Citation Nr: 21024578 Decision Date: 04/23/21 Archive Date: 04/23/21 DOCKET NO. 14-11 016A DATE: April 23, 2021 REMANDED Entitlement to service connection for sleep apnea, to include as secondary to service-connected disabilities is remanded. REASONS FOR REMAND The Veteran had active service from February 1967 to January 1970. 1. Entitlement to service connection for sleep apnea, to include as secondary to service-connected disabilities is remanded. This case was previously before the Board in September 2019 when it denied entitlement to service connection for sleep apnea. The Veteran appealed to the Court of Appeals for Veterans Claims (Court) which issued a Joint Motion for Remand, vacating the September 2019 Board decision regarding sleep apnea, partially based on the July 2018 VA medical opinion which it deemed inadequate. The Board remanded the case for a new medical opinion in December 2020. The AOJ obtained a new medical opinion in January 2021 which opined on the Veteran’s sleep apnea for direct relation to active service and secondary direct or aggravating causation from service-connected diabetes and the relationship with obesity. Unfortunately, the opinion is inadequate because it cites erroneous medical information on which the examiner based the opinion. The January 2021 medical opinion in part states, “the Veteran was noted to have a BMI of 50+ in 2007 prior to being diagnosed with DM 2.” In another part of the opinion, the examiner states, “At the time of his sleep study in 2007, he was noted to have a BMI of 50 which places him at a significant risk for OSA. He was not diagnosed with DM 2 until 2008, which is after he was diagnosed with severe OSA.” The Board notes that the Veteran had a VA examination for diabetes mellitus in September 2001 where he was diagnosed with “adult onset diabetes mellitus, recent onset approximately eight months’ duration… Also has… obesity.” The Veteran has an effective date for service connection for diabetes mellitus from May 2001. Accordingly, as this is a material error in the January 2021 medical opinion, the Board is remanding for a new medical opinion for the Veteran’s sleep apnea. The matter is REMANDED for the following action: 1. Obtain a new addendum VA medical opinion for the Veteran’s sleep apnea. The need for a new VA examination is at the discretion of the examiner. The examiner should have access to the Veteran’s complete claims file and should acknowledge such. The examiner should opine on the following and should not consider the January 2021 or the July 2018 VA medical opinions concerning sleep apnea. (a.) Does the Veteran have a diagnosis of sleep apnea? (b.) Is it at least as likely as not that the Veteran’s sleep apnea is related to an event, injury, or disease in active service? (c.) The Veteran is service-connected from 2001 for diabetes mellitus. Is it at least as likely as not that the Veteran’s sleep apnea is caused by any of the Veteran’s service-connected disabilities, including but not limited to diabetes mellitus? (d.) The Veteran is service-connected from 2001 for diabetes mellitus. Is it at least as likely as not that the Veteran’s sleep apnea is aggravated by any of the Veteran’s service-connected disabilities, including but not limited to diabetes mellitus? (e.) Is it as least as likely as not that the Veteran’s service-connected disabilities, including but not limited to diabetes mellitus, caused or aggravated the Veteran’s obesity? (f.) Is it at least as likely as not that the Veteran’s obesity caused or aggravated the Veteran’s sleep apnea? DAVID L. WIGHT Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board E. Miller, 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.