Citation Nr: 21009451 Decision Date: 02/22/21 Archive Date: 02/22/21 DOCKET NO. 08-18 932 DATE: February 22, 2021 REMANDED Entitlement to service connection for obstructive sleep apnea, to include as secondary to a service-connected disability, is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1969 to March 1972. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a February 2015 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). In June 2017, the Veteran testified at a videoconference hearing before the undersigned Veterans Law Judge (VLJ). A transcript of that proceeding has been associated with the record. This case was previously before the Board in July 2020. It was remanded for further development. 1. Entitlement to service connection for obstructive sleep apnea is remanded. During the August 2020 examination, the Veteran reported that he usually woke-up in panic gasping for air during service. Also, he was told by fellow soldiers that would snore loudly during his sleep. He reported going to sick call several times during his 15-month tour due to feeling fatigued and being unable to sleep at night. He reported being treated with sedatives so he could rest. The examiner opined that it was less likely than not that the Veteran’s sleep apnea was incurred or caused by service. In her rationale, the examiner noted that there was no diagnosis or treatment for OSA during service. The examiner also noted that service records did not support a claim for obstructive sleep apnea. The examiner did not consider the Veteran’s statements of waking up in the night gasping for air, reports of snoring or that he had sought treatment for fatigue during service. In addition, the examiner opined that it was less likely than not that the Veteran’s sleep apnea was aggravated beyond natural progression by the service-connected coronary artery disease, but she gave no rationale for her opinion. For these reasons, an addendum opinion is needed. The matters are REMANDED for the following action: 1. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s obstructive sleep apnea is at least as likely as not related to his military service, including the Veteran’s reports of waking up gasping for air, snoring, and seeking treatment for fatigue during service. The examiner is advised that the Veteran is competent to report injuries and symptoms in service, regardless of the contents of the service treatment records, and that the Veteran’s reports must be considered. A clinician must opine whether it is at least as likely as not that his obstructive sleep apnea was proximately due to service-connected disability, including coronary artery disease with cardiomyopathy, posttraumatic stress disorder and diabetes mellitus. A clinician must opine whether it is at least as likely as not that his obstructive sleep apnea was aggravated beyond its natural progression by a service-connected disability, including coronary artery disease with cardiomyopathy, posttraumatic stress disorder and diabetes mellitus The rationale for all opinions should also be provided. 2. Readjudicate the Veteran’s claim, with application of all appropriate laws, regulations, and case law, and consideration of any additional information obtained as a result of this remand. If the decision remains adverse to the Veteran, he should be furnished a supplemental statement of the case and afforded an appropriate period of time within which to respond thereto. KRISTI L. GUNN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Tahirih S. Samadani, 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.