Citation Nr: 21021860 Decision Date: 04/14/21 Archive Date: 04/14/21 DOCKET NO. 15-36 768 DATE: April 14, 2021 REMANDED Entitlement to service connection for sleep apnea, to include as secondary to tinnitus, is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Navy from December 1971 to September 1975. Most recently, the Board of Veterans’ Appeals (Board) remanded the matter on appeal for additional development in October 2018. Entitlement to service connection for sleep apnea, to include as secondary to tinnitus, is remanded. The Veteran maintains entitlement to service connection for sleep apnea. He has averred that this currently diagnosed disability is related to his now service-connected acquired psychiatric disability and/or to his service-connected tinnitus. While VA has provided a medical opinion concerning whether an etiological relationship exists between the Veteran’s sleep apnea and his now service-connected acquired psychiatric disability, it has not obtained a medical opinion concerning whether an etiological relationship exists between the Veteran’s sleep apnea and his service-connected tinnitus. The Board finds that a medical opinion is necessary to determine whether this condition is related to his tinnitus. See McLendon v. Nicholson, 20 Vet. App. 79, 83 (2006). The matters are REMANDED for the following action: The Board cannot make a fully-informed decision on the issue of entitlement to service connection for sleep apnea because no VA examiner has opined whether it is at least as likely as not (a 50 percent or greater probability) that the Veteran’s sleep apnea condition is either proximately due to or aggravated beyond its natural progression by his service-connected tinnitus. A rationale must be provided. Also, in answering this question, two opinions are required: one for proximate causation and a second for aggravation. If aggravation is found, then, to the extent possible, the examiner should attempt to establish a baseline level of severity for the sleep apnea prior to aggravation by the tinnitus. JENNIFER HWA Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board L. Bush 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 This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.