Citation Nr: 21040345
Decision Date: 07/03/21	Archive Date: 07/03/21

DOCKET NO. 17-01 427
DATE: July 3, 2021

REMANDED

Entitlement to service connection for obstructive sleep apnea is remanded.

REASONS FOR REMAND

The Veteran served on active duty from October 1985 to October 1988, December 1990 to May 1991, and from February to November 2002. The Veteran's service records reflect that she was awarded the Southwest Asia Service Medal for her service in Southwest Asia, including Kuwait and Saudi Arabia.

This appeal was remanded by the Board in December 2018 in order for the Agency of Original Jurisdiction (AOJ) to obtain a medical opinion that addresses whether the Veteran's obstructive sleep apnea is related to her military service. The Board specifically directed the VA examiner to discuss the Veteran's contention that her obstructive sleep apnea is due to her exposure to a SCUD missile, nerve gas, and/or burning oil fumes. 

In January 2020, a VA examiner opined that the Veteran's obstructive sleep apnea is less likely than incurred in or caused by the claimed in-service injury or event, noting the causes and likely risk factors for sleep apnea. The VA examiner also noted the Veteran's report of nerve gas exposure, which she stated might cause central sleep apnea; however, the examiner stated there was no evidence of significant neurotoxin exposure in the Veteran's service treatment records or significant central sleep apneas. 

While the VA examiner addressed the Veteran's report of exposure to nerve gas, the examiner did not address her reported exposure to SCUD missiles and any residual particulates caused thereby or to oil and other fumes from burn pits. In this regard, the Board notes that the Veteran's statements regarding her exposure to environmental hazards during service in Southwest Asia are competent and credible evidence of such and must be addressed, as requested. See Stegall v. West, 11 Vet. App. 268, 271 (1998).  

Therefore, the Board finds the January 2020 VA opinion is inadequate, thereby necessitating the need for another remand.  

The matters are REMANDED for the following action:

1. Obtain an addendum opinion regarding the Veteran's obstructive sleep apnea. Following a review of the complete record, the examiner is asked to opine whether it is at least as likely as not (i.e., a 50 percent or greater probability) that the Veteran's obstructive sleep apnea was incurred as a result of her military service, including her exposure to environmental hazards in Southwest Asia?

The examiner must address the Veteran's assertions that she was exposed to a SCUD missile and any residual particulates caused thereby, nerve gas, and burn pits. The requested opinion must address each environmental hazard separately and discuss whether any such exposure as likely as not caused the Veteran's obstructive sleep apnea. However, if there is a medical reason to doubt the Veteran's statements, the examiner should explain why the Veteran's statements or recollection are inconsistent with the evidence in this case, medical principles relating to the onset and progress of the disease, the specific findings in the record, and/or your professional judgment. 

A well-reasoned rationale must be provided in support of any opinion offered. 

 

 

M. Donohue

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	A. Turnipseed, 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.