Citation Nr: 21066859
Decision Date: 11/02/21	Archive Date: 11/02/21

DOCKET NO. 17-63 597
DATE: November 2, 2021

REMANDED

Entitlement to service connection for obstructive sleep apnea, to include as secondary to bronchial asthma and PTSD, is remanded.

REASONS FOR REMAND

The Veteran had active service in the United States Air Force from February 1968 to November 1979.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a January 2018 rating decision by the Department of Veterans Affairs (VA); this case is in VA's legacy appeals system.

Entitlement to service connection for obstructive sleep apnea, to include as secondary to bronchial asthma and PTSD

The Board remanded this claim in May 2021 to obtain VA medical opinions on the possible relationships between obstructive sleep apnea and asthma, PTSD, and obesity, as well as the potential relationship between obesity and asthma, PTSD, and lumbosacral strain.  In August 2021, VA obtained several new medical opinions addressing these issues.  The May 2021 remand order addressing the possible connection between asthma and obstructive sleep apnea stated that the examiner should "[c]onsider all relevant evidence, including the article submitted in October 2016."  That article, Obstructive Sleep Apnea Syndrome and Asthma: What Are the Links? (Alkhalil M, Schulman E, Getsy J. Obstructive sleep apnea syndrome and asthma: what are the links?. J Clin Sleep Med. 2009;5(1):71-78.) is not mentioned or cited in any of the new opinions.  

Unfortunately, because the August 2021 VA opinion addressing the potential relationship between asthma and obstructive sleep apnea did not substantially comply with the Board's previous remand directive, another remand is required.  Stegall v. West, 11 Vet. App. 268, 271 (1998). 

The matters are REMANDED for the following action:

1. Obtain an addendum opinion on the issue of service connection for obstructive sleep apnea from the examiner who provided the August 2021 opinions, if they are available.  Otherwise obtain an opinion from any appropriate medical professional.  

The examiner should review the claims file and address the following:

Did the Veteran's service-connected asthma at least as likely as not contribute to the development of or aggravate (worsen) his sleep apnea?  If so, please express the degree of contribution or aggravation based on a percentage.  Consider all relevant evidence, including the article submitted in October 2016.

 

2. Readjudicate the issue on appeal.

 

L. M. BARNARD

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Zimmerman, Micah

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.