Citation Nr: 21012168 Decision Date: 03/03/21 Archive Date: 03/03/21 DOCKET NO. 16-31 040 DATE: March 3, 2021 REMANDED Entitlement to service connection for sleep apnea is remanded. REASONS FOR REMAND The Veteran served on active duty from September 2001 to September 2005. This matter comes before the Board of Veterans’ Appeals (Board) on appeal of a March 2014 rating decision by a Department of Veterans Affairs (VA) Regional Office. In December 2019, the Veteran testified before the undersigned Veterans Law Judge during a travel Board hearing. A transcript has been associated with the claims file. Entitlement to service connection for sleep apnea is remanded. The Veteran seeks service connection for obstructive sleep apnea, asserting this disability was incurred during active duty service. In the alternative, he asserts his sleep apnea is secondary to his service-connected disabilities, specifically his posttraumatic stress disorder (PTSD) and/or weight gain due to his service-connected disabilities, to include a thoracolumbar spine, left ankle status post sprain with degenerative arthritis, right ankle status post sprain with degenerative arthritis and/or right knee status post injury with limitation of motion. A review of the medical evidence of record reveals he was formally diagnosed in 2014 with obstructive sleep apnea post-service. In support of his claim, the Veteran submitted a February 2020 statement from Q.R.S., a friend with whom the Veteran served. This statement describes snoring and pauses in the Veteran’s breathing which Q.R.S. witnessed while rooming together in service, suggesting the Veteran’s obstructive sleep apnea may have its onset during active duty service. Despite the foregoing, the Veteran has yet to be afforded a VA examination with respect to this claim. As the McLendon elements necessitating an examination have been met, a remand is necessary to obtain one. See McLendon v. Nicholson, 20 Vet. App. 79 (2006). The matters are REMANDED for the following action: 1. Obtain all relevant, outstanding VA treatment records. 2. Once the above request has been completed, to the extent possible, schedule the Veteran for an examination with an appropriate medical professional to determine the nature and etiology of his claimed obstructive sleep apnea. After reviewing the record, the examiner should: (a.) Opine as to whether it is at least as likely as not (50 percent probability or greater) the Veteran’s obstructive sleep apnea was incurred in or caused by his active duty service and explain why. (b.) If the Veteran’s obstructive sleep apnea was not incurred in or caused by his active duty service, opine was to whether it is at least as likely as not (50 percent probability or greater) the Veteran’s obstructive sleep apnea is proximately due to or aggravated beyond its natural progression by his service-connected disabilities, to include PTSD and/or any weight gain due to his service-connected thoracolumbar spine, left ankle status post sprain with degenerative arthritis, right ankle status post sprain with degenerative arthritis, and/or right knee status post injury with limitation of motion, and explain why. In doing so, the examiner is reminded that an opinion must address both causation and aggravation. The examiner is also reminded that even though obesity itself is not a disability eligible for VA compensation benefits, the VA has acknowledged that it may be an intermediate step between a service-connected disability and another current disability allowing service connection on a secondary basis. (c.) In rendering an opinion, the examiner should consider the Veteran’s relevant lay statements of record, to include his testimony during the December 2019 travel Board hearing that he was woken up in service by his roommate on several occasions and was told that he was snoring or had stopped breathing; his obstructive sleep apnea may be secondary to his service-connected disabilities, specifically his PTSD and/or weight gain due to his service-connected thoracolumbar spine, left ankle status post sprain with degenerative arthritis, right ankle status post sprain with degenerative arthritis and/or right knee status post injury with limitation of motion, which prevent him from exercising. (d.) In rendering an opinion, the examiner’s attention is drawn to the other relevant lay evidence of record, to include the February 2020 Buddy Statement from Q.R.S., a friend with whom the Veteran served, describing snoring and pauses in the Veteran’s breathing he witnessed while rooming together in-service. 3. Once each of the above requests have been completed, to the extent possible, readjudicate the appeal. M. Donohue Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Thomas D. Jones, 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.