Citation Nr: 21021856 Decision Date: 04/14/21 Archive Date: 04/14/21 DOCKET NO. 16-20 190 DATE: April 14, 2021 ORDER Entitlement to service connection for an upper respiratory condition (previously claimed as sinusitis), including secondary to sleep apnea, is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Army from January 2002 to August 2006. This matter was previously before the Board, on appeal from a from a July 2016 Department of Veterans’ Affairs (VA) Regional Office (RO) rating decision that denied service connection for sinusitis. In its April 2020, the Board remanded the claim for further development based on a new theory of secondary service connection of sinusitis due to sleep apnea and its treatment. However, careful review of the record has identified a need for additional development as part of the VA’s duty to assist the Veteran. The VA has not fully complied with its duty to assist for an adequate opinion based on the evidence of record. The Veteran initially claimed service connection for sinusitis. However, the Veteran is not a trained medical professional and as such is not expected to, not competent, to diagnose complex medical conditions. See Jandreau v. Nicholson, 429 F.3d 1372 (Fed. Cir. 2007). The Veteran has been afforded two VA examinations for sinusitis. However, an April 2016 opinion stated that the Veteran’s described symptoms and the April 2016 examination results are more consistent with allergic rhinitis than sinusitis. The record contains no opinion on service connection of allergic rhinitis. Therefore, the Board finds that another remand is needed to obtain a medical opinion on the etiology of the Veteran’s upper respiratory condition. The matter is REMANDED for the following actions: 1. Obtain a VA medical opinion on the nature and likely etiology of the Veteran’s upper respiratory condition, to include rhinitis. The examiner is asked to clarify the Veteran’s diagnosis. The examiner is asked to opine if the Veteran’s symptoms support a diagnosis of allergic rhinitis. The examiner is asked to explain why any identified symptoms do or do not support one diagnosis over another, or if the Veteran may have multiple conditions with over lapping symptoms. The need for an additional examination (to include in-person, telehealth, or other examinations) is left to the discretion of the VA examiner. (a.) The examiner must provide a medical opinion on whether it is as likely as not (50 percent or greater probability) that any diagnosis is related to the Veteran’s active service. (b.) The examiner must provide a medical opinion on whether it is as likely as not (50 percent or greater probability) that any identified diagnosis was aggravated beyond its natural progression by the Veteran’s sleep apnea, including by the prescribed CPAP for treating the Veteran’s sleep apnea. The examiner must address the April 2016 VA examination report that the Veteran’s symptoms are more consistent with allergic rhinitis than sinusitis and the December 2013 sleep study noting “comorbid, chronic sinusitis.” The examiner must also address the January 2020 and February 2020 statements that observed the Veteran’s ongoing symptoms, during and after service, to include facial swelling, runny nose, sneezing, nose crusting over, as well as apparent increases in symptoms when the Veteran uses his CPAP to treat his service connected sleep apnea. The entire claims file, including a copy of this REMAND, must be reviewed. A thorough rationale should be provided for all opinions expressed. If any requested medical opinion cannot be given, the examiner should state the reason(s) why. DELYVONNE M. WHITEHEAD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Boushehri, Darjush M. 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.