Citation Nr: 21012076 Decision Date: 03/03/21 Archive Date: 03/03/21 DOCKET NO. 12-12 925 DATE: March 3, 2021 REMANDED Entitlement to service connection for sleep apnea is remanded. REASONS FOR REMAND The Veteran served on active duty in the Army from February 1999 to February 2005. The matter comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2011 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). In June 2019, the Board denied service connection for sleep apnea. The Veteran appealed the Board’s June 2019 decision to the United States Court of Appeals for Veterans Claims (the Court). In April 2020, the Court granted a Joint Motion for Remand (JMR), which vacated the Board’s decision to deny entitlement to service connection for sleep apnea. Pursuant to the JMR, the Board remanded the claim in September 2020 for further development by the RO. The case has been returned to the Board for further appellate action.   Entitlement to service connection for sleep apnea is remanded. In February 2021, the Veteran’s representative submitted an Appellate Brief raising an alternative theory of entitlement that has not yet been addressed by the RO or any VA medical examiner. The contention is that the Veteran’s sleep apnea is secondary to his service-connected posttraumatic stress disorder (PTSD) and/or migraines. As none of the medical opinions of record address this contention, a remand is necessary to obtain an addendum opinion. 38 U.S.C. § 5103A(d); 38 C.F.R. § 3.159(c)(4); McLendon v. Nicholson, 20 Vet. App. 79 (2006). The matter is REMANDED for the following action: 1. Obtain updated VA treatment records. 2. Thereafter, obtain an addendum opinion from the VA examiner who performed the September 2020 examination or an appropriate medical professional if the examiner is unavailable. The claims file, to include a copy of this remand, must be made available to and reviewed by the examiner in conjunction with the examination. The examiner must opine on the following: (a) Is the Veteran’s sleep apnea at least as likely as not (a 50 percent probability or greater) proximately due to or the result of service-connected disability, to include PTSD, migraines, and asthma? (b) Is the Veteran’s sleep apnea at least as likely as not (a 50 percent probability or greater) aggravated (increased in severity) beyond its natural progress by service-connected disability, to include PTSD, migraines, and asthma? In rendering this opinion, the examiner should address relevant evidence from the claims file, to include the medical literature discussed in the February 2021 Appellate brief. If, and only if, the examiner determines that another VA examination is necessary to provide an informed opinion, such an examination should be scheduled. A complete rationale should be given for all opinions and conclusions expressed. If the examiner cannot provide an opinion without resort to speculation, the examiner should provide an explanation as to why this is so and must state whether there is additional evidence that would permit the necessary opinion to be made. Nathaniel J. Doan Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Minaya, 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.