Citation Nr: 21020891
Decision Date: 04/08/21	Archive Date: 04/08/21

DOCKET NO. 18-24 353
DATE: April 8, 2021

REMANDED

Entitlement to service connection for obstructive sleep apnea is remanded.

Entitlement to a total disability rating on the basis of individual unemployability (TDIU) due to service-connected disabilities is remanded.

REASONS FOR REMAND

The Veteran served on active duty in the United States Air Force from December 1973 to December 1993.

This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a July 2018 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO).

In January 2020, the Veteran testified at a hearing held before the undersigning Veterans Law Judge (VLJ).

Unfortunately, the Board finds a remand is warranted for further development.  Specifically, the Board notes that the Veteran asserts that his diagnosed obstructive sleep apnea (OSA) was caused by his obesity which started during service.  See April 2019 VA Form 9, January 2020 Hearing Transcript, pg. 2-3.  The Board finds that the June 2018 VA medical opinion noted that the Veteran was obese, which was a medically acknowledged risk factor for OSA.  The examiner found that when the Veteran lost 20 pounds his OSA improved.  Therefore, the June 2018 VA examiner found that the etiology of the Veteran’s OSA was obesity.  See June 2018 VA Medical Opinion Disability Benefit Questionnaire (DBQ).  The Board notes that the VA examiner stated that the Veteran’s obesity was a risk factor and did not state it to be the sole reason for the Veteran’s OSA.

Then, in September 2020, a new VA medical opinion was completed in connection with the June 2020 prior Board remand.  Here, the examiner found that it was less likely than not that the Veteran’s OSA was incurred in or caused by hypersomnolence or was due to or aggravated by his in-service dental surgery.  The Board finds the examiner did not address the Veteran’s in-service obesity and whether it caused his OSA.  Therefore, the Board finds a remand is warranted to determine whether the Veteran’s in-service obesity caused OSA.

In addition, the Board notes that the issue of entitlement to TDIU still cannot be adjudicated until the service connection issue is addressed, as they are intertwined.  Harris v. Derwinski, 1 Vet. App. 180, 183 (1991).

The matters are REMANDED for the following action:

1. The RO should obtain an addendum opinion regarding the Veteran’s service connection claim.  In-person examination is not necessary unless the examiner determines it must be conducted to address the questions below.  The examiner is asked to specifically address the following, with a rationale provided:

Whether the Veteran’s currently diagnosed obstructive sleep apnea is at least as likely as not (50 percent or greater probability) caused by service, including obesity therein.   

The examiner must thoroughly consider and discuss the Veteran’s contention that his OSA is caused by his obesity during service.  The examiner must also consider the prior VA medical opinions regarding the Veteran’s OSA.  All opinions must be supported by a rationale.

 

 

A. C. MACKENZIE

Veterans Law Judge

Board of Veterans’ Appeals

Attorney for the Board	J. Glaeser, 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.