Citation Nr: 21010570 Decision Date: 02/25/21 Archive Date: 02/25/21 DOCKET NO. 15-32 489 DATE: February 25, 2021 REMANDED Entitlement to service connection for obstructive sleep apnea (OSA) is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1969 to August 1970, from January 1991 to June 1992, from October 1992 to April 1993, and from August 2006 to November 2007. This matter comes to the Board of Veterans’ Appeals (Board) from a December 2011 rating decision which, in pertinent part, denied entitlement to service connection for sleep apnea. In June 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 (OSA) is remanded. The Board cannot make a fully-informed decision on the issue of entitlement to service connection for OSA at this time. While a January 2020 VA examiner opined that the Veteran’s OSA was less likely than not incurred in or caused by service, the Board finds the January 2020 examiner’s opinion inadequate, as it is based on an absence of service treatment records. Furthermore, it does not appear that the examiner considered the Veteran’s competent reports that he had difficulty breathing and still felt tired after sleeping during his 2007 deployment to Afghanistan on a September 2007 post-deployment health assessment. An opinion based on the absence of treatment records without consideration of a veteran’s competent reports is inadequate. See Dalton v. Nicholson, 21 Vet. App. 23 (2007). Therefore, the Board finds that a remand is warranted for a new VA medical opinion as to the nature and etiology of the Veteran’s OSA. The matter is REMANDED for the following actions: 1. Obtain an addendum opinion from an appropriate clinician as to the Veteran’s obstructive sleep apnea. The examiner must review the claims file. The examiner is asked to provide a response to the following: Did the Veteran’s obstructive sleep apnea at least as likely as not (1) begin during of active service, to include related environmental exposures during service and a September 2007 post-deployment health assessment in which the Veteran reported difficulty breathing and still feeling tired after sleeping during his deployment to Afghanistan, (2) manifested within one year after discharge from a period of active service, or (3) was noted during a period of active service with continuity of the same symptomatology since service. Provide a rationale to support the opinion(s). In providing the requested opinion, consider the Veteran’s description of his in-service and symptoms as well as his post-service symptoms. If there is any medical reason to accept or reject the proposition that the Veteran’s reported symptoms in service and thereafter represented the onset of his current disability, this should be noted. Stated another way, do the Veteran’s reports about his symptoms align with how the currently diagnosed disability is known to develop or are the Veteran’s reports generally inconsistent with medical knowledge or implausible? 2. 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. Stephanie M. Owen Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Javier Peluyera, 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.