Citation Nr: 21076203 Decision Date: 12/22/21 Archive Date: 12/22/21 DOCKET NO. 16-11 342 DATE: December 22, 2021 REMANDED Entitlement to service connection for obstructive sleep apnea (OSA) is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1971 to November 1972 and February 1977 to November 1991. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a March 2013 rating decision. The Board remanded the Veteran's claim of entitlement to service connection for OSA in September 2018, and then denied the claim in December 2019. The Veteran appealed the denial to the Court of Appeals for Veterans Claims (Court), and the Court granted a Joint Motion for Remand (JMR) in October 2020, thereby returning the claim to the Board. The Board denied the claim in March 2021, and the Veteran again appealed that denial to the Court. In August 2021, the Court issued a Joint Motion for Partial Remand (JMPR), which vacated the March 2021 denial of the Veteran's claim for entitlement to service connection for OSA. Accordingly, the claim now returns to the Board for further adjudication. Entitlement to service connection for OSA. The Court vacated the Board's March 2021 denial of service connection for OSA for three reasons. First, the Parties to the JMPR found that the decision was confusing as to whether the Board found credible the Veteran's claim that he snored during service. Second, the Parties found that the Board provided an inadequate statement of reasons or bases for finding that the January 2019 VA medical examiner "accepted" the Veteran's statements regarding in-service snoring. Third, the Parties found inadequate the January 2019 VA medical opinion that served as the basis for the March 2021 denial, as the rationale supporting the opinion was general in nature and not specific to the Veteran. Accordingly, the JMPR specifically required that the Board obtain a medical opinion that is clearly based on the Veteran's complete, relevant medical history. Furthermore, in a November 2021 Informal Hearing Presentation, the Veteran's representative argued that the Veteran's obesitywhich the January 2019 VA examiner found to be the cause of his OSAbegan during service and caused his OSA during service. Accordingly, the Board finds that a new medical opinion must be obtained that adequately considers the Veteran's statements and all other relevant evidence of record concerning the etiology of his currently diagnosed OSA. The matters are REMANDED for the following action: Obtain a VA medical opinion from an appropriate clinician regarding the etiology of the Veteran's OSA. After reviewing the Veteran's claims file, the clinician is asked to opine whether it is at least as likely as not (i.e., a 50 percent or greater probability) that the Veteran's OSA had its onset in or is otherwise directly related to service. In offering this opinion, the examiner must consider and discuss the clinical significance of the lay assertions regarding in-service symptoms, to include buddy statements attesting to the Veteran's in-service snoring; the Veteran's argument that his weight gain and obesity began during service; and the Veteran's claim of continuity of OSA symptomatology since service. The sole basis for a negative opinion cannot be that the most common cause of OSA, in general, is excess weight/obesity. A rationale must be provided for all opinions rendered. R.R. WATKINS Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Breckenridge 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.