Citation Nr: 21065854 Decision Date: 10/27/21 Archive Date: 10/27/21 DOCKET NO. 17-06 929 DATE: October 27, 2021 REMANDED Entitlement to service connection for a respiratory condition, to include reactive airway disease and sleep apnea, as secondary to exposure to Gulf War environmental hazards is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from August 1996 to August 2002 and from September 2004 to February 2008. The Veteran testified before the undersigned Veterans Law Judge at a July 2021 Board Hearing, and the case is being adjudicated under the One Touch Program. Entitlement to service connection for a respiratory condition, to include reactive airway disease and sleep apnea, as secondary to exposure to Gulf War environmental hazards is remanded. The Veteran appeals the denial of service connection for reactive airway disease and sleep apnea. He contends that his respiratory condition started after his deployment in Iraq, due to exposure to diesel fumes and burn pits. In light of the Veteran's contention, the Board has recharacterized the Veteran's claim as entitlement to service connection for a respiratory condition, to include reactive airway disease and sleep apnea. See Clemons v. Shinseki, 23 Vet. App. 1 (2009). The Veteran was afforded a VA examination in June 2015, where he was diagnosed with respiratory airway disease. However, the examiner stated that she only reviewed the Veteran's VA treatment records, and no opinion was provided as to the etiology of his reactive airway disease. The Veteran was afforded a VA examination in December 2017 for his sleep apnea disability. The examiner opined that the Veteran's sleep apnea is less likely than not related to service. He reasoned the following: "[no] record of sleep c/o, treatment or dx in years of service indicated in his DD214 8/21/1996 TO 8/20/2002 or /29/2004 TO 2/13/2008." The Board finds the VA examination inadequate for adjudicative purposes, as the examiner relied on the lack of an in-service diagnosis for providing an opinion. See Dalton v. Nicholson, 21 Vet. App. 23, 39-40 (2007). Additionally, the examiner did not provide an opinion as to whether his sleep apnea was due to hazardous environmental exposure in Iraq and no etiology was provided for his sleep apnea. Therefore, an additional examination is warranted. The matters are REMANDED for the following action: 1. Obtain any updated treatment records and associate these records with the claims file. 2. Schedule the Veteran for an examination (or telehealth interview, review of the record, etc. if an in-person examination is not feasible) to clarify the diagnosis/es of of all existing respiratory conditions, to include reactive airway disease and sleep apnea, and their relationship to service. The claims file should be made available to and reviewed by the examiner. The examiner should opine as to whether it is at least as likely as not that any respiratory condition manifested in service or after service had its onset in service or is otherwise related to service, to include due to environmental exposures in Southwest Asia including burn pits and diesel fumes. In doing so, the examiner should consider the Veteran's March 2006 STR chest x-ray, finding minimal increased prominence of the perihilar bronchial markings without pulmonary hyperinflation "the significance of which requires clinical correlation for any history of tobacco smoking or bronchial asthma," the Veteran's testimony of wheezing and shortness of breath symptoms which started after service in Iraq, and VA's recent determination that the Veteran's service exposed him to PM25 while serving in Iraq. See Presumptive Service Connection for Respiratory Conditions Due to Exposure to Particulate Matter, 86 Fed. Reg. 42724 (Aug. 5, 2021). The examiner should also identify the criteria for diagnosing obstructive sleep apnea, and discuss whether the January 2017 spousal description of the Veteran snoring and gasping for air during his sleep, when viewed in the context of the entire record, is establishes the onset of obstructive sleep apnea in service. The examiner must provide a detailed rationale for any opinion expressed. The examiner is advised that the rationale must be pertinent to this specific Veteran, his symptoms, medical history, and circumstances. The examiner should also identify and explain the relevance or significance, as appropriate, of any history, clinical findings, medical knowledge or literature, etc., relied upon in reaching the conclusion(s). If any of the above requested opinions cannot be made without resort to speculation, the examiner must state this and provide a rationale for such conclusion. 3. Thereafter, readjudicate the claim. If any benefit sought on appeal remains denied, furnish the Veteran and his representative a supplemental statement of the case and allow an appropriate time to respond. T. MAINELLI Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Adeleke, T. 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.