Citation Nr: 22012154
Decision Date: 03/02/22	Archive Date: 03/02/22

DOCKET NO. 17-37 852
DATE: March 2, 2022

REMANDED

Entitlement to service connection for a sleep disability, to include obstructive sleep apnea, is remanded.

REASONS FOR REMAND

The Veteran served on active duty from July 1993 to July 1995 and from December 2003 to April 2005.  The Veteran had additional service in the Naval Reserve and the Army National Guard.

In June 2021, the Board remanded this case for additional development.  The Board finds that there has been substantial compliance with the remand requests. Stegall v. West, 11 Vet. App. 268 (1998).  

Entitlement to service connection for a sleep disability, to include obstructive sleep apnea is remanded.

The Veteran asserts that a sleep disability is the result of service.  

Although the Veteran has not asserted a secondary service connection theory of entitlement, the Board finds that a secondary theory of entitlement for diagnosed obstructive sleep apnea has been raised by the evidence of record.

During a May 2011 psychiatric VA examination, the examiner stated that a sleep study was necessary to determine "whether or not [the Veteran's] difficulties [were] exacerbated by sleep apnea."  Additionally, in October 2013, the Veteran's pulmonologist recommended that the Veteran wear a CPAP machine due to "narcotic use worsening sleep apnea."

The Board is required to consider all theories of entitlement reasonably raised by the record.  Robinson v. Shinseki, 557 F.3d 1355 (Fed. Cir. 2009).  To date, there has been no medical opinion regarding whether any of the service-connected disabilities or treatment for any service-connected disability has caused, contributed to, or aggravated diagnosed obstructive sleep apnea.  

Therefore, although the Board regrets the additional delay, remand for a medical opinion is necessary in order to allow the Veteran every possible opportunity to substantiate the claim for service connection.

The matter is REMANDED for the following action:

1. After obtaining any necessary releases, obtain all relevant VA and private medical records not already associated with the claims file.  All attempts to locate records must be documented in the claims file.

2. Then, schedule the Veteran for a VA examination by a medical doctor who has not previously examined the Veteran in conjunction with this claim to determine the etiology of any diagnosed sleep disability, to include obstructive sleep apnea.  The examiner must review the claims file, to include a copy of this Remand, and consider the Veteran's lay statements.  A clearly stated rationale with references to the record, and medical literature should be provided for each opinion.  The examiner should: 

(a.) Opine whether it is at least as likely as not (50 percent probability or greater) that any diagnosed sleep disability is related to service or any event, injury, or disease in service.  The examiner should discuss the Veteran's and the Veteran's wife's lay statements regarding onset of symptomatology.

(b.) Opine whether it is at least as likely as not (50 percent probability or greater) that any service-connected disability or treatment for any service-connected disability caused or contributed to any diagnosed sleep disability.  Discuss the significance of the record showing that in October 2013, the Veteran's pulmonologist recommended that the Veteran wear a CPAP machine due to "narcotic use worsening sleep apnea."

(c.) Opine whether it is at least as likely as not (50 percent probability or greater) that any diagnosed sleep disability has been aggravated (increased in severity beyond the natural progress of the disorder) by any service-connected disability or treatment for any service-connected disability.   Discuss the significance of the record showing that in October 2013, the Veteran's pulmonologist recommended that the Veteran wear a CPAP machine due to "narcotic use worsening sleep apnea.

 

 

Harvey P. Roberts

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	E.O., 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.