Citation Nr: 21073293 Decision Date: 12/08/21 Archive Date: 12/08/21 DOCKET NO. 17-52 278 DATE: December 8, 2021 REMANDED Entitlement to service connection for a psychiatric disability, to include drug and alcohol dependence, is remanded. Entitlement to service connection for a recurrent headache disability, to include tension headaches, is remanded. Entitlement to service connection for a recurrent sleep disability, to include obstructive sleep apnea, is remanded. REASONS FOR REMAND The Veteran had active service from July 1980 to March 1982. Entitlement to service connection for a psychiatric disability to include drug and alcohol dependence, a recurrent headache disability to include tension headaches, and a recurrent sleep disability to include obstructive sleep apnea, is remanded. In its March 2019 Remand instructions, the Board of Veterans' Appeals (Board) requested that the Veteran be afforded Department of Veterans Affairs (VA) psychiatric, headache, and sleep disorder examinations. There are notations in the record that the Veteran did not report for the May 2019 scheduled examinations. However, there is no documentation that the Veteran was provided with written notification of the scheduled examinations. Therefore, the Agency of Original Jurisdiction should take appropriate action to reschedule the Veteran for the requested VA psychiatric, headache, and sleep disorder examinations. Written examination notices should be sent to the Veteran and incorporated into the record. Clinical documentation dated after April 2020 is not of record. VA should obtain all relevant VA and private treatment records which could potentially be helpful in resolving the Veteran's claims. Murphy v. Derwinski, 1 Vet. App. 78 (1990); Bell v. Derwinski, 2 Vet. App. 611 (1992). The matters are REMANDED for the following action: 1. Ask the Veteran to complete a VA Form 21-4142 for each private healthcare provider who has treated any psychiatric, headache, and sleep disabilities. Make two requests for the authorized records from all identified healthcare providers unless it is clear after the first request that a second request would be futile. 2. Obtain any VA treatment records not of record, to include those pertaining to treatment after April 2020. 3. Schedule the Veteran for a VA psychiatric examination to assist in determining the nature and etiology of any identified psychiatric disability. The Veteran must be provided a written examination notice. A copy of the examination notice should be incorporated into the record. The examiner must review the record, including the October 2017 evaluation from H. Henderson Galligan, Ph.D., and should note that review in the reports. A rationale for all opinions should be provided. The examiner should: (a) Diagnose all psychiatric disabilities found. (b) Opine whether it is at least as likely as not (a 50 percent probability or greater) that any identified psychiatric disorder had its onset during active service or is related to any incident of service, including the Veteran's report of a traumatic flight deck incident in-service. The examiner should specifically address the October 2017 evaluation from H. Henderson Galligan, Ph.D. 4. Schedule the Veteran for a VA headache examination conducted by a medical doctor to assist in determining the nature and etiology of any identified recurrent headache disability. The Veteran must be provided a written examination notice. A copy of the examination notice should be incorporated into the record. The examiner must review the record, including the May 2018 evaluation from H. Skaggs, M.D., and should note that review in the report. The examiner should: (a) Diagnose all headache disabilities found. (b) Opine whether it is at least as likely as not (a 50 percent probability or greater) that any identified recurrent headache disability had its onset during active service or is related to any incident of service. (c) Opine whether it is at least as likely as not (a 50 percent probability or greater) that any recurrent headache disability is due to or the result of any identified psychiatric disability. The examiner should specifically address the May 2018 evaluation from H. Skaggs, M.D. (d) Opine whether it is at least as likely as not (a 50 percent probability or greater) that any identified recurrent headache disability has been aggravated (increased in severity beyond the natural progression of the disorder) by any identified psychiatric disability. The examiner should specifically address the May 2018 evaluation from H. Skaggs, M.D. 5. Schedule the Veteran for a VA sleep examination conducted by a medical doctor to assist in determining the nature and etiology of the diagnosed obstructive sleep apnea. The Veteran must be provided a written examination notice. A copy of the examination notice should be incorporated into the record. The examiner must review the record, including the May 2018 evaluation from H. Skaggs, M.D., and should note that review in the report. The examiner should: (a) Diagnose all sleep disabilities found. (b) Opine whether it is at least as likely as not (a 50 percent probability or greater) that any identified recurrent sleep disability had its onset during active service or is related to any incident of service. (Continued on the next page) (c) Opine whether it is at least as likely as not (a 50 percent probability or greater) that any identified recurrent sleep disability is due to or the result of any psychiatric disorder. The examiner should specifically address the May 2018 evaluation from H. Skaggs, M.D. (d) Opine whether it is at least as likely as not (a 50 percent probability or greater) that any identified recurrent sleep disability has been aggravated (increased in severity beyond the natural progression of the disorder) by any psychiatric disorder. The examiner should specifically address the May 2018 evaluation from H. Skaggs, M.D. J. T. HUTCHESON Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K.R. Kardian, 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.