Citation Nr: 21071789 Decision Date: 12/01/21 Archive Date: 12/01/21 DOCKET NO. 16-46 251 DATE: December 1, 2021 REMANDED Entitlement to service connection for obstructive sleep apnea (OSA) is remanded. Entitlement to service connection for hypertension is remanded. REASONS FOR REMAND The Veteran had active service from March 1994 to September 1998. These matters come before the Board of Veterans' Appeals (Board) on appeal from a June 2013 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). In April 2019, the Veteran testified before the undersigned Veterans Law Judge (VLJ). A copy of the transcript has been associated with the Veteran's electronic claims folder. All matters are remanded. In August 2019, the Board remanded the matters for further development, to include obtaining a VA examination to determine the etiology of the Veteran's claimed disabilities. In December 2019, the Veteran was afforded a VA examination where the examiner opined that the Veteran's OSA and hypertension were less likely than not related to service. Regarding the OSA, the examiner reasoned that the Veteran's OSA was more likely to have originated in his 30-pound weight gain post-service. However, the examiner does not address the Veteran's lay statements that he suffered symptoms of snoring during and post service and was directed to seek help by his ex-wife, who is a nurse. See Dalton v. Nicholson, 21 Vet. App. 23 (2007) (an examination must consider lay evidence of in-service incurrence or continuity of symptomatology since service.) Regarding the hypertension, the examiner reasoned that the Veteran's isolated incidences of elevated during service were transient and did not meet VA's criteria for hypertension. However, the examiner does not address the Veteran's lay statements that he discovered his undiagnosed hypertension shortly after his Reserve service after his discharge from active duty in 1998. Based on the foregoing, the Board finds that a remand is necessary to obtain an addendum opinion which addresses all lay statements and favorable evidence. The matters are REMANDED for the following action: Obtain an addendum opinion from the December 2019 examiner (or a suitable substitute) regarding the etiology of the Veteran's sleep apnea and hypertension. The electronic claims folder, including a copy of this remand, must be made available to the examiner for review in connection with the opinion. The examiner is requested to review the electronic claims file (and note such a review) and offer an opinion as to the following: (a) Whether it is at least as likely as not (50 percent probability or greater) that the Veteran's sleep apnea, had its onset in active service, or is otherwise related to service. The examiner's attention is directed to the Veteran's lay statements that he experienced symptoms of snoring shortly towards the end of service and post-service (in 1998) and his ex-wife, who is a registered nurse, advised him to seek treatment for possible sleep apnea. (b) Whether it is at least as likely as not that the Veteran's hypertension was incurred in or is otherwise related to service. The examiner's attention is directed to the Veteran's separation examination which shows elevated blood pressure readings. The examiner is also requested to address the Veteran's lay statements that he discovered his undiagnosed hypertension after undergoing ankle surgery shortly after discharge. The rationale for an examiner's opinion must not be based solely on the absence of treatment records during and after service. See Dalton v. Nicholson, 21 Vet. App. 23 (2007) (an examination must consider lay evidence of in-service incurrence or continuity of symptomatology since service). The matter is being returned to the examiner to address the Veteran's lay statements and other favorable evidence of record in addition to the written evidence in the claims file. A complete rationale for all opinions reached must be provided. Michael A. Pappas Veterans Law Judge Board of Veterans' Appeals Attorney for the Board L. Baskerville 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.