Citation Nr: 21014139
Decision Date: 03/11/21	Archive Date: 03/11/21

DOCKET NO. 15-33 238
DATE: March 11, 2021

REMANDED

The issue of service connection for obstructive sleep apnea, to include as secondary to service-connected migraine headaches, is remanded.

REASONS FOR REMAND

The Veteran served on active duty from March 1992 to March 2012.  This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a rating decision of a Department of Veterans Affairs (VA) Regional Office (RO).  In June 2020, the Board remanded this matter for further evidentiary development.

Following the June 2020 remand, the RO ordered additional development to determine whether the Veteran’s obstructive sleep apnea is secondary to his service-connected migraines.  The RO noted the Veteran asserted that he was treated for migraines during service rather than sleep apnea, as migraines were believed to be the cause of his sleeping issue.  The RO requested an opinion to address whether the Veteran’s sleep apnea, diagnosed during the period on appeal in December 2013, is secondary to his service-connected migraines.  An opinion was obtained in January 2021.  The examiner opined,

There is no nexus between his migraines and sleep apnea; sleep apnea is characterized by periods of apnea (cessation of breathing) and loud snoring primarily; such features are not attributable to migraines.  The sleep apnea diagnosed in 2013 was less likely due to his migraines as they are not medically connected and sleep apnea is a respiratory condition.

Upon review, the examiner did not address aggravation.  Accordingly, remand is required.

The matters are REMANDED for the following action:

Obtain an addendum opinion from the January 2021 VA examiner, if available, and if unavailable from another appropriate clinician, regarding the following:

Is it at least as likely as not (50 percent or greater probability) that the Veteran’s service-connected migraine headaches aggravated his obstructive sleep apnea?

For purposes of the opinion the examiner must take as fact that obstructive sleep apnea was diagnosed during the course of the appeal (i.e., December 2013 VA treatment records from Nite Watch showing a diagnosis of mild obstructive sleep apnea).

The examiner must provide a rationale for the opinion.

 

 

JAMES L. MARCH

Veterans Law Judge

Board of Veterans’ Appeals

Attorney for the Board	S. Griffith

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.