Citation Nr: 21062933 Decision Date: 10/12/21 Archive Date: 10/12/21 DOCKET NO. 17-50 447 DATE: October 12, 2021 REMANDED Entitlement to service connection for sleep apnea is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1971 to August 1991. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a May 2015 rating decision by the Department of Veterans Affairs (VA) Regional Office. The RO denied service connection for sleep apnea. This claim was remanded by the Board in May 2019 for additional development and is now before the Board again. 1. Entitlement to service connection for sleep apnea is remanded. The Veteran asserts that his sleep apnea arose during or as a result of his active service. In May 2019, the Board remanded the Veteran's claim for an addendum VA medical opinion addressing the etiology of his sleep apnea. In December 2019, an addendum VA medical opinion was provided that addressed the Veteran's March 1989 service treatment record (STR) showing a snoring consult. The examiner found the condition less likely than not related to service. Their rationale was based on the Veteran only being diagnosed with snoring during service, with a diagnosis for sleep apnea only occurring in 2000, 9 years after leaving active service. In a May 2020 statement, the Veteran argued that the December 2019 VA opinion was inadequate, as it did not address a June 1988 STR that reflected a "degree of restriction, suggesting superimposed airway obstruction." The Veteran asserted that airway obstruction was evidence of sleep apnea. The Board agrees with the Veteran's argument and finds that another addendum VA medical opinion must obtained to address the June 1988 STR. The matters are REMANDED for the following action: Obtain an addendum opinion from an appropriate clinician as to the nature and etiology of the Veteran's sleep apnea. Specifically, the examiner should opine as to whether it is at least as likely as not (a 50 percent or greater probability) that the Veteran's sleep apnea is causally or etiologically due to service, including as due to claimed in-service asbestos exposure. The claims folder must be provided to the examiner for review. The examiner must state in the examination report that the claims folder has been reviewed. The examiner must consider and address the June 1988 service treatment record reflecting evidence of airway obstruction. The examiner must also address the March 1989 service treatment note showing a snoring consult. All opinions should be supported by a clear rationale, and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. A. C. MACKENZIE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board E. Hicks, Associate 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.