Citation Nr: 21064496 Decision Date: 10/20/21 Archive Date: 10/20/21 DOCKET NO. 17-10 502 DATE: October 20, 2021 REMANDED Entitlement to service connection for obstructive sleep apnea (OSA), to include as a residual of multiple sclerosis (MS) or secondary to a service-connected right leg disability or psychiatric disorder, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from June 2000 to December 2004. In June 2020, the Veteran testified at a virtual hearing with the undersigned Veterans Law Judge. A transcript of the hearing is of record. In August 2020 and April 2021, these matters were remanded by the Board for further development. In the April 2021 remand, the Board requested a medical opinion regarding whether the Veteran's OSA is at least as likely as not a residual of his service-connected MS. Pursuant to the Board's remand, in a July 2021 VA medical opinion a VA examiner opined that the Veteran's OSA is not proximately due to or the result of his MS. The examiner further opined that OSA is not a residual of MS based on the fact that the Veteran consistently denied symptoms known to be associated with MS that would likely contribute to the development of OSA. However, in a September 2021 statement the Veteran contended that his OSA was either related to bilateral lower extremity weakness or to his psychiatric disorder. The Veteran also submitted an article from NIH in support of his claim that his OSA is related to his psychiatric disorder. As it remains unclear whether the Veteran has OSA that is related to his service or any service-connected disability, on remand an addendum VA medical opinion should be obtained. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). The matter is REMANDED for the following action: Obtain an appropriate addendum by an examiner, other than the July 2021 VA examiner, regarding the nature and etiology of the Veteran's OSA. Unless the examiner finds that a new examination is required, the Veteran need not be examined again. The claims file, including a copy of this remand, must be made available to the examiner for review who should indicate that the claims file was reviewed. The examiner should provide the following opinion(s): Is it at least as likely as not (50 percent probability or more) that the Veteran's OSA is (a) proximately due to or the result of the Veteran's service-connected MS, psychiatric disorder, or right leg disability, or (b) aggravated (any incremental increase in the OSA beyond its normal progression) by his service-connected MS, psychiatric disorder, or right leg disability? If it is determined that the OSA is related to any service-connected disability, to the extent possible, the examiner should indicate the approximate degree of disability or baseline before the onset of aggravation. The examiner is asked to consider and discuss as necessary the pertinent evidence of record to include the Veteran's lay statements, including those made to medical providers, September 2021 statement and articles/treatise evidence cited therein, and June 2020 testimony concerning the onset of his OSA. The Board, by this remand, makes no determination, expressed or implied, concerning the credibility of any statements on file. The addendum should include the complete rationale for all opinions expressed. KELLI A. KORDICH Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Adams, 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.