Citation Nr: 21064428 Decision Date: 10/20/21 Archive Date: 10/20/21 DOCKET NO. 18-49 414 DATE: October 20, 2021 REMANDED Service connection for sleep apnea is remanded. REASONS FOR REMAND The Veteran served honorably on active duty in the United States Navy from September 1971 to September 1995. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a June 2018 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran attended a virtual hearing before the undersigned in March 2021. Sleep Apnea At his March 2021 hearing, the Veteran testified that during service he reported multiple times that he had trouble with fatigue. A review of his service treatment records confirms this with reports of fatigue in November 1988, June 1989, and April 1994. Furthermore, in his June 1995 separation examination questionnaire, the Veteran had a question about his bad snoring asking if it can be treated. The Veteran also submitted a January 2018 statement from his wife stating that during the Veteran's service he would loudly snore, occasionally stop breathing in his sleep, and had a tendency to doze off while driving. No VA examiner has opined whether the Veteran's sleep apnea began during active service. As such, a remand is necessary to obtain an addendum opinion. In May 2018, the Veteran underwent a VA examination for his claim. The examiner opined that it was less likely than not that the Veteran's sleep apnea was proximately due to or the result of the Veteran's service-connected hypertension. This opinion is inadequate as the examiner did not opine if the Veteran's sleep apnea was aggravated beyond its natural progression by his hypertension. Furthermore, the examiner's rationale for their opinion states that hypertension is not a known risk factor for sleep apnea. This conflicts with evidence submitted by the Veteran stating that hypertension is a risk factor for developing sleep apnea. As such, a remand is necessary to obtain an adendum opinion. The matter is REMANDED for the following actions: (Continued on the next page) 1. Obtain an addendum opinion regarding whether the Veteran's sleep apnea at least as likely as not began during service. The Board draws to the clinician's attention the January 2018 statement from the Veteran's wife reporting that he loudly snored and would occasionally stop breathing in his sleep during his service. The Board also draws to the clinician's attention service treatment records dated November 1988, June 1989, April 1994, and June 1995 where the Veteran reported fatigue and his snoring problem. The rational for the opinion must be provided. 2. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran's sleep apnea is at least as likely as not proximately due to his service-connected hypertension or aggravated beyond its natural progression by his service-connected hypertension. The Board draws to the clinician's attention evidence submitted by the Veteran stating that hypertension is a risk factor in developing sleep apnea. The rationale for the opinion must be provided. JOHN Z. JONES Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Michael Chandeck, 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.