Citation Nr: 21064147 Decision Date: 10/19/21 Archive Date: 10/19/21 DOCKET NO. 18-23 001 DATE: October 19, 2021 REMANDED Service connection for sleep apnea is remanded. Service connection for an acquired psychiatric disorder, to include post-traumatic stress disorder (PTSD) and depression, is remanded. A total disability rating based on individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Army from October 1978 to August 1980. The matter is on appeal before the Board from November 2016 and October 2017 rating decisions. The Veteran provided testimony at a July 2021 Board hearing before the undersigned Veterans Law Judge. A transcript of the hearing is of record. Service Connection Sleep Apnea, Service Connection Acquired Psychiatric Disorder, and TDIU At the July 2021 Board hearing, the Veteran's representative noted that there were treatment records from the West L.A. VAMC that were not associated with the Veteran's file. The Veteran's record reflects that he has received treatment at West L.A. VAMC, however, the records only go through 2018. There are no VA treatment records associated with the Veteran's file after 2018. As such, a remand is warranted to obtain the Veteran's VA treatment records from West L.A. VAMC. The Board notes that the Veteran did submit a letter from his psychologist at West L.A. VAMC in August 2021. In the letter, it is reported that the Veteran is diagnosed with PTSD and that he receives treatment through the VA Mental Health Clinic. Additionally, the psychologist states that the Veteran's PTSD is a result of his traumatic experiences in the military, and that his symptoms have been present since his discharge from the military. As the psychologist did not indicate whether the Veteran's diagnosis is in accordance with DSM-5, nor provide any rationale with the opinion pertaining to the etiology of the Veteran's psychiatric disability, the opinion is not adequate to grant service connection for a psychiatric disability. While the opinion does not rise to the level of the appropriate standard to grant, it nevertheless indicates that the Veteran's psychiatric disability may be related to his active military service. As the Veteran has not been provided with a VA psychiatric examination, a remand is warranted to provide the Veteran with a VA examination to determine the nature and etiology of his psychiatric disabilities. The Veteran's service treatment records (STRs) show on a July 1980 Report of Medical History for discharge purposes that the Veteran checked that he was having trouble sleeping. In the Veteran's VA treatment records, an October 2011 ambulatory sleep study report provides a diagnosis of obstructive sleep apnea. At the July 2021 Board hearing, the Veteran expressed that it was his belief that his sleep apnea was related to his service because he has had trouble sleeping and breathing during his sleep since service. The Veteran has not been provided a VA examination, as such a remand is warranted to provide the Veteran with a VA examination to determine the nature and etiology of his sleep apnea. The Veteran is not currently service-connected for any disabilities, and therefore, the issue of a TDIU is intrinsically intertwined with the issues for service connection. The matters are REMANDED for the following action: 1. Obtain and associate with the Veteran's file any West L.A. VAMC treatment records from 2018 to present. 2. Schedule the Veteran for a VA examination to determine the nature and etiology of his claimed psychiatric disability. The examiner should answer the following question: (a.) Is it at least as likely as not (50 percent or greater probability) that the Veteran's claimed acquired psychiatric disability, to include PTSD and depression, was incurred in or otherwise related to his active military service? Why or why not? The examiner should take into account and discuss the Veteran's testimony at the July 2021 Board hearing, the personal statement submitted by the Veteran's sibling in August 2021, and the medical opinion submitted from the Veteran's psychologist in August 2021. If PTSD is diagnosed, the examiner should identify the stressor(s) the diagnosis is based upon. 3. Schedule the Veteran for a VA examination to determine the nature and etiology of the Veteran's claimed sleep apnea disability. The examiner should answer the following questions: Is it at least as likely as not (50 percent or greater probability) that the Veteran's claimed sleep apnea disability was incurred in or otherwise related to his active military service? Why or why not? The examiner should take into account and discuss the July 1980 Report of Medical History where the Veteran checked trouble sleeping, which is contained in the Veteran's STRs, and the testimony provided by the Veteran at the July 2021 Board hearing. MATTHEW W. BLACKWELDER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Lutgens-Staley, 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.