Citation Nr: 21072385 Decision Date: 12/03/21 Archive Date: 12/03/21 DOCKET NO. 17-44 197 DATE: December 3, 2021 REMANDED Entitlement to service connection for right upper extremity neuropathy is remanded. Entitlement to service connection for a right hip disorder is remanded. Entitlement to service connection for sleep apnea is remanded. REASONS FOR REMAND The Veteran had active service in the Air Force from September 1969 to January 1991. The appeal originates from a December 2013 decision of a Department of Veterans Affairs (VA) Regional Office. The Veteran appeared for a hearing before the undersigned in January 2021. 1. Entitlement to service connection for right upper extremity neuropathy is remanded. With respect to the right upper extremity, the Board notes that the December 2013 rating decision confirmed and continued a prior denial of service connection for muscle spasm of the right shoulder in addition to neuropathy. In the November 2014 notice of disagreement, the Veteran limited his appeal for the right upper extremity, specifying that he was only appealing the issue of neuropathy. Initially, the Board notes that there appear to be outstanding VA treatment records. In February 2017, VA requested treatment records since 1994 as identified by the Veteran. However, it does not appear that these records were obtained or any further action taken. The Veteran contends that he has neuropathy of the right upper extremity potentially from an in-service athletic injury. See January 2021 Hearing Transcript. While VA made a formal finding of unavailability of the Veteran's complete service treatment records in December 2016, the record does contain a selection of them provided by him. A September 1990 retirement examination reflects normal evaluation of the neurologic system and upper extremities, and he denied a history of neuritis on a contemporaneous report of medical history. The Veteran was afforded a VA examination in February 2017. The examiner identified intermittent pain, paresthesias, and numbness of the right upper extremity but did not diagnose radiculopathy or a peripheral nerve condition. Instead, the examiner suggested that the Veteran may have cervical radiculopathy based on May 2007 neurological testing. As additional VA treatment records may be added to the file, an addendum should be obtained accounting for any new evidence and the symptoms noted on the February 2017 examination. 2. Entitlement to service connection for a right hip disorder is remanded. The Veteran contends that he has a right hip disorder with its onset in service or secondary to pain and altered gait from his service-connected left knee osteoarthritis. See August 2017 Form 9; January 2021 Hearing Transcript. He was afforded a VA examination in September 2013 and diagnosed with right hip osteoarthritis status-post total arthroplasty. The examiner provided an opinion addressing direct service connection but not secondary service connection. An addendum should be obtained. 3. Entitlement to service connection for sleep apnea is remanded. The Veteran contends that the initial symptoms of sleep apnea (snoring and dry mouth) first manifested in service. See January 2021 Hearing Transcript. Private treatment records indicate a diagnosis of obstructive sleep apnea. He contends that the symptoms have been persistent over many years. Accordingly, he should be afforded a VA examination. The matters are REMANDED for the following action: 1. Obtain VA treatment records since 1994 per the February 2017 VA Form 21-6789. 2. Then, request an addendum from the February 2017 peripheral nerves examiner. The examiner is asked to address the following: a. Specify whether the Veteran has peripheral neuropathy or radiculopathy of the right upper extremity. If a diagnosis is not made, reconcile the finding with the February 2017 examination indicating intermittent pain, paresthesias, and numbness, as well as the May 2007 neurological evaluation. b. For any diagnosis, is it at least as likely as not that the disorder had its onset in service or within a year of service discharge or is otherwise etiologically related to active service? 3. Then, request an addendum from the September 2013 hip examiner. The examiner is asked to address the following: a. Is it at least as likely as not that a right hip disorder had its onset in service or within a year of service discharge or is otherwise etiologically related to active service? b. Is it at least as likely as not that a right hip disorder was proximately caused by service-connected left knee osteoarthritis, including pain or altered gait? c. Is it at least as likely as not that a right hip disorder underwent any incremental increase in disability, regardless of its permanence, due to service-connected left knee osteoarthritis, including pain or altered gait? 4. Then, schedule the Veteran for a sleep apnea examination. The examiner is asked to opine whether it is at least as likely as not that sleep apnea had its onset in or is otherwise etiologically related to active service. The examiner should address the reported lay history of symptoms such as snoring and dry mouth in service. MICHAEL A. HERMAN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Alhinnawi 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.