Citation Nr: 21063443 Decision Date: 10/14/21 Archive Date: 10/14/21 DOCKET NO. 20-15 512 DATE: October 14, 2021 REMANDED Entitlement to service connection for obstructive sleep apnea, to include as secondary to service-connected posttraumatic stress disorder (PTSD), is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1978 to February 1979 with additional periods of National Guard service. This matter is before the Board of Veterans' Appeals (Board) on appeal from a November 2018 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In March 2020, the Veteran submitted VA Form 9 appealing the issue of entitlement to service connection for obstructive sleep apnea. In April 2020, the Veteran also submitted VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), noting that he would like to opt-into the modernized review system created by the Appeals Modernization Act (AMA) and appeal the same issue of entitlement to service connection for obstructive sleep apnea. Although VA received the VA Form 9 and VA Form 10182 on different dates, they were both postmarked on March 27, 2020. Therefore, in March 2021, the Board sent the Veteran a letter requesting that he clarify whether he wished to have his appeal continued under the legacy system or reviewed under the AMA system. He was informed that, if he did not submit the requested response within 60 days of the date of the letter, his appeal would be continued in the legacy system. To date, a response has not been received from the Veteran. Therefore, the Board will review his appeal under the legacy system. Entitlement to service connection for obstructive sleep apnea, to include as secondary to service-connected PTSD, is remanded. The Board finds remand for further development is required before a decision can be made on the Veteran's claim. A review of the record reflects that medical opinions addressing whether the Veteran's sleep apnea was caused or aggravated by his service-connected PTSD were obtained. However, a May 2016 private treatment record indicates that the Veteran reported that he began having sleep problems during service and that he averaged two to three hours of sleep per night. It was also noted that he was scheduled for a sleep study with the VA as he had indicated he snored and stopped breathing during sleep. Consequently, the issue of whether his sleep apnea is directly related to his service has been raised. In light of this, the Board finds remand for a medical opinion addressing whether his sleep apnea is directly related to his service, to include his reports of in-service sleep problems, is warranted. The matters are REMANDED for the following action: 1. Obtain any outstanding VA treatment records for the period from January 2020 to the present. 2. After obtaining any additional records, obtain an addendum opinion from an appropriate clinician addressing the etiology of the Veteran's sleep apnea. The Veteran's claims file must be made available to the examiner for review. An examination, including via telehealth, should only be scheduled if the examiner deems one is necessary for providing the requested opinion. Following a review of the Veteran's claims file, the examiner is asked to provide an opinion as to whether the Veteran's sleep apnea is directly related to his active duty. In providing the requested opinion, the examiner should address the May 2016 private treatment record from Dr. H.J. in which the Veteran reported that he began having sleep problems during service. A complete rationale for all opinions must be provided. If the clinician cannot provide a requested opinion without resorting to speculation, it must be so stated, and the clinician must provide the reasons why an opinion would require speculation. The clinician must indicate whether there was any further need for information or testing necessary to make a determination. Additionally, the clinician must indicate whether any opinion could not be rendered due to limitations of knowledge in the medical community at large and not those of the particular examiner. M. SORISIO Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Jiggetts 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.