Citation Nr: 21074575 Decision Date: 12/15/21 Archive Date: 12/15/21 DOCKET NO. 17-28 263 DATE: December 15, 2021 REMANDED Entitlement to service connection for sleep apnea syndromes is remanded. Entitlement to a disability rating in excess of 50 percent for posttraumatic stress disorder (PTSD) is remanded. REASONS FOR REMAND The Veteran had active military service from November 2002 to May 2005. This matter comes before the Board of Veterans' Appeals (Board) on appeal from November 2014 and April 2016 rating decisions of a VA Regional Office (RO). 1. Entitlement to service connection for sleep apnea syndromes is remanded. The Veteran asserts that he experiences sleep apnea that arose during or as a result of his active service. His VA treatment records reflect a diagnosis for sleep apnea. See, e.g., April 2014 VA treatment records. In the November 2021 Appellate Brief, the Veteran's representative argued that his sleep apnea might have been caused by his service-connected PTSD. The Veteran has yet to be afforded a VA examination for this claim; therefore, this claim must be remanded for additional development. 2. Entitlement to a disability rating in excess of 50 percent for PTSD is remanded. The Veteran asserts that his-service connected PTSD is more severe than is reflected by his current evaluation. The last VA examination for this claim was conducted in February 2016, more than 5 years ago. In the November 2021 Appellate Brief, the Veteran's representative argued that his PTSD symptoms had become more severe since his last VA examination and were causing increased problems at work. The Board finds that the February 2016 VA examination is too remote in time to serve as contemporaneous evidence of the current severity of the Veteran's PTSD. Accordingly, this claim is remanded for additional development. The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA examination by an appropriate professional to determine the nature and etiology of any sleep apnea disorder found upon examination. The entire electronic claims file must be made available to the examiner. All tests deemed necessary should be conducted and the results reported in detail. To the extent possible, the examiner is asked to address and reconcile the contradictory findings of the VA examination reports and other medical evidence of record. The examiner is asked to specifically address the following questions: (a) Upon clinical examination, has the Veteran, at any time during the period on appeal, even if the condition is currently resolved, had a diagnosed sleep disorder that is separate from being a symptom of the service-connected PTSD? (b) If a separately diagnosed sleep disorder is found, is it at least as likely as not (at least an approximate balance of positive and negative evidence) that any currently diagnosed sleep disorder is related to the Veteran's active service? (c) Is it at least as likely as not that any currently diagnosed sleep disorder was caused by the Veteran's service-connected PTSD? (d) Is it at least as likely as not that any currently diagnosed sleep disorder was aggravated (i.e., any increase in severity) by the Veteran's service-connected PTSD? If aggravation is found, the examiner should provide the baseline manifestations of the Veteran's sleep disorder prior to aggravation by the service-connected depression. A complete rationale must be provided for all opinions expressed and conclusions reached. The Board recognizes the practical difficulties of scheduling an examination in view of the COVID-19 epidemic, and requests flexibility and understanding in affording the Veteran an opportunity to report for an examination. 2. Schedule the Veteran for an examination by an appropriate psychiatrist or psychologist to determine the current severity of his service-connected PTSD. The Board recognizes the practical difficulties of scheduling an examination in view of the COVID-19 epidemic, and requests flexibility and understanding in affording the Veteran an opportunity to report for an examination. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran's disability under the rating criteria. The examiner must attempt to elicit information regarding the severity, frequency, and duration of symptoms. To the extent possible, the examiner should identify any symptoms and social and occupational impairment due to his service-connected PTSD alone. The examiner should elicit from the Veteran his complete educational, vocational, and employment history and should note his complaints regarding the impact of PTSD on employment. The examiner should identify all limitations or functional impairment caused solely by PTSD. The Board recognizes the practical difficulties of scheduling an examination in view of the COVID-19 epidemic, and requests flexibility and understanding in affording the Veteran an opportunity to report for an examination. A. C. MACKENZIE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board E. Hicks, Associate 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.