Citation Nr: 21010669 Decision Date: 02/25/21 Archive Date: 02/25/21 DOCKET NO. 14-24 800 DATE: February 25, 2021 REMANDED Entitlement to service connection for obstructive sleep apnea is remanded. REASONS FOR REMAND The Veteran served honorably in the United States Air Force from February 1974 to March 1979. This matter was previously before the Board of Veterans’ Appeals (Board) in March 2018, whereupon the Board denied service connection for obstructive sleep apnea and migraine headaches (service connection for migraine headaches has since been granted). The Veteran appealed that decision to the United States Court of Appeals for Veterans Claims (Court). In a May 2019 Memorandum Decision, the Court vacated the March 2018 Board decision and remanded the claim for further adjudication. In a December 2019 decision, the Board again denied the claim. The Veteran once again appealed the Board’s decision to the Court. In September 2020, while the case was pending at the Court, the parties signed a Joint Motion for Partial Remand (JMPR) requesting that the Court vacate the Board’s decision. In a subsequent order, the Court granted the JMR. The claim has now been returned to the Board for further consideration. Entitlement to service connection for obstructive sleep apnea The Veteran seeks entitlement to service connection for obstructive sleep apnea; he contends he developed this disorder in service, to include as a result of a deviated septum and resulting septoplasties performed in February 1976 and October 1976. As discussed in the JMPR, the parties have agreed that a remand is necessary to afford the Veteran a new VA examination. On review, the JMPR reflects that the Board erred in its prior decision by relying on an August 2012 VA examination report and accompanying opinion when denying the Veteran’s claim. Specifically, the parties concluded that the August 2012 examination report was inadequate because it failed to meaningfully discuss the Veteran’s in-service nasal surgeries and did not meaningfully address his descriptions of his symptoms and their proximity to the surgeries. The parties determined that a new VA examination was necessary in order to address these inadequacies. See Barr v. Nicholson, 21 Vet. App. 303, 311-12 (2007) (holding that when VA elects to provide a medical examination, the examination must be adequate). The JMPR further noted that it was necessary to discuss an article titled, “Can Septoplasty Relieve My Sleep Apnea,” particularly the article’s discussion of the relationship between deviated septum and the development of obstructive sleep apnea. Accordingly, the Board finds, pursuant to the instructions laid out in the JMPR, that an additional examination and readjudication is necessary in this case. Accordingly, a remand is warranted. The matters are REMANDED for the following action: 1. Obtain and associate with the record any outstanding VA medical records pertaining to the Veteran, to include records from November 2020 to the present. 2. Schedule the Veteran for an examination with an appropriate clinician to determine the nature and likely etiology of his current obstructive sleep apnea. The clinician must opine whether it is at least as likely as not that his obstructive sleep apnea was incurred or aggravated in service, or is otherwise related to service, to include as a result of the Veteran’s in-service deviated septum and septoplasties performed in February 1976 and October 1976. The examiner should specifically address the following: • The Veteran’s lay contentions (for example, in an April 2012 statement) regarding the chronology of his symptoms, to include his descriptions of his symptoms and their proximity to his in-service nasal surgeries. The examiner is advised that the Veteran is competent to report symptoms, treatment, events, and injuries in service and that his assertions must be taken into account, along with the other evidence of record, in formulating the requested medical opinion. (Continued on the next page)   • The medical significance of the Veteran’s in-service deviated septum and subsequent February 1976 and October 1976 septoplasties, in the context of his current obstructive sleep apnea. • The significance of the article submitted by the Veteran, titled, “Can Septoplasty Relieve My Sleep Apnea.” In particular, the examiner should discuss the finding that sleep apnea can be “caused by a variety of issues, one of which is a blocked airway,” and that “a deviated septum, this misalignment causes snoring and sleep apnea problem. A. S. CARACCIOLO Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Minot, 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.