Citation Nr: 21040982 Decision Date: 07/07/21 Archive Date: 07/07/21 DOCKET NO. 16-61 364 DATE: July 7, 2021 REMANDED Entitlement to service connection for sleep apnea is remanded. REASONS FOR REMAND The appellant is a Veteran who served on active duty from March 1999 to July 1999, January 2004 to April 2004, January 2008 to January 2009 and April 2011 to August 2012. He had additional Army Reserve service and Army National Guard service. This matter is before the Board of Veterans' Appeals (Board) on appeal from a February 2015 Department of Veterans Affairs (VA) rating decision. In May 2021, a virtual hearing was held before the undersigned. Entitlement to service connection for sleep apnea The Board finds that further development of the record is necessary to comply with VA's duty to assist the Veteran in the development of facts pertinent to his claim of service connection for sleep apnea. The Veteran contends his sleep apnea is etiologically related to his active duty service. Mild obstructive sleep apnea (OSA). with apnea-hypopnea index (AHI) of 9.5 events per hour, was diagnosed on an August 2013 sleep study of the Veteran. A February 2014 lay statement (from a former fellow service member, who is also the Veteran's current representative) noted his loud snoring and breathing pauses during deployment from 2011 to 2012. At the May 2021 Board hearing, the Veteran testified that he constantly felt tired during deployment (from 2011 to 2012) and that the fatigue continued after service separation. He stated that OSA was diagnosed on an August 2013 sleep study, and that he was provided a CPAP machine to help him breathe more easily during sleep (which reduced his fatigue and made him feel "much better"). April 2011 to August 2012 STRs are not associated with the Veteran's claims file, are pertinent evidence in the matter at hand, and must be secured for association with the record. 38 C.F.R. § 3.159(c). The matter is REMANDED for the following: 1. Arrange for an exhaustive search, and secure for the record the Veteran's complete STRs service (to specifically include medical records from his active duty service from April 2011 to August 2012). If any records cannot be located because they have been irretrievably lost or destroyed (or did not exist), it should be so certified; the scope of the search for the records should be described; and the Veteran should be so notified. He should be asked to provide copies of any pertinent STRs (not already in his claims file) he may have in his possession. 2. Secure for the record updated (to the present, any not already associated with the claims file) complete clinical records of VA evaluations and treatment the Veteran has received for sleep apnea. 3. After the development requested above is completed, arrange for the Veteran's claims file to be forwarded to an appropriate clinician (one with experience in the diagnosis, and identifying the etiology, of OSA) for review and an advisory medical opinion regarding the likely etiology of his OSA. Upon review of the record (noting specifically the February 2014 lay statement regarding his loud snoring and breathing pauses), the consulting provider should: (a.) Identify the likely etiology for the Veteran's diagnosed (in August 2013) OSA. Is it at least as likely as not (a 50% or greater probability) that it is etiologically related directly to his service (was incurred therein)? The rationale provided must acknowledge consideration of the lay statement the Veteran has submitted in support of his claim regarding symptoms noted during his deployment. (b.) If the OSA is determined to be unrelated to the Veteran's service, identify the etiology for the OSA that is considered to be more likely (and explain why that so). All opinions must include rationale that cites to supporting clinical data and medical principles. GEORGE R. SENYK Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D. Chu, 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.