Citation Nr: 21042744 Decision Date: 07/13/21 Archive Date: 07/13/21 DOCKET NO. 17-33 786 DATE: July 13, 2021 REMANDED Entitlement to service connection for sleep apnea is remanded. REASONS FOR REMAND The Veteran had active service from May 1966 to May 1970. The Veteran testified at a virtual tele-conference hearing before the undersigned Veterans Law Judge in February 2021. A transcript has been associated with the file and reviewed. The Board of Veterans' Appeals (Board) regrets the delay as the Veteran has been waiting for a decision on his appeal. However, the Board finds a remand is necessary in the Veteran's service claim for sleep apnea. The Board notes that the Veteran did not receive a Department of Veterans Affairs (VA) examination for his claim. A VA examination is required when there is (1) competent evidence of a current disability or persistent or recurrent symptoms of a disability, (2) evidence establishing that an event, injury, or disease occurred in service, or establishing certain diseases manifesting during an applicable presumptive period for which the claimant qualifies, and (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the veteran's service or with another service-connected disability, but (4) there is insufficient competent medical evidence on file for the Secretary to make a decision on the claim. McLendon v. Nicholson, 20 Vet. App. 79 (2006). Here, the Board finds that a VA examination is necessary to appropriately make an informed decision in this claim. The Veteran's post-service treatment records show he was diagnosed with moderate obstructive sleep apnea in 2008. See Richmond VAMC Sleep Polysomnography Consult, December 2008. Moreover, the Veteran is currently service connected for unspecified depressive disorder (claimed as PTSD) due chiefly to his experiences in Vietnam. The Veteran alleges this his sleeping problems began after returning home from Vietnam and have persisted since that time until being diagnosed as sleep apnea in 2008. Additionally, the Veteran and his spouse reported symptoms of a sleep disorder such that the Veteran experienced nightmares, loud snoring, non-continuous breathing while sleeping and excessive fatigue during the daytime immediately after he returned home from Vietnam, in 1970. See February 2021 Board Hearing Transcript. Put simply, the Veteran has not been afforded an examination for his sleep condition and the Board finds one is necessary because there is insufficient competent medical evidence on file to decide the claim. McLendon, supra. For these reasons, the Board finds that a medical opinion is necessary to adequately consider the Veteran's theories of entitlement for service connection. The matters are REMANDED for the following action: 1. The Agency of Original Jurisdiction (AOJ) should obtain any of the Veteran's outstanding pertinent VA and private medical records and associate them with the claims file. If possible, the Veteran should submit these records (if any) himself or indicate that all pertinent records have been submitted. 2. After completing the development requested in item 1, arrange for the record to be forwarded to an appropriate clinician for review and to provide the opinions sought. If further examination of the Veteran is deemed necessary, arrange an in-person examination. The reviewing clinician should be requested to provide an opinion (based on a review of the record) to answer the following: 3. Is it at least as likely as not (a 50 percent or greater probability) that the Veteran's sleep apnea was incurred in or related to his service? 4. Is it at least as likely as not (a 50 percent or greater probability) that the Veteran's sleep apnea is causally related to his service-connected unspecified depressive disorder (claimed as PTSD)? 5. Is it at least as likely as not (a 50 percent or greater probability) that the Veteran's sleep apnea is aggravated by (i.e., any worsening of the condition beyond its natural progress) his service-connected unspecified depressive disorder (claimed as PTSD)? The examiner is asked to consider the lay statements submitted by the Veteran and his wife, to specifically include his (and spouse's) credible statements of loud snoring, cessation of breathing and fatigue during the day, immediately following his return from Vietnam. A complete rationale for all opinions must be provided. If the clinician cannot provide a requested opinion without resorting to speculation, it must be so stated, and the clinician must provide the reasons why an opinion would require speculation. The clinician must indicate whether there was any further need for information or testing necessary to make a determination. Additionally, the clinician must indicate whether any opinion could not be rendered due to limitations of knowledge in the medical community at large and not those of the particular examiner. John J. Crowley Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Christopher M. Davidson 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.