Citation Nr: 21026192 Decision Date: 04/30/21 Archive Date: 04/30/21 DOCKET NO. 15-41 488 DATE: April 30, 2021 REMANDED The claim for service connection for sleep apnea is remanded. The claim for a rating in excess of 10 percent for radial head fracture and osteoarthritis of the left elbow (non-dominant) for the period from November 15, 2011, to March 30, 2017, is remanded. The claim for a rating in excess of 20 percent for radial head fracture and osteoarthritis of the left elbow (non-dominant) for the period beginning March 31, 2017, is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1975 to March 1998. The Veteran testified before the undersigned Veterans Law Judge during a December 2018 hearing. A transcript of the hearing is associated with the Veteran’s claims file. First with respect to the claim for service connection for sleep apnea, this claim was remanded by the Board of Veterans’ Appeals in April 2019 for the completion of an examination and opinion as to whether this condition was incurred in service. Such was accomplished in November 2019, and the conclusion following this examination was that it was less likely as not that the Veteran’s sleep apnea was caused by service. The rationale for this opinion was limited to the following: During service, sleep apnea was not diagnosed. There is no evidence of chronicity of care while the Veteran was in the Military. A nexus has not been established. The Board finds this opinion to be inadequate as it is based solely on the lack of in-service evidence of sleep apnea, and did not consider the Veteran’s competent and credible assertions of having problems with interrupted sleep due to snoring from service to the present time. Dalton v. Nicholson, 21 Vet. App. 23 (2007). In this regard, the Veteran testified at his hearing before the undersigned that he was a firefighter for the twenty-two years he was in service and had problems sleeping during and since service. [The Veteran’s official service department records document duty as a firefighter.] He attributed his issues with sleep, to include interrupted sleep due to snoring, to being half awake and half asleep because he was on duty twenty-four hours. He also testified that he was not familiar with the existence of sleep apnea until after service; that his wife noticed that he had stopped breathing when he was asleep one night; and that he thereafter went to an ENT doctor and that is when he became aware of the condition of sleep apnea. In short therefore, an addendum opinion from the clinician who conducted the November 2019 examination that reflects consideration of these assertions of continuity of relevant symptomatology associated with sleep apnea from service to the present time will be requested below so as to fulfill the duty to assist. Id. With respect to the matter of increased compensation for a radial head fracture and osteoarthritis of the left elbow, while it addressed some aspects of the holding in Correia v. McDonald, 28 Vet. App. 158 (2016) as directed by the April 2019 Board remand, the November 2019 VA examination of the left elbow did not include the range of motion findings required by Correia; namely, that demonstrated on active and passive motion, and in weight-bearing and non-weight-bearing. As the range   of motion findings required by Correia are not otherwise of record, this case must be remanded to obtain such findings so as to fulfill the duty to assist with respect to the claims for increased ratings for the service connected left elbow disability on appeal. For the reasons stated above, this case is REMANDED for the following action: 1. Obtain any outstanding private and or VA records associated with the above claims. 1. Obtain an addendum opinion from the clinician who conducted the November 2019 VA examination to address the Veteran’s claim for service for sleep apnea, or another suitable substitute if this clinician is not available, as follows: Is it at least as likely as not (50 percent probability or greater) that the Veteran’s sleep apnea was incurred in service? A complete detailed rationale is requested for the opinion that is rendered. The rationale for any negative opinion should not be based solely on the lack of sufficient in-service evidence of relevant disability and should specifically document consideration of the Veteran’s reports of continuity of symptomatology, to include interrupted sleep due to snoring, from service to the present time.   2. Schedule the Veteran for a VA examination of the left elbow that includes the range of motion findings required by Correia. MARJORIE A. AUER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Andrew Ahlberg, 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.