Citation Nr: 21064676 Decision Date: 10/21/21 Archive Date: 10/21/21 DOCKET NO. 15-38 662 DATE: October 21, 2021 REMANDED Entitlement to service connection for obstructive sleep apnea is remanded. Entitlement to service connection for hypertension, claimed as secondary to obstructive sleep apnea, is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1977 to May 1980. He also served in the Texas Army National Guard from March 1983 to January 1990, with periods of active duty, active duty for training, or full-time training duty from July 30, 1983, to August 13, 1983; June 16, 1984, to June 30, 1984; June 9, 1985, to June 23, 1985; May 31, 1986, to June 14, 1986; June 14, 1987, to June 28, 1987; July 9, 1988, to July 23, 1988; and June 18, 1989, to July 2, 1989. This matter comes to the Board of Veterans' Appeals (Board) on appeal from a rating decision issued in May 2014 by a Department of Veterans Affairs (VA) Regional Office. In July 2018, the Veteran and his spouse testified at a Board hearing before the undersigned Veterans Law Judge. A transcript of the hearing is of record. In March 2019, the Board remanded the case for additional development and, in October 2020, denied service connection for obstructive sleep apnea and hypertension. The Veteran subsequently appealed such decision to the United States Court of Appeals for Veterans Claims (Court). In August 2021, the Court granted the Veteran's and the Secretary of VA's (the parties') Joint Motion for Remand (JMR), which vacated and remanded the Board's October 2020 decision for action consistent with the JMR. The case now returns to the Board for further appellate review. 1. Entitlement to service connection for obstructive sleep apnea. In the October 2020 decision, the Board denied service connection for the Veteran's obstructive sleep apnea on the basis that the preponderance of the evidence was against a finding that such was related to his military service. In reaching such decision, the Board relied upon a November 2019 VA opinion; however, the parties to the JMR found that such opinion was inadequate to decide the claim. Specifically, the parties noted that the November 2019 VA examiner opined that the Veteran's obstructive sleep apnea was not etiologically related to his military service as "there is no medical literature to support irregular work hours as a risk factor to developing OSA" and "[o]besity is a major risk factor for OSA development." In this regard, the parties found that the examiner provided an inadequate rationale as such was general in nature and failed to address the Veteran's specific circumstances. Thus, the Board finds that a remand is warranted to obtain an addendum opinion that addresses such concerns. 2. Entitlement to service connection for hypertension, claimed as secondary to obstructive sleep apnea. The Veteran claims that he has hypertension as secondary to his obstructive sleep apnea. As the outcome of his claim for service connection for obstructive sleep apnea may affect his claim for hypertension as secondary to such disorder, the latter claim is inextricably intertwined with the former claim. Tyrues v. Shinseki, 23 Vet. App. 166, 177 (2009) (en banc); Harris v. Derwinski, 1 Vet. App. 180, 183 (1991). Thus, adjudication of the Veteran's claim for service connection for hypertension must be deferred until his claim for service connection for obstructive sleep apnea is resolved. The matters are REMANDED for the following action: Return the record, to include a copy of this Remand, to the VA examiner who rendered the opinion addressing the etiology of the Veteran's obstructive sleep apnea in November 2019. If he is not available, the record should be provided to an appropriate medical professional so as to render the requested opinion. After a review of the record, the examiner should offer an opinion as to whether it is at least as likely as not (i.e., a 50 percent or greater probability) that the Veteran's currently diagnosed sleep apnea had its onset during, or is otherwise related to, his active duty military service from June 1977 to May 1980, to include his irregular work hours and/or reports of snoring, constant tiredness, and gasping for breath. In offering such opinion, the examiner should address the specific facts pertinent to the Veteran's case. To the extent that he/she relies upon medical literature in providing an opinion, he/she should discuss how such principles relate to the Veteran. A rationale for any opinion offered should be provided. A. JAEGER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Koria B. Stanton, 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.