Citation Nr: 21029979 Decision Date: 05/17/21 Archive Date: 05/17/21 DOCKET NO. 17-61 329 DATE: May 17, 2021 REMANDED Entitlement to service connection for sleep apnea, to include as associated with the Veteran's service-connected posttraumatic stress disorder (PTSD). REASONS FOR REMAND The Veteran served on active duty from June 1966 to March 1970. This matter comes to the Board of Veterans' Appeals (Board) on appeal from a January 2017 rating decision by the Regional Office (RO). The Veteran testified before the Board in September 2020; a transcript of that hearing is of record. Entitlement to service connection for sleep apnea is remanded. The Veteran contends that his sleep apnea is related to his service-connected posttraumatic stress disorder. In October 2017, the Veteran's claims file was provided to a physician for review. Following review of the evidence, the examiner concluded that the Veteran's sleep apnea was less likely than not proximately due to or the result of the Veteran's PTSD. The examiner stated that his opinion as based upon the evidence of record to include a 2016 polysomnogram finding and he stated that he was unaware of any medical literature or evidence that supported the Veteran's claim. At his September 2020 hearing before the Board, the Veteran argued that these findings were inadequate as they failed to consider the Veteran's contentions that he has had sleep problems since he came back from Vietnam and was diagnosed with sleep apnea prior to 2016 by his private physician. When VA undertakes to provide a VA examination or obtain a VA opinion, it must ensure that the examination or opinion is adequate. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). Here, the Board agrees that a new examination is necessary which includes the Veteran's lay observations of sleep symptoms. See Buchanan v. Nicholson, 451 F.3d 1331, 1337 (Fed. Cir. 2006) (noting the lack of contemporaneous medical records does not serve as an "absolute bar" to the service connection claim). Moreover, the Veteran has identified relevant outstanding private treatment records from his private physician, Dr. G. A remand is required to allow VA to obtain authorization and request these records. The matters are REMANDED for the following action: 1. Ask the Veteran to complete a VA Form 21-4142 for Dr. G. of Lock Haven Medical. Make two requests for the authorized records from unless it is clear after the first request that a second request would be futile. Obtain any outstanding VA treatment records and/or additional private treatment records that the Veteran authorizes for release. 2. Schedule the Veteran for a VA examination for his claimed sleep apnea. The examiner must review the claims file. If a diagnosis cannot be provided but the Veteran's condition manifests in symptoms that cause functional impairment, then the examiner should consider them a "disability" for the purpose of providing the requested opinion(s) below. The examiner is asked to provide a response to the following: a) Is sleep apnea at least as likely as not proximately due to the Veteran's service-connected PTSD? b) Is sleep apnea at least as likely as not aggravated, i.e., worsened beyond its natural progression, by PTSD? 3. Then readjudicate the claims remaining on appeal. If any of the benefits sought are not granted in full, furnish the Veteran and his representative with a supplemental statement of the case and an opportunity to respond, and return the case to the Board. KELLI A. KORDICH Veterans Law Judge Board of Veterans' Appeals Attorney for the Board G. Slovick, 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.