Citation Nr: 21009758 Decision Date: 02/23/21 Archive Date: 02/23/21 DOCKET NO. 17-30 615 DATE: February 23, 2021 REMANDED Entitlement to service connection for obstructive sleep apnea, to include as secondary to service-connected cervical spine fusion or an acquired psychiatric disorder, is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1986 to September 1986 and from November 2004 to January 2006. This matter comes to the Board of Veterans’ Appeals (Board) from a December 2014 rating decision which, in pertinent part, denied entitlement to service connection for obstructive sleep apnea. In September 2019, the Veteran testified before the undersigned Veterans Law Judge (VLJ) at a Central Office hearing in Washington, D.C. A copy of the transcript is of record. In November 2019, the Board remanded the matter for further development, to include obtaining a VA examination and medical opinion.   Entitlement to service connection for obstructive sleep apnea, to include as secondary to service-connected cervical spine fusion or an acquired psychiatric disorder, is remanded. The Board cannot make a fully-informed decision on the issue of entitlement to service connection for obstructive sleep apnea at this time. While a December 2019 VA examiner opined that the Veteran’s obstructive sleep apnea was less likely than not proximately due to or aggravated by his service-connected cervical spine fusion or acquired psychiatric disorder, but was rather due to weight gain, the opinion is conclusory as the examiner did not provide an adequate rationale or basis for the Board to consider and weigh the opinion. Furthermore, the examiner did not consider the Veteran’s assertions that his weight gain is due to his psychiatric disorder and while the examiner indicated that posttraumatic stress disorder causes interrupted sleep due to nightmares, the examiner did not appear to consider the effect of the Veteran’s acquired psychiatric disorder, diagnosed as adjustment disorder with associated sleep impairment, on the Veteran’s obstructive sleep apnea. In a February 2021 appellant brief, the Veteran’s representative provided citations to several articles in support of the Veteran’s claim purporting to show a link between obstructive sleep apnea and psychiatric disorders with associated sleep disturbances and weight gain. Therefore, the Board finds that a remand is warranted for a new VA medical opinion. The matter is REMANDED for the following actions: 1. Obtain the Veteran’s VA treatment records from December 2019 to present. 2. Obtain an addendum opinion from an appropriate clinician for the Veteran’s obstructive sleep apnea. The examiner must review the claims file. An in-person examination is not necessary unless deemed so by the examiner. The examiner is asked to provide a response to the following: Is the Veteran’s obstructive sleep apnea at least as likely as not proximately due to a service-connected cervical spine disability or acquired psychiatric disorder, to include associated sleep disturbances and/or weight gain that is directly attributable to his service-connected psychiatric disorder? If the Veteran’s obstructive sleep apnea is less likely than not proximately due to a service-connected disability, is the Veteran’s obstructive sleep apnea at least as likely as not aggravated, i.e., worsened beyond its natural progression, by a service-connected cervical spine disability or acquired psychiatric disorder, to include associated sleep disturbances and/or weight gain that is directly attributable to his service-connected psychiatric disorder? Provide a rationale to support the opinion(s). Although a complete review of the claims file is required, the examiner’s attention is drawn to articles cited by the Veteran’s representative in support of his claim purporting to show a link between obstructive sleep apnea and psychiatric disorders with associated sleep disturbances and/or weight gain that is directly attributable to his service-connected psychiatric disorder. 3. After completing the above, and any other development as may be indicated, the Veteran’s claim should be readjudicated based on the entirety of the evidence. If the claim remains denied, the Veteran and his representative should be issued a supplemental statement of the case (SSOC). An appropriate period of time should be allowed for response. Thereafter, the case should be returned to the Board for further appellate consideration, if otherwise in order. K. Parakkal Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. Owen, 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.