Citation Nr: 21077045
Decision Date: 12/28/21	Archive Date: 12/28/21

DOCKET NO. 20-03 307
DATE: December 28, 2021

REMANDED

The claim of entitlement to service connection for a sleep disorder is remanded.

REASONS FOR REMAND

The Veteran served on active duty from December 1965 to March 1969.  He died in January 2021.  The appellant is his surviving spouse.  She has been properly substituted as the claimant.

This matter came to the Board of Veterans' Appeals (Board) on appeal of a rating decision by a U.S. Department of Veterans Affairs (VA) Regional Office (RO).

The Board remanded this matter for additional development in August 2020 and March 2021.  

Another remand is warranted for additional medical inquiry.  

Pursuant to the Board's March 2021 remand, a medical opinion addressing the claim was included in the claims file in August 2021.  In light of a recent grant of entitlement to service connection for idiopathic pulmonary fibrosis, an addendum opinion should be sought.  

The Board also refers to the RO a separate issue for appropriate consideration.  In February 2021, the appellant claimed entitlement to service connection for the cause of the Veteran's death and to Dependency and Indemnity Compensation (DIC).  The Veteran has been service connected for idiopathic pulmonary fibrosis, which is listed as the cause of death on his death certificate.    

The matter is REMANDED for the following action:

Return the case to the VA examiner who issued the August 2021 report, or to a suitable substitute, for issuance of an addendum medical opinion regarding the claim of entitlement to service connection for a sleep disorder.  

After again reviewing the electronic claims file, the examiner should answer the following questions.

1. What sleep disorders did the Veteran have?

In answering this question, assume that he had obstructive sleep apnea prior to death. 

2. Is it at least as likely as not (i.e., probability of 50 percent or more) that a diagnosed sleep disorder was due to or caused by service-connected pulmonary disability? 

3. If not, is it at least as likely as not that any diagnosed sleep disorder was aggravated (i.e., permanently or temporarily worsened beyond the natural progress) by service-connected pulmonary disability?

The term "at least as likely as not" does not mean within the realm of medical possibility, but rather that the medical evidence both for and against a certain conclusion is so evenly divided that it is as medically sound to find in favor of such a conclusion as it is to find against it.

In rendering the requested opinions, the examiner should note that lay persons are competent to attest to matters of which they have first-hand knowledge, including observable symptomatology.

In remanding this case, the Board makes no credibility determination, expressed or implied, at this juncture.

(Continued on the next page)

 

Please explain in detail any opinion provided and the supporting rationale.  

If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation for why an opinion cannot be rendered.  In so doing, the examiner shall explain whether the inability to provide a more definitive opinion is the result of a need for additional information, or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question(s).

 

 

G. A. WASIK

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Christopher McEntee

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.