Citation Nr: 21010151 Decision Date: 02/24/21 Archive Date: 02/24/21 DOCKET NO. 15-14 897A DATE: February 24, 2021 REMANDED Entitlement to service connection for sleep apnea is remanded. REASONS FOR REMAND The Veteran had active service in the United States Air Force from March 1991 to September 2011, to include service in Saudi Arabia. For his meritorious service, the Veteran was awarded (among other decorations) the Air Force Commendation Medal, the Air Force Achievement Medal, and the Southwest Asia Service Medal. This appeal comes to the Board of Veterans’ Appeals (Board) from an October 2013 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). Entitlement to service connection for sleep apnea is remanded. VA obtained medical opinions for the Veteran in October 2013 and January 2015 for his currently diagnosed sleep apnea. Both opinions were negative; however, the Board finds both opinions to be inadequate. The VA examiners found that the Veteran was not diagnosed as suffering from sleep apnea until 2013, two years after his retirement from active service. The January 2015 VA examiner concluded that there was insufficient clinical documentation to show that clear signs of sleep apnea were present while he was in service. The January 2015 VA medical opinion and the other opinion of record did not consider the Veteran’s lay statements that, despite his nasal surgery, he continued to snore every night since service. As the Veteran was diagnosed with sleep apnea only about two years after separation from service, the Board finds this to be pertinent information for the VA examiner to consider in formulating his opinion. Moreover, the Veteran is competent to report observable symptoms. Layno v. Brown, 6 Vet. App. 465 (1994). A remand is warranted for a new VA medical opinion to consider this information. The matters are REMANDED for the following action: 1. Obtain a VA addendum medical opinion to determine the nature and etiology of the Veteran’s sleep apnea. If this opinion cannot be rendered without a VA examination, then the Veteran should be scheduled for a VA examination. This remand and the claims file must be reviewed. After reviewing the Veteran’s claims file, the examiner is to state whether it is at least as likely as not that the Veteran’s current sleep apnea had its onset during or is otherwise related to his active service. In providing this opinion, the examiner must discuss the significance of the Veteran’s nasal surgery in 1999, and whether that surgery or its residuals played any part in the later development of sleep apnea. The examiner must also consider and discuss the Veteran’s statements regarding the history of symptoms he experienced. Finally, the examiner must discuss the significance of the fact that the Veteran was diagnosed as suffering from sleep apnea in 2013, two years after his retirement from service, and whether this close temporal relationship suggests that the Veteran had sleep apnea prior to his diagnosis, or that his sleep apnea arose after his retirement. All opinions must be supported by a sufficient rationale. The absence of medical evidence should not be the sole basis for a negative opinion. Evan M. Deichert Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Crawford, 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.