Citation Nr: 21012635 Decision Date: 03/04/21 Archive Date: 03/04/21 DOCKET NO. 17-23 390 DATE: March 4, 2021 REMANDED Entitlement to service connection for obstructive sleep apnea is remanded. REASONS FOR REMAND The Veteran served on active duty in the Air Force from July 1997 to December 1997, October 2001 to October 2002, February 2003 to March 2004, and May 2007. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a March 2017 rating decision by a Department of Veterans Affairs (VA) Regional Office. In January 2021, the Veteran testified at a videoconference before the undersigned Veterans Law Judge. A transcript of the hearing has been associated with the claims file. Now the matter is before the Board on appeal. The Veteran seeks service connection for severe, obstructive sleep apnea, asserting no problems with snoring, loss of breath during sleep, or excessive tiredness until his return from Qatar in 2002. See April 2017 Notice of Disagreement (NOD). At the January 2021 hearing, the Veteran testified that his wife never complained about snoring before his deployment, but that her complaints after he returned made him inquire with his provider but the costs for testing were prohibitive. See BVA Hearing Transcript, January 13, 2021 at page 3, 5-7. The Veteran underwent testing at VA, obtaining diagnosis and treatment for sleep apnea. The Board finds further development is necessary prior to final adjudication of the Veteran's service connection claim for sleep apnea. The Veteran has a current diagnosis of severe obstructive sleep apnea. See North Hampton VA Medical Center treatment record, dated February 14, 2017. The Veteran contends that working odd hours and shifts for approximately 45 days while deployed to Qatar in 2002 resulted in sleep apnea. See April 2017 NOD. He asserts that his snoring, loss of breath during sleep, and excessive tiredness began when he returned from deployment. Id. In January 2021, the Veteran submitted a buddy statement from another Veteran (T.C.), who affirmed that he never saw any symptoms of sleep apnea or snoring when he was deployed with the Veteran in Qatar from May 2002 to September 2002. The Veteran’s spouse also cited that he never had problems sleeping until his return from Qatar, when he became a restless sleeper, grinding his teeth, snoring quite loudly and taking long pauses as if he was not taking in air while asleep. See January 2021 Buddy Statement (Spouse). As the Veteran was not afforded an examination for sleep apnea, the Board finds that obtaining an examination by an appropriate medical examiner to determine the nature and etiology of his sleep apnea is necessary to make a fully-informed decision. Accordingly, the matters are REMANDED for the following action: 1. The Agency of Original Jurisdiction (AOJ) should contact the Veteran and his representative to provide VCAA notice and request assistance in identifying and obtaining any outstanding VA or private treatment records relevant to his sleep apnea. In particular, the Veteran should be asked to identify and/or submit the medical release or treatment records for the primary care provider he consulted about his sleeping concerns in or about 2002 when he returned from Qatar. 2. Then, schedule the Veteran for a VA examination to determine the nature and etiology of his sleep apnea disability. The examiner must review the entire claims folder and a copy of this REMAND order prior to the examination, including a notation in the examination report that the review was performed. (a.) The examiner should opine whether it is at least as likely as not (50 percent or greater probability) that sleep apnea had its onset in, or is otherwise related to, military service. The examiner should consider the Veteran’s and other lay statements regarding onset when formulating the opinion. Specifically, the examiner is asked to address the contention that irregular sleep cycles during deployment to Qatar caused sleep apnea. (b.) The examiner is advised that the Veteran is competent to report his history and symptoms. Such reports must be acknowledged and considered in formulating any opinion. If the examiner rejects the Veteran's reports, the examiner must provide an explanation for such rejection. (c.) If the examiner cannot provide an opinion, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner does not have the knowledge or training. (d.) Complete written rationale must be provided for any opinion offered. 3. After the above and any other necessary development has been completed, the AOJ should readjudicate the issues on appeal. If the claim remains denied, a Supplemental Statement of the Case must be provided to the Veteran and his representative. After the Veteran and his representative have had an adequate opportunity to respond, the appeal must be returned to the Board for appellate review. MICHAEL LANE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board N. Gipson, 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.