Citation Nr: 21067669 Decision Date: 11/05/21 Archive Date: 11/05/21 DOCKET NO. 14-14 917 DATE: November 5, 2021 REMANDED Entitlement to service connection for sleep apnea is remanded. Entitlement to service connection for gastroesophageal reflux disease (GERD) is remanded. Entitlement to service connection for an acquired psychiatric disorder, other than posttraumatic stress disorder, is remanded. REASONS FOR REMAND The Veteran served in the United States Army from December 1990 to June 1991. These matters come before the Board of Veterans' Appeals (Board) on appeal of a September 2010 rating decision from a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran originally requested a hearing before a Veterans Law Judge in her April 2014 VA Form 9, Appeal to Board of Veterans' Appeals. A hearing was scheduled for April 21, 2017; however, the Veteran failed to appear for this hearing. In a May 2017 written statement, the Veteran explained that she was unable to appear for her hearing due to her spouse having a medical emergency. A new videoconference hearing was scheduled for August 30, 2021, and the Veteran again failed to appear for this hearing. Because the Veteran has not requested a new hearing or shown good cause as to her failure to appear, the hearing request is deemed withdrawn. 38 C.F.R. § 20.603. Additionally, in September 2021, the Veteran's representative submitted a written Appellate Brief in lieu of a hearing, further supporting the withdrawal. REASONS FOR REMAND 1. Entitlement to service connection for sleep apnea is remanded. 2. Entitlement to service connection for gastroesophageal reflux disease (GERD) is remanded. In a September 2021 Appellate Brief, the Veteran's representative raised a new theory of entitlement for the Veteran's sleep apnea and GERD, arguing that her conditions were both proximately due to or otherwise aggravated by her service-connected PTSD. However, none of the sleep apnea or GERD examinations address whether the Veteran's conditions are either due to or otherwise aggravated by her PTSD. The Court of Appeals for Veterans Claims has found that the Board errs when it fails to address the theory of secondary service connection when such was expressly raised by the record. See DeLisio v. Shinseki, 25 Vet. App. 45, 53 (2011); see also Robinson v. Peake, 21 Vet. App. 545, 552 (2008), aff'd sub nom. Robinson v. Shinseki, 447 F.3d 355 (Fed. Cir. 2009). Therefore, because no examinations in the record address whether the Veteran's sleep apnea or GERD is secondary to her service-connected PTSD, the Board finds that a remand is necessary in order to obtain addendum opinions on these matters. 3. Entitlement to service connection for an acquired psychiatric disorder, other than posttraumatic stress disorder, is remanded. The Veteran was afforded VA Mental Health examinations in September 2010, May 2017, February 2018, and April 2020. The September 2010, May 2017, and April 2020 examinations only noted a diagnosis of PTSD, while the February 2018 examination includes a diagnosis for major depressive disorder. Additionally, the Veteran's VA treatment records contain a diagnosis of generalized anxiety disorder from August 2009. However, none of the VA examinations address whether the Veteran's major depressive disorder, generalized anxiety disorder, or any other acquired psychiatric conditions are separate diagnoses from her PTSD and, if so, whether any of these disorders are related to service. Therefore, the Board finds all of these examinations to be inadequate, and a remand is necessary in order to obtain an addendum opinion. Accordingly, these matters are REMANDED for the following action: 1. Obtain an addendum medical opinion from a qualified clinician in order to further address the nature and etiology of the Veteran's sleep apnea. If an in-person or telehealth examination is deemed necessary, one should be scheduled. The examiner is to address the following: (a.) Whether it is at least as likely as not (a 50 percent probability or greater) that the Veteran's sleep apnea is proximately due to her service-connected PTSD. (b.) Whether it is at least as likely as not (a 50 percent probability or greater) that the Veteran's sleep apnea has been aggravated by her service-connected PTSD. The examiner must specifically consider the effects of any PTSD medications on the Veteran's sleep apnea. A complete rationale is required for all opinions provided 2. Obtain an addendum opinion from a qualified clinician to determine the nature and etiology of the Veteran's GERD. If an in-person or telehealth examination is deemed necessary, one should be scheduled. The examiner is to address the following: (a.) Whether it is at least as likely as not that the Veteran's GERD is proximately due to her PTSD. (b.) Whether it is at least as likely as not that the Veteran's GERD is aggravated by her PTSD. The examiner must specifically consider the effects of any PTSD medication on the Veteran's GERD. A complete rationale is required for all opinions provided. 3. Obtain an addendum opinion from a qualified clinician to determine the nature and etiology of the Veteran's acquired psychiatric conditions other than PTSD. If an in-person or telehealth examination is deemed necessary, one should be scheduled. The examiner must provide a specific diagnosis for any psychiatric disorders found to be present in addition to, and separable from, the Veteran's current diagnosis of PTSD. For each such separately diagnosed psychiatric disability, the examiner must address the following: (a.) Whether it is at least as likely as not that the disorder is due to or otherwise related to service. (b.) Whether it is at least as likely as not that the disorder is proximately due to the Veteran's service-connected PTSD. (c.) Whether it is at least as likely as not that the disorder is aggravated by her service-connected PTSD. A complete rationale is required for all opinions provided. Caroline B. Fleming Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Gabrielle Ongies, Associate 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.