Citation Nr: 21012380 Decision Date: 03/04/21 Archive Date: 03/04/21 DOCKET NO. 18-03 398 DATE: March 4, 2021 REMANDED Entitlement to service connection for an acquired psychiatric disorder, to include insomnia and anxiety, is remanded. Entitlement to service connection for sleep apnea, to include as secondary to an acquired psychiatric disorder, is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1978 to April 1981. The Veteran testified at a hearing with the undersigned Veterans Law Judge in February 2021. 1. Entitlement to service connection for an acquired psychiatric disorder, to include insomnia and anxiety, is remanded. 2. Entitlement to service connection for sleep apnea, to include as secondary to an acquired psychiatric disorder, is remanded. The Veteran contends that he suffers from an acquired psychiatric disorder, manifested by anxiety and insomnia, related to service. He also contends that he suffers from sleep apnea secondary to his acquired psychiatric disorder. During the February 2021 hearing, the Veteran testified that he experienced traumatic events during service, including a near injury while servicing an F-14 Tomcat and an assault that occurred at a fast food restaurant. The Veteran reported difficulty sleeping and anxiety since service. There are four elements necessary in determining the need for a medical examination: (1) a current disability; (2) an in-service event, injury, or disease; (3) an indication that the claimed disability may be associated with the established event; and (4) insufficient competent medical evidence on file for the VA to make a decision on the claim. McClendon v. Nicholson, 20 Vet. App. 79, 81-85 (2006). The third prong, which requires the evidence of record “indicate” the claimed disability or symptoms “may be” associated with the established event, disease, or injury, is a low threshold. McLendon, 20 Vet. App. at 83. As to the Veteran’s claims for an acquired psychiatric disorder and sleep apnea, the Board finds the criteria set forth in McClendon have been met and that VA examinations and etiological opinions should be obtained. The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA examination for his acquired psychiatric disorder, to include insomnia and anxiety. The examiner must review the claims file. The examiner is asked to provide a response to the following: Is the disability at least as likely as not related to service, including traumatic events during service? Provide a rationale to support the opinion. In providing the requested opinion, consider the Veteran’s description of his/her in-service injury 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 injury and symptoms in service and thereafter represented the onset of his/her 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. Schedule the Veteran for a VA examination for his sleep apnea. The examiner is asked to provide a response to the following: Is the disability at least as likely as not related to service? Is the disability at least as likely as not proximately due to his acquired psychiatric disorder? Is the disability at least as likely as not aggravated, i.e., worsened beyond its natural progression, by his acquired psychiatric disorder? Provide rationale to support each of the opinions. In providing the requested opinion, consider the Veteran’s description of his/her in-service injury 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 injury and symptoms in service and thereafter represented the onset of his/her 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? JENNIFER HWA Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Casey, 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.