fine particulate matter, and includes Veterans with qualifying service in the Southwest Asia theater of operations during the Persian Gulf War. See 86 Federal Register 42724 (August 5, 2021). The Veteran's personnel records confirm service in Saudi Arabia in 1991. In light of the above, remand for a VA examination is necessary. Further, the Veteran testified about receiving disability benefits from the Social Security Administration (SSA) due to his lung problems. On remand, those records should be obtained. 2. Entitlement to service connection for a left knee disorder is remanded. 3. Entitlement to service connection for a right knee disorder is remanded. The Board cannot make a fully-informed decision on the issues of service connection for bilateral knee disorders because no VA examination has been provided to the Veteran to determine what knee disorders he has, and whether such are related to service. VA treatment records show diagnoses of rheumatoid arthritis and left knee arthritis. The Veteran asserted having knee problems during service. Based on the above, remand for a VA examination is necessary. Additionally, the Veteran testified that he had left knee surgery done privately in 2003. On remand, those records should be obtained, if available. 4. Entitlement to service connection for sleep apnea is remanded. The Board cannot make a fully-informed decision on the issue of service connection for sleep apnea because no VA examination has been provided to the Veteran to determine whether it is related to service. VA treatment records show a diagnosis of obstructive sleep apnea. The Veteran asserted that his sleep apnea is due to exposures while serving in Southwest Asia. Remand for a VA examination is necessary. The matters are REMANDED for the following action: 1. In accordance with the provisions of 38 C.F.R. § 3.159(c)(1), make efforts to obtain all records identified by the Veteran, including any outstanding VA treatment records, and private treatment records for left knee surgery in 2003. 2. Obtain the Veteran's federal records from SSA. Document all requests for information as well as all responses in the claims file. 3. Schedule the Veteran for (a) VA examination(s) by an appropriate clinician(s) to determine the etiology of any diagnosed respiratory, bilateral knee, and sleep apnea disorders. (Multiple examinations may instead be conducted, and most likely are necessitated; the Board leaves this to the discretion of the Agency of Original Jurisdiction (AOJ) and the facility at which any examination is to be conducted.) The most up-to-date Disability Benefits Questionnaire(s) must be utilized. For any respiratory, bilateral knee, and sleep apnea disorders diagnosed, the examiner(s) is requested to review the record and offer an opinion as to whether it is at least as likely as not (at least an approximate balance of positive and negative evidence) that any diagnoses are related to the Veteran's military service. A complete rationale should be given for all opinions and conclusions expressed. a) For any diagnosed respiratory and sleep apnea disorders, the examiner should consider the Veteran's exposures in Southwest Asia during the Persian Gulf War. b) For any diagnosed bilateral knee disorders, the examiner should consider the Veteran's testimony of knee problems during service. A. C. MACKENZIE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board L. Barstow, 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.