Citation Nr: 22011920
Decision Date: 03/02/22	Archive Date: 03/02/22

DOCKET NO. 18-54 963
DATE: March 2, 2022

REMANDED

Entitlement to service connection for obstructive sleep apnea, to include as secondary to service-connected posttraumatic stress disorder (PTSD) or diabetes mellitus, is remanded.

REASONS FOR REMAND

The Veteran served on active duty from January 1970 to February 1974. This appeal comes before the Board of Veterans' Appeals (Board) from a rating  decision of a Department of Veterans Affairs (VA) Regional Office (RO).

In a March 2020 decision, the Board denied the claim. The Veteran subsequently appealed that decision to the United States Court of Appeals for Veterans Claims (Court). In a January 2021 order, the Court granted a Joint Motion for Remand (JMR), which vacated the Board's decision and remanded the Veteran's appeal to the Board for action consistent with the terms of the JMR. The claim was most recently before the Board in December 2021.  There has not been substantial compliance with the remand directives and the claim must be remanded again. 

1. Entitlement to service connection for obstructive sleep apnea, to include as secondary to posttraumatic stress disorder (PTSD) or diabetes mellitus 

The Veteran is seeking service connection for obstructive sleep apnea. He contends that apnea is secondary to or aggravated by his service-connected PTSD or by his service-connected diabetes mellitus.  The August 2021 VA examiner listed central nervous system depressant medications as an inherent risk factor for sleep apnea but did not discuss whether the effects of any medication used to treat any of the Veteran's service-connected disabilities, to include his PTSD, fall into this risk category, and if not, whether any of these medications cause or aggravate the Veteran's sleep apnea condition. 

The Board regrets the additional delay but finds that a remand is warranted for substantial compliance with its prior remand. See Stegall v. West, 11 Vet. App. 268, 271 (1998).

The matters are REMANDED for the following action:

1. Obtain an addendum opinion with respect to the Veteran's sleep apnea claim.  The claims file must be reviewed by the examiner. If an examination is deemed necessary to respond to the request, one should be scheduled. After review of the claims file, the examiner should respond to the following: 

(a.) Is it at least as likely as not (approximate balance) that the Veteran's diagnosed sleep apnea is caused by the effect of medications used to treat the service-connected PTSD and diabetes?

(b.) If not, is it at least as likely as not that the Veteran's sleep apnea has been aggravated (any increase in disability) by the effects of medications used to treat the service-connected PTSD and diabetes? 

A rationale for the conclusions reached must be provided.

 

2. If the claim remains denied, issue a supplemental statement of the case, as appropriate.

 

 

K. A. BANFIELD

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	A. Asare, 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.