Citation Nr: 21073301 Decision Date: 12/08/21 Archive Date: 12/08/21 DOCKET NO. 18-17 623 DATE: December 8, 2021 REMANDED Entitlement to service connection for sleep apnea is remanded. Entitlement to service connection for skin rash on both eyelids is remanded. REASONS FOR REMAND The Veteran had active military service from August 1989 to October 1991, from July 1998 to February 1998, and from October 2007 to May 2008. His service included being in the Southwest Asia theater of action during the Persian Gulf War. The Veteran testified before the undersigned Veterans Law Judge during an August 2020 hearing. This matter is on appeal from February 2015, April 2015, and June 2015 rating decisions. It was previously remanded by the Board of Veterans' Appeals (Board) in March 2021. Unfortunately, there has not been substantial compliance with the Board's previous remand directives, and another remand is required. Stegall v. West, 11 Vet. App. 268, 271 (1998). The Board also remanded the issue of service connection for diarrhea. That issue is no longer on appeal since service connection for irritable bowel syndrome was granted in a June 2021 rating decision. 1. Entitlement to service connection for sleep apnea is remanded. 2. Entitlement to service connection for skin rash on both eyelids is remanded. The Board remanded these issues to obtain medical opinions addressing the Veteran's contentions of his sleep apnea and seborrheic dermatitis beginning during service. The examiner was reminded that the absence of evidence in the service treatment records (STRs) was not a sufficient rationale for a negative opinion. New opinions were obtained in May 2021 and June 2021. These opinions did not address the Veteran's contentions, and again relied on a lack of evidence in the STRs as part of their rationale. As such, these opinions are not adequate and another remand is necessary. In September 2021, the Veteran's representative questioned the credentials of the VA examiner who provided the 2021 opinions. On remand, the qualifications of the new examiner should be documented in the claims file. The matters are REMANDED for the following action: 1. In accordance with the provisions of 38 C.F.R. § 3.159(c)(1), make efforts to obtain all records identified by the Veteran, including any outstanding VA treatment records. 2. Furnish the Veteran's representative with the credentials of the September 2021 VA examiner, as well as the examiner (if different) who provides the opinion requested below. 3. Obtain an addendum medical opinion from a VA examiner (either the prior examiner or, if unavailable, a different examiner) to determine the etiology of the diagnosed sleep apnea and seborrheic dermatitis. The examiner is requested to review the record and offer an opinion as to whether it is at least as likely as not (at least an approximate balance of positive and negative evidence) that the diagnosed sleep apnea and seborrheic dermatitis are related to the Veteran's military service. The examiner must consider the Veteran's August 2020 testimony regarding his sleep apnea and seborrheic dermatitis beginning during service. The examiner is reminded that the absence of evidence in the STRs is not a sufficient rationale for a negative nexus opinion. Any opinion that does not follow these guidelines will be returned for correction. The qualifications of the examiner should be documented in the claims file, and a complete rationale should be given for all opinions and conclusions expressed. A. C. MACKENZIE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board L. Barstow, 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.