Citation Nr: 21070170 Decision Date: 11/23/21 Archive Date: 11/23/21 DOCKET NO. 17-25 001 DATE: November 23, 2021 REMANDED Entitlement to service connection for a sleep disorder, to include insomnia is remanded. REFERRED The issue of entitlement to service connection for obstructive sleep apnea was raised is by the record and is referred to the Agency of Original Jurisdiction (AOJ) for adjudication. REASONS FOR REMAND The Veteran served on active duty from July 1964 to May 1967. This matter comes before the Board of Veterans' Appeals (Board) on appeal of a May 2014 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). The Board previously remanded this case for additional development in February 2020 and June 2021. The matter has now returned to the Board for review. In October 2019, the Veteran testified at a Board hearing before a Veterans Law Judge who is no longer available to participate in the adjudication of the appeal. A transcript of that hearing is of record. The appellant was sent notice in September 2021 that the Veterans Law Judge was no longer available and that he had the right to a new hearing prior to a decision. The Veteran did not respond to the letter within the required time period; thus, the Board deems that the Veteran has waived his right to a hearing; thus, adjudication may proceed. Entitlement to service connection for a sleep disorder, to include insomnia, is remanded. The Board cannot make a fully-informed decision on the issue of entitlement to service connection for a sleep disorder, including insomnia. In the June 2021 Board remand, the Board directed the RO to obtain an addendum opinion regarding entitlement to service connection for a sleep disorder, to include insomnia. The opinion obtained had nothing to do with the Board's remand orders. As there has not been substantial compliance with the Board's remand directives, the matter must be remanded. Stegall v. West, 11 Vet.App. 268, 271 (1998). The matter is REMANDED for the following action: (Note, this appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.900(c). Expedited handling is required.) 1. Update the Veteran's VA treatment records. 2. Obtain an addendum opinion from a mental health professional to address the nature and etiology of insomnia. The examiner must review the electronic claims and note such review in each examination report. All tests deemed necessary should be conducted and the results reported in detail. Following a review of the claims file, the examiner is to address whether it is at least as likely as not (probability of 50 percent or greater) that the Veteran's sleep disorder had its onset or is otherwise etiologically related to the Veteran's period of active service. The examiner is to address whether it is at least as likely as not (probability of at least 50 percent) that the Veteran's sleep disorder is either proximately due to (caused by) or aggravated (chronically worsened beyond normal progression) by the Veteran's service-connected bilateral hearing loss and tinnitus. A medical opinion regarding secondary service connection must address both causation and aggravation, or it will be deemed inadequate. Full rationales for the opinions must be provided. Jennifer White Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Susan Leary 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.