Citation Nr: 21065518 Decision Date: 10/26/21 Archive Date: 10/26/21 DOCKET NO. 17-50 217 DATE: October 26, 2021 REMANDED Entitlement to service connection for obstructive sleep apnea (OSA), as secondary to service-connected post-traumatic stress disorder (PTSD), is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from October 1984 to October 1987. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a December 2016 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). The Board remanded the matter in April 2019 for further development. 1. Entitlement to service connection for OSA, as secondary to service-connected PTSD, is remanded. The Veteran contends that his current diagnosis of OSA was caused or aggravated by his service-connected PTSD. See Sept. 2016 Fully Developed Claim; Jan. 2017 Notice of Disagreement. In April 2019, the Board remanded the matter for further development. Specifically, the Board directed the RO to schedule the Veteran for a VA examination to obtain an opinion as to whether his OSA is related to his service-connected PTSD. In October 2019, an examination request was associated with the claims file. However, this request indicated that the Veteran did not need to report for an examination regarding his claim for service connection for OSA. In November 2019, a VA examiner issued a medical opinion as to secondary service connection with a negative finding as to nexus. The examiner did not note that an in-person examination was performed. The examiner further stated that the type of examination for which the opinion was requested was "medical opinion only." A Disability Benefits Questionnaire (DBQ) for sleep apnea conditions was not associated with the claims file. The Board finds that the April 2019 Board remand directives have not been satisfied, as the claims file does not indicate that the Veteran was afforded the opportunity to undergo a complete VA examination as to his OSA condition. The Board directed the RO to schedule the Veteran for an examination, not only to obtain a medical opinion based solely on evidence associated with the claims file. Accordingly, the matter must be remanded in order to allow the Veteran to undergo a VA examination for OSA, as directed by the April 2019 remand. See Stegall v. West, 11 Vet. App. 268 (1998) (holding that a remand confers on the claimant, as a matter of law, the right to compliance with the remand order). The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA examination to determine the nature and etiology of his obstructive sleep apnea. Any indicated evaluations, studies, or tests deemed necessary by the examiner should be accomplished. The entire claims file, to include a complete copy of this REMAND, should be made available to the examiner designated to provide an opinion and the examination report should include a discussion of the Veteran's documented medical history and assertions. The examiner must address the following: (a.) Determine whether it is at least likely as not (a 50 percent probability or greater) that the Veteran's current sleep apnea is caused by his service-connected PTSD. (b.) Determine whether it is at least likely as not (a 50 percent probability or greater) that the Veteran's current sleep apnea is aggravated by his service-connected PTSD. If aggravation is found, the examiner should attempt, to the extent possible, to identify the baseline level of severity of the Veteran's sleep apnea before the onset of such aggravation, and the degree to which the aggravation is worsened by the PTSD. 2. The examiner should consider and address the Veteran's contentions that his sleep apnea is the result of military sexual trauma experienced during service and his fear of sleeping due to his PTSD and trauma. The examiner is advised that the Veteran is competent to report symptoms, treatment, and injuries and that his reports must be taken into account in formulating the requested opinions. (Continued on the next page) The examiner must provide rationale for all proffered opinions. If the examiner is unable to provide any required opinion, he or she should explain why. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation as to why this is so. If the inability to provide a more definitive opinion is the result of a need for additional information, the examiner should identify the additional information that is needed. A. S. CARACCIOLO Veterans Law Judge Board of Veterans' Appeals Attorney for the Board R. Watkins, 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.