Citation Nr: 21072874 Decision Date: 12/06/21 Archive Date: 12/06/21 DOCKET NO. 14-23 264 DATE: December 6, 2021 REMANDED Entitlement to service connection for an upper back disability, to include as due to in-service exposure to electromagnetic fields (to include high voltage power lines and high frequency radios), is remanded. Entitlement to service connection for chronic fatigue, to include as due to in-service exposure to electromagnetic fields (to include high voltage power lines and high frequency radios), is remanded. Entitlement to service connection for sleep apnea, to include as due to in-service exposure to electromagnetic fields (to include high voltage power lines and high frequency radios), is remanded. Entitlement to service connection for residuals of Guillain-Barre Syndrome, to include as due to in-service exposure to electromagnetic fields (to include high voltage power lines and high frequency radios), is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1947 to July 1949. This matter comes before the Board on appeal from a June 2012 Regional Office (RO) rating decision. In May 2015, the Veteran testified at a hearing before the undersigned Veterans Law Judge. These claims were previously denied by the Board in September 2015. The Veteran appealed the Board's decision to the United States Court of Appeals for Veterans Claims (Court) which, by order dated April 2017, granted a Joint Motion for Remand, vacated the Board's decision, and remanded the matter for compliance with the instructions in the Joint Motion. In October 2017, the Board remanded these claims for additional development, and the case was returned to the Board for further review. These claims were subsequently denied by the Board in an August 2019 decision. The Veteran appealed the Board's decision to the Court which, by order dated February 2021, granted a January 2021 Joint Motion for Remand, vacated the Board's decision, and remanded the matter for compliance with the instructions in the Joint Motion. The Board remanded this case for additional development in July 2021, and the case has been returned to the Board. 1. Entitlement to service connection for an upper back disability, to include as due to in-service exposure to electromagnetic fields (to include high voltage power lines and high frequency radios), is remanded. 2. Entitlement to service connection for chronic fatigue, to include as due to in-service exposure to electromagnetic fields (to include high voltage power lines and high frequency radios), is remanded. 3. Entitlement to service connection for sleep apnea, to include as due to in-service exposure to electromagnetic fields (to include high voltage power lines and high frequency radios), is remanded. 4. Entitlement to service connection for residuals of Guillain-Barre Syndrome, to include as due to in-service exposure to electromagnetic fields (to include high voltage power lines and high frequency radios), is remanded. The July 2021 Board remand noted, in relevant part, that the January 2021 Joint Motion had determined that remand was necessary because the Board failed to obtain the Veteran's complete records from the VA Medical Center (VAMC) in Minneapolis, Minnesota. The Joint Motion noted that "The record also indicates that Appellant was seen at that facility as early as 1995," but that "the record now before the Court contains records from the Minneapolis VA Medical Center dating no earlier than 2007." The Board thus remanded to attempt to obtain these records. The Veteran's VA medical records contain a July 2021 record entitled "ARCHIVED PAPER RECORDS" that notes the following: VistA Imaging Scanned Document ARCHIVED PAPER RECORDS Records dated 1994-1998 from VA paper charts that have been retired/archived to an off-site storage facility. Open Vista Imaging Display to view. The Board notes that it does not have access to documents scanned into VistA Imaging and that these documents have not been separately added to the claims file. Therefore, a remand is required in order to add the VistA Imaging records to the claims file for Board review. In addition, with respect to the sleep apnea claim specifically, the July 2021 Board remand noted that the January 2021 Joint Motion also determined there was a deficiency in the March 2019 VA examination report that must be addressed. The Joint Motion noted that "the medical examiner noted that in October 2006 Appellant had been diagnosed with moderate to severe sleep obstructive apnea, based on a sleep study." The Joint Motion notes that "The examiner also noted that Appellant underwent a sleep study in April 2016, which was negative for sleep apnea." The examiner noted "that Appellant did not currently have any finding, signs, or symptoms attributable to sleep apnea" and determined that no current diagnosis of obstructive sleep apnea was warranted. The Joint Motion objected that "the examiner did not discuss how he concluded that Appellant did not have a current diagnosis of sleep apnea, particularly in light of Appellant's 2006 diagnosis of moderate to severe sleep apnea." The July 2021 Board remand determined that a new opinion needed to be obtained that addresses this deficiency. The resulting July 2021 VA medical opinion concludes that "The condition claimed was less likely than not (less than 50% probability) incurred in or caused by the claimed in-service injury, event or illness." The rationale was as follows: "To date there is no medical evidence exposure to electromagnetic fields to include high voltage power lines and high frequency radios, causes or is a significant risk factor for sleep apnea." The VA examiner cited multiple articles to support her conclusion. The opinion does not, however, address the question of whether the Veteran has a current diagnosis of sleep apnea, and it does not discuss the conflicting indications of record. On remand, an addendum opinion should be obtained that addresses this specific aspect of the sleep apnea claim. The matters are REMANDED for the following action: 1. Obtain all relevant VA and private treatment records not currently associated with the claims file, to include any VA medical records that were created since the Veteran's records were last obtained. Specifically, associate the following records with the claims file: Records dated 1994-1998 from VA paper charts that have been retired/archived to an off-site storage facility. Open Vista Imaging Display to view. 2. Obtain an addendum opinion to the July 2021 VA medical opinion that addresses the following question: Does the Veteran have a current diagnosis of sleep apnea? When making this determination, please discuss and reconcile the following documents: (a) The March 2019 VA examination report, which noted "that Appellant did not currently have any finding, signs, or symptoms attributable to sleep apnea" and determined that no current diagnosis of obstructive sleep apnea was warranted. The Joint Motion objected that "the examiner did not discuss how he concluded that Appellant did not have a current diagnosis of sleep apnea, particularly in light of Appellant's 2006 diagnosis of moderate to severe sleep apnea." (b) The October 2006 diagnosis of moderate to severe sleep apnea based on a sleep study. (c) The April 2016 sleep study that was negative for sleep apnea. TANYA SMITH Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Elizabeth Jalley, 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.