Citation Nr: 21009335 Decision Date: 02/22/21 Archive Date: 02/22/21 DOCKET NO. 15-16 188 DATE: February 22, 2021 REMANDED Entitlement to service connection for sleep apnea is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1976 to November 1980. In October 2018, he testified at a videoconference hearing before the undersigned Veterans Law Judge. A transcript of the proceeding is in the record. The claim was most recently before the Board in May 2020 when it was remanded for further development. There has not been substantial compliance with the remand directives and another remand is required. Stegall v. West, 11 Vet. App. 268 (1998). Despite multiple remands, the record still does not contain an adequate medical examiner’s opinion that would allow the Board to adjudicate this claim. Most recently, a VA examiner provided a negative nexus opinion in June 2020. However, the examiner failed to comply with the Board’s specific instruction to comment on the Veteran’s reports of being told by doctors that his sleep apnea may be caused by his headaches. Further evidence has also been added to the claims file which calls into question the adequacy of the June 2020 VA opinion. In October 2020, a fellow service member submitted a statement that he remembered the Veteran would stop breathing and gasp for air during their service together. Remand is needed to obtain a more thorough addendum VA opinion on this issue. The matters are REMANDED for the following action: Obtain an addendum opinion from appropriate examiner, based on a review of the record (or telehealth interview, with examination, if needed), on the likely etiology of his obstructive sleep apnea. Please answer the following questions: (a) Is it at least as likely as not (probability of 50 percent or higher) that the Veteran’s obstructive sleep apnea is related to the Veteran’s active duty service? (b) Is it at least as likely as not that obstructive sleep apnea is (i) caused by or (ii) aggravated by (defined as any increase in disability) his service-connected migraine headaches? The examiner is asked to comment on the significance of the Veteran’s reports of experiencing fatigue symptoms during active duty service, statements from his brother that the Veteran has had sleep problems dating to 1981, the Veteran’s reports of being told by doctors that his sleep apnea may be caused by his headaches, and the October 2020 statement from a fellow service member stating that he remembered the Veteran would stop breathing and gasp for air during their service together. (Continued on the next page)   The examiner is asked to provide thorough rationales to all opinions provided that consider the medical evidence of record, as well as the Veteran’s contentions. If an opinion cannot be provided without resorting to speculation, the examiner should explain the reason why a complete opinion cannot be provided. M. E. Larkin Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Jack S. Komperda, 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.