Citation Nr: 21066558
Decision Date: 11/01/21	Archive Date: 11/01/21

DOCKET NO. 18-36 726
DATE: November 1, 2021

REMANDED

Service connection for obstructive sleep apnea is remanded.

REASONS FOR REMAND

The Veteran served on active duty from March 1979 to March 1982.

This claim is on appeal to the Board of Veterans' Appeals (Board) from a February 2018 rating decision.  

In May 2021, the Veteran provided testimony at a hearing before the undersigned Veterans Law Judge, and the transcript is associated with the evidence of record.

The Veteran is claiming her obstructive sleep apnea is secondary to her service-connected posttraumatic stress disorder (PTSD).  VA treatment records confirm a current diagnosis of obstructive sleep apnea.  See October 2016 Sleep Medicine Diagnostic Study Report.

At her May 2021 hearing before the Board, her representative indicated that there were several medical studies indicating a relationship between obstructive sleep apnea and the Veteran's non-combat related PTSD.  In August 2021, the Veteran's representative submitted medical literature discussing a relationship between PTSD and sleep apnea.  Based on the foregoing, the Board finds the low-threshold requiring VA to obtain an opinion has been met, as the evidence suggests her obstructive sleep apnea may be secondary to her PTSD.   See McLendon v. Nicholson, 20 Vet. App. 79, 84 (2006).

The matters are REMANDED for the following action:

1. Obtain a medical opinion regarding the etiology of the Veteran's sleep apnea.  An in-person examination is not required unless the medical professional designated to provide the opinions finds one is necessary. 

The examiner must consider the Veteran's lay statements credible for the purposes of these opinions requested herein.  The examiner must specifically note that the lay statements of record and the medical literature of record have been considered in making a determination.

Following a review of the evidence of record, and with consideration of the Veteran's statements, please provide the following opinions:

(a)	Is it at least as likely as not (50 percent probability or higher) that the Veteran's obstructive sleep apnea is caused by her PTSD?  Why or why not?

(b)	Is it at least as likely as not (50 percent probability or higher) that the Veteran's obstructive sleep apnea is aggravated by her PTSD?  Why or why not?

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The medical professional is informed that the aggravation prong of secondary service connection analysis requires worsening of the claimed disability, but not permanent worsening of the disability.

A complete rationale for each opinion is required.  If the medical professional is unable to provide any opinion without resorting to speculation, he or she must explain why.

 

 

Jennifer White

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	O'Connell, Jessica L.

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.