Citation Nr: 21032876 Decision Date: 05/28/21 Archive Date: 05/28/21 DOCKET NO. 17-55 674 DATE: May 28, 2021 REMANDED Entitlement to service connection for obstructive sleep apnea (OSA) is remanded. Entitlement to service connection for chronic rhinitis is remanded. REASONS FOR REMAND The Veteran had active military service from June 1997 to June 2002. 1. Entitlement to service connection for OSA is remanded. 2. Entitlement to service connection for chronic rhinitis is remanded. The Veteran contends that his OSA and rhinitis are attributable to his service. He contends that, throughout his service, he snored and had daytime sleepiness and other symptoms typically associated with OSA, moreover, that the conditions of living on a submarine caused or aggravated his OSA and rhinitis. During his recent March 2021 hearing before this Board, he cited chronic congestion and other common cold and allergy symptoms in service from breathing in the recycled air that he was exposed to in his military occupational specialty (MOS) responsibility aboard the submarine. He said he was hesitant at first to complain about these issues in service since that might have resulted in him being removed from his MOS responsibility on the submarine, but, nonetheless, that he did eventually complain about these issues at least once if not more while in service. As for what has or has not occurred since his service, he said he initially had no healthcare coverage from 2002 to 2011, which is why there is a gap in his treatment history following his discharge from the military. Also, during recent hearing, the Veteran pointed out that a fellow solider (J.M.) has provided a supporting "buddy" statement. The Veteran explained they attended submarine school together and later were roommates in Hawaii. As well, the Veteran's wife testified that she has known him since 2000, so since he was in the military, and that she started living with him in 2001, and that he has had these symptoms and conditions ever since she has known him, so for the entire time. Earlier, in August 2016, the Veteran's private physician had submitted a supporting medical opinion concluding the Veteran's OSA was likely related to his service onboard submarines. This commenting physician did not provide any rationale for the opinion, however, which is where most of the probative value of a medical opinion is derived. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 302-04 (2008) Two accompanying articles also submitted in support of the claims address Continuous Positive Airway Pressure (CPAP) machine usage amongst shift workers on submarines and the consequent effects of high ambient carbon dioxide levels during sleep on submarines. But neither of these articles specifically addresses the Veteran's contentions. In October 2016, a VA compensation examiner concluded that the Veteran's OSA is less likely than not related to his service explaining that the symptom of snoring in service, alone, does not indicate onset or predisposition for the development of OSA. But in so concluding, that VA examiner did not address the supporting August 2016 opinion or the Veteran's contentions that his OSA was related to his service onboard a submarine. Thus, the Board is obtaining additional medical comment before deciding the appeal of this claim for OSA. With regard to the Veteran's remaining claim for service connection for rhinitis, medical comment also is needed to assist in deciding the appeal of this other claim. Accordingly, these claims are REMANDED for the following action: Schedule the Veteran for an additional VA examination for his OSA and rhinitis. The examiner must review the relevant evidence in the claims file, including a complete copy of this remand and all supporting medical and other evidence. The examiner is specifically asked to provide responses to the following: a) Is it at least as likely as not the Veteran's OSA incepted during his service from June 1997 to June 2002 or is otherwise related or attributable to his service, including especially to the conditions inherent to serving on a submarine? b) Is it at least as likely as not the Veteran's rhinitis incepted during his service from June 1997 to June 2002 or is otherwise related or attributable to his service, including especially to the conditions inherent to serving on a submarine? *To assist in making these determinations, the examiner must consider the evidence submitted by the Veteran in support of these claims concerning the change of sleep patterns while on a submarine and possible toxins inhaled while on a submarine. Rationale for the opinions is essential, regardless of whether favorable or unfavorable to the claims, preferably citing to evidence in the file supporting conclusions and/or accepted medical authority. KEITH W. ALLEN Veterans Law Judge Board of Veterans' Appeals R. Erdheim, Attorney for the Board Department of Veterans Affairs 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.