Citation Nr: 21030991
Decision Date: 05/20/21	Archive Date: 05/20/21

DOCKET NO. 15-43 262
DATE: May 20, 2021

REMANDED

Entitlement to service connection for low back pain is remanded.

Entitlement to service connection for a sleeping disorder is remanded.

Entitlement to service connection for chronic cystitis is remanded.

Entitlement to service connection for sciatica is remanded.

REASONS FOR REMAND

The Veteran served on active duty from July 2004 to April 2011.  

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a November 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO).

This matter was previously remanded by the Board in February 2019 for further development.  A review of the record indicates that the Board's directives were substantially complied with.  See Stegall v. West, 11 Vet. App. 268, 271 (1998).  However, as explained below, further remand is necessary.

Regarding the Veteran's claims of entitlement to service connection for low back pain, sciatica, and chronic cystitis, in March 2021, the Veteran submitted additional statements and medical literature that give rise to the need for an updated opinion in relation to these claims.  As such, remand is necessary.

Further, regarding the Veteran's claim of entitlement to service connection for a sleeping disorder, it is clear from the Veteran's statements that there are two separate conditions she believes are related to service.  First, obstructive sleep apnea, for which an opinion has been obtained, and second, insomnia, due to pain from her back disability.  As a decision on the remanded claim of entitlement to service connection for a back disability could significantly impact a decision on the issue of entitlement to service connection for a sleep disability the issues are inextricably intertwined.  A remand of the claims for entitlement to service connection for a sleep disability is required.

The matters are REMANDED for the following action:

1. Return the claims file to an appropriate VA examiner for an addendum opinion as to whether the Veteran's sciatica, low back pain, or chronic cystitis are due to service.  The claims file, including a copy of this Remand, must be made available to and be reviewed by the examiner in conjunction with the examination.  The need for another examination is left to the discretion of the medical professional offering the addendum opinion.

In discussing the above conditions, the examiner must address the newly submitted medical literature and the Veteran's lay assertions regarding onset and etiology of the conditions.

The report should include reasons for any opinion expressed.  If the clinician completing the report is unable to provide an opinion without resort to speculation, he or she should state whether the inability is due to the limits of the person's knowledge, the limits of medical knowledge in general, or there is additional evidence that would permit the needed opinion to be provided.

2. In the event the examiner finds a link between the Veteran's sciatica or low back pain and service, the Veteran should be provided an examination to determine the nature and etiology of any sleep disorder other than sleep apnea.

3. Readjudicate the appeal.

 

 

A.	ADAMSON

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	J. Uller, Associate 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.