Citation Nr: 21006097 Decision Date: 02/03/21 Archive Date: 02/03/21 DOCKET NO. 16-47 300 DATE: February 3, 2021 REMANDED The claim of entitlement to service connection for sleep apnea is remanded. REASONS FOR REMAND The Veteran had honorable active duty service with the United States Army from June 2004 to January 2009. The claim is on appeal from a January 2016 Rating Decision by the Regional Office in Lincoln, Nebraska. In June 2020, the United States Court of Appeals for Veterans Claims (Court) concluded that the Board, in its January 2019 denial, had provided an inadequate statement of reasons or bases because it relied on the December 2015 VA nexus opinion. 38 U.S.C. § 7104(d)(1). The Court vacated the Board’s prior decision and remanded the issue back to the Board. 1. The claim of entitlement to service connection for sleep apnea is remanded. As a general matter, once VA undertakes to provide an examination, it must provide an adequate one or, at a minimum, notify the claimant why one will not be provided. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). In the December 2015 VA examination, which was a review of the records and not an in-person examination, the examiner stated that “[w]hile the [appellant] did express some insomnia complaints during service, this would be a common finding in someone who has seen combat such as this[appellant].” The examiner appears to have not fully considered the appellant’s medical history. See Stefl v. Nicholson, 21 Vet. App. 120, 123 (2007) (a medical examination is adequate “where it is based upon consideration of the veteran’s prior medical history and examinations and also describes the disability, if any, in sufficient detail so that the Board's evaluation of the claimed disability will be a fully informed one” (internal quotation marks omitted)). In the Veteran’s December 2005 post-deployment questionnaire, he reported lingering tiredness after sleeping. Then, he filed for service connection for breathing problems about a year after his service. It is unclear why the examiner limited her discussion to merely the appellant’s in-service complaints of insomnia. The December 2015 VA medical opinion does not consider all the relevant evidence of record, including lay statements. Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008); Dalton v. Nicholson, 21 Vet. App. 23 (2007). An addendum VA medical opinion addressing all the Veteran’s lay statements is warranted. The matter is REMANDED for the following actions: 1. Obtain updated VA and/or private treatment records.  If any identified records are unavailable, the Veteran’s claim file must be clearly documented to that effect and the Veteran notified in accordance with 38 C.F.R. § 3.159(e). 2. Obtain an addendum opinion from an appropriate clinician regarding the Veteran’s sleep apnea. Schedule the Veteran for a VA examination only if needed to answer the following question. The examiner must review the claims file. If a diagnosis cannot be provided but the Veteran’s condition manifests in symptoms that cause functional impairment, then the examiner should consider them a “disability” for the purpose of providing the requested opinion below. The examiner is asked to provide a response to the following: (a.) Is sleep apnea at least as likely as not related to service? Provide a rationale to support the opinion. In the Veteran’s December 2005 post-deployment questionnaire, he reported lingering tiredness after sleeping. Then, he filed for service connection for breathing problems about a year after his service. Address this evidence. In providing the requested opinion, consider the Veteran’s description of in-service symptoms as well as post-service symptoms. Do the Veteran’s reports about symptoms align with how the currently diagnosed disability is known to develop or are the Veteran’s reports generally inconsistent with medical knowledge or implausible? G. A. WASIK Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board James Hekel, 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.