Citation Nr: 21009624
Decision Date: 02/23/21	Archive Date: 02/23/21

DOCKET NO. 16-00 440
DATE: February 23, 2021

REMANDED

Service connection for a sleep disorder, identified as obstructive sleep apnea, including as secondary to service-connected posttraumatic stress disorder (PTSD) is remanded.

REASONS FOR REMAND

The Veteran served on active duty in the U.S. Army from March 1982 to March 1985, in the U.S. Navy from January 1991 to May 1991, including service in Southwest Asia in support of Operation Desert Shield/Storm from February 1991 to May 1991; and in the U.S. Army from May 2007 to March 2008.  The Veteran had additional duty with the Missouri Army National Guard.

This appeal arises from a March 2017 rating decision, denying service connection for sleep apnea.  In September 2018, the Board remanded issues of entitlement to service connection for a sleep disorder, lumbar spine disorder and right hip disorder to the agency of original jurisdiction (AOJ) for additional development and consideration.  On remand, in an August 2020 rating decision, the AOJ granted service connection for both the lumbar spine disorder and right hip disorder.  As these determinations constitute a full grant of the benefits sought as to the lumbar spine and right hip claims, they are no longer in appellate status.  See Grantham v. Brown, 114 F.3d. 1156 (Fed. Cir. 1997).  The file is again before the Board for further appellate review.  

1. Service connection for a sleep disorder, identified as obstructive sleep apnea, including as secondary to service-connected PTSD

The Veteran contends that his sleep apnea is secondary to his service-connected PTSD.  The Veteran’s representative’s November 2020 correspondence cited medical literature in support of the notion that the Veteran’s obstructive sleep apnea was related to or caused by his service-connected PTSD; and seeks a VA medical nexus opinion.  Service connection may be granted for a disability that is proximately due to, or aggravated by, service-connected disease or injury.  38 C.F.R. § 3.310.  A December 2016 private sleep study diagnosed obstructive sleep study, so that the Veteran presently has a current sleep disorder.  The Board also observes that the Veteran’s June 2018 Disability Benefits Questionnaire on PTSD found chronic sleep impairment was a symptom of his PTSD.  The Board finds that the low threshold of McLendon has been met, and a VA examination and medical opinion are necessary.  See McLendon v. Nicholson, 20 Vet. App. 79, 83-86 (2006). 

The matters are REMANDED for the following action:

1. Obtain a VA medical opinion by an appropriate clinician to determine the etiology of the Veteran’s sleep apnea.  Specifically, the examiner should opine as to the following: 

(a) Whether it is at least as likely as not that the Veteran’s sleep apnea is related to service. 

(b) Whether it is at least as likely as not that the Veteran’s sleep apnea was caused and/or aggravated by his service-connected PTSD.  The examiner must consider and discuss medical literature cited by the Veteran’s representative that associates sleep apnea with   PTSD.  See November 2020 Veteran’s representative’s correspondence.

A complete rationale should be provided for all opinions rendered. 

 

 

C. CRAWFORD

Veterans Law Judge

Board of Veterans’ Appeals

Attorney for the Board	Biswajit Chatterjee, 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.