Citation Nr: 21067388
Decision Date: 11/04/21	Archive Date: 11/04/21

DOCKET NO. 17-29 911
DATE: November 4, 2021

REMANDED

Entitlement to service connection for obstructive sleep apnea (OSA) is remanded.

REASONS FOR REMAND

The Veteran served on active duty from June 1987 to June 2005.

In an April 2020 Joint Motion for Remand (JMR), the parties to the JMR agreed that a July 2015 examination report failed to adequately address the lay evidence of in-service excessive daytime tiredness.  As such, the Board remanded the Veteran's claim in December 2020 so that a new opinion could be obtained that addressed the lay evidence.

An opinion was obtained in January 2021.  Thereafter, however, the Veteran submitted additional evidence in July 2021.  Specifically, in addition to his own lay statement, the Veteran submitted a statement from his son, a U.S. Army medic, who recalled his father's excessive snoring when he was growing up.  The Veteran's son also noted that there were times when he would be snoring in his recliner, that he would stop all of a sudden and appear not to breath for a few seconds, then he would "violently continue back with his snoring."

Given the basis for the April 2020 JMR and the fact that the January 2021 VA opinion provider did not have the benefit of reviewing the July 2021 statement from the Veteran's son in providing his opinion, another opinion is necessary.

On remand, the Veteran should be given the opportunity to identify any outstanding pertinent records.

The matters are REMANDED for the following action:

1. Give the Veteran the opportunity to identify and/or submit any outstanding pertinent evidence that has not already been associated with the claims file. 

2. Obtain a medical opinion addressing whether the Veteran's sleep apnea had its onset during, or is otherwise related to his military service. The record must be made available to, and reviewed by the opinion provider.  The need for another examination is left to the discretion of the medical professional offering the opinion.

Following a review of the entire record, the opinion provider should address the following question:

Is it at least as likely as not (i.e., approximately 50 percent probability) that the Veteran's OSA had its onset during, or is otherwise related to, his active duty service?

In providing a response, the opinion provider is asked to consider and comment upon the Veteran's reports of excessive daytime tiredness and frequent sleep disruption during his service aboard submarines in combination with the reports of loud in-service snoring.  Additionally, the opinion provider should specifically discuss the April 2015 statement from a shipmate, M.C.D., attesting to the Veteran's in-service excessive daytime tiredness and tendency to fall asleep during the day.  Finally, the opinion provider's attention is drawn to the July 2021 statement from the Veteran's son, a U.S. Army medic, who described the Veteran's excessive snoring when he was growing up, as well as instances when the Veteran would be snoring in his recliner, that he would stop all of a sudden and appear not to breath for a few seconds, then he would "violently continue back with his snoring.

The examiner's opinion must reflect consideration of the reports as to the Veteran's history and symptomatology.  

All opinions should be supported by a medical explanation or rationale.

3. Thereafter, and after any further development deemed necessary, the appeal should be readjudicated.

 

 

V. Chiappetta

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	James R. Springer, 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.