Citation Nr: 21014629 Decision Date: 03/15/21 Archive Date: 03/15/21 DOCKET NO. 11-26 576A DATE: March 15, 2021 REMANDED Entitlement to service connection for obstructive sleep apnea (OSA), to include as secondary to a service-connected disability, is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1978 to November 1998. This matter is on appeal from a July 2009 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). This matter was remanded by the Board in January 2017 and December 2017 before the Board denied the claim for service connection for OSA in October 2019. The Veteran appealed the Board’s decision to the United States Court of Appeals for Veterans Claims (Court). In an October 2020 Order, the Court granted a Joint Motion for Remand (JMR) and vacated the Board’s decision. This matter was remanded to the Board for readjudication in accordance with the JMR. 1. Service connection for OSA The Court directed the Board to attempt to obtain medical records that were reported by the Veteran. Specifically, 1998 sleep study from the National Navy Center in Bethesda, Maryland; 1998 hospitalization records from Dewitt Army Community Hospital in Fort Belvoir, Virginia; and hospital records from the VA facility in Washington, D.C. that date from 1985 to 2000. See August 2008 claim for benefits and statement in support of claim received in August 2009. Remand is also necessary to obtain a new VA medical opinion. At a January 2018 VA examination, the examiner opined that OSA was not incurred in service or aggravated by his service connected disabilities. As pointed out by the Court, the examiner failed to adequately consider the lay statements of record regarding the onset and continuity of the Veteran’s symptoms of sleep problems. The matters are REMANDED for the following action: 1. The RO should contact the appropriate entity and attempt to obtain records that pertain to the Veteran from the National Navy Center in Bethesda, Maryland (1998 sleep study); from Dewitt Army Community Hospital in Fort Belvoir, Virginia(1998 hospitalization records); and from the VA facility in Washington, D.C. that date from 1985 to 2000, for incorporation into the record. If no such records are available, the RO MUST: (1) make a formal finding of unavailability and associate it with the file, and (2) send a notification letter of the unavailability to the Veteran and his appointed representative. 2. Following the receipt of outstanding records, obtain an etiology opinion from an appropriate examiner to determine the nature and etiology of the Veteran’s claimed sleep disorder. The need for a physical examination is left to the discretion of the medical professional offering the medical opinion. Based on the review of the record, the examiner must provide an opinion as to whether it is at least as likely as not that the currently diagnosed OSA, had its onset during his active service, or is caused or aggravated beyond its natural progression by his lumbar spine disability, residuals of viral meningitis with migraine headaches, chronic neck strain, hypertension, and/or radiculopathy of the lower extremities? The examiner must address the Veteran’s lay statements (and other witnesses) regarding the onset and continuity of his symptoms. A complete rationale should be given for each opinion expressed. In this regard, a discussion of the facts and medical principles involved would be considerable assistance to the Board. Nathaniel J. Doan Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A.D. Jackson, 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.