Citation Nr: 21067561
Decision Date: 11/04/21	Archive Date: 11/04/21

DOCKET NO. 16-50 003A
DATE: November 4, 2021

REMANDED

Service connection for sleep apnea.

REASONS FOR REMAND

Additional development is necessary to decide the issue on appeal.  Specifically, a July 2021 VA medical opinion adequately addressed the issue of direct service connection but did not address secondary service connection which had been raised by the record.  

Specifically, in a May 2019 VA clinical record, the Veteran claimed that sleep apnea symptoms began after his diagnosis of service-connected Guillain-Barre syndrome (GBS) in 1990.  In the May 2021 informal hearing presentation (IHP), he claimed that all his disabilities then on appeal, to include sleep apnea, were the result of GBS and GBS treatment. 

Similarly, in a June 2019 claim for compensation, the Veteran stated that sleep apnea was caused by his service-connected psychiatric disability.  In April 2019, a treating medical professional stated that sleep apnea was due to his long-standing depression; however, no rationale was provided.  Nonetheless, it triggers VA's duty to assist in obtaining a medical opinion for secondary service connection.  Therefore, a new medical opinion is required.

The matter is REMANDED for the following actions:

1. Obtain all outstanding VA medical records and associate them with the claims file.

2. Refer the claims file to a clinician to address the following:

	Is it at as likely as not (a 50 percent probability or greater) that sleep apnea is proximately due to service-connected Guillain-Barre syndrome?

	Is it as likely as not (a 50 percent probability or greater) that sleep apnea was aggravated beyond its normal course by service-connected Guillain-Barre syndrome?

	Is it at as likely as not (a 50 percent probability or greater) that sleep apnea is proximately due to service-connected adjustment disorder with anxiety and depression?

	Is it as likely as not (a 50 percent probability or greater that sleep apnea was aggravated beyond its normal course by service-connected adjustment disorder with anxiety and depression?

All opinions must be accompanied by a well-reasoned rationale.

 

3. If the clinician determines that an examination is necessary in order to provide the requested opinions, then one should be scheduled.

 

 

L. HOWELL

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Brendan Evans, 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.