Citation Nr: 21064311
Decision Date: 10/19/21	Archive Date: 10/19/21

DOCKET NO. 18-12 303
DATE: October 19, 2021

REMANDED

Entitlement to service connection for sleep apnea as secondary to posttraumatic stress disorder (PTSD) is remanded.

REASONS FOR REMAND

The Veteran served on active duty from March 2004 to December 2004.

This appeal comes to the Board of Veterans' Appeals (Board) from a rating decision dated January 2018 issued by a Department of Veterans Affairs (VA) Regional Office. The Veteran timely appealed.

The Veteran's appeal has previously been before the Board. In March 2020, the Board remanded the Veteran's sleep apnea claim to the Agency of Original Jurisdiction (AOJ) for additional development.

This appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.900(c). 38 U.S.C. § 7107(a)(2).

Although the Board regrets the additional delay, the Appellant's claim must be remanded before the Board is able to make a determination on the merits.

The Veteran had a VA examination in December 2017, in which the examiner determined that the Veteran's sleep apnea was less likely than not proximately due to or the result of the Veteran's service-connected PTSD.

In its March 2020 decision, the Board remanded the Veteran's claim in order to obtain an opinion addressing the medical literature the Veteran submitted in support of his claim.

Thereafter, the Veteran was provided another VA examination in March 2020. The examiner opined that the Veteran's sleep apnea was less likely than not incurred in or caused by the in-service injury, event, or illness.

The Board notes, however, that neither VA examination addressed the issue of aggravation. Thus, while these opinions may be sufficient for causation, they are not sufficient for aggravation. Although the examiners provided rationales for their causation opinions, they did not provide any opinion or rationale regarding aggravation. Findings of "not due to," "not caused by," and "not related to" a service-connected disability are insufficient to address the question of aggravation under 38 C.F.R. § 3.310(b). See El-Amin v. Shinseki, 26 Vet. App. 136, 140 (2013); see also Atencio v. O'Rourke, 30 Vet. App. 74 (2018) (holding that causation and aggravation are independent concepts and should have separate findings and rationales).

Therefore, the Board finds that a remand is required in order to obtain an addendum opinion as to whether the Veteran's service-connected PTSD aggravated his sleep apnea.

Accordingly, the matter is REMANDED for the following action:

1. Request an addendum opinion as to whether the Veteran's PTSD aggravated the Veteran's sleep apnea. In-person examination is not required unless requested by the examiner.

Based upon a review of the entire claims file, the examiner is requested to provide an addendum opinion as to the following question:

(a.) Is it at least as likely as not (probability of 50 percent or greater) that the Veteran's PTSD aggravated (worsened beyond the natural progression) the Veteran's sleep apnea?

Explanations for all opinions must be provided. In providing the requested rationale, the examiner is asked to cite to the pertinent evidence of record, including clinical records and the Veteran's statements regarding the onset of his symptoms. 

 

K. A. KENNERLY

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	K. Minock

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.