Citation Nr: 22018491 Decision Date: 03/29/22 Archive Date: 03/29/22 DOCKET NO. 08-27 944 DATE: March 29, 2022 ORDER Service connection for posttraumatic stress disorder (PTSD) is granted. REMANDED Service connection for obstructive sleep apnea (OSA) is remanded. FINDING OF FACT The evidence persuasively supports a finding that the Veteran's PTSD is caused by stressors related to the fear of hostile military activity during active duty. CONCLUSION OF LAW The criteria for service connection for PTSD have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304(f), 4.125(a). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from August 1982 to February 2005. The Veteran appeared for a hearing before the undersigned Veterans Law Judge in January 2016. The hearing transcript is associated with the claims file. Service Connection Service connection for PTSD is granted. The Veteran contends entitlement to service connection for PTSD, related to numerous stressors he experienced during service. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004). Claims for service connection for PTSD require medical diagnosis conforming to the requirements of 38 C.F.R. § 4.125(a), an in-service stressor accompanied by credible and supporting evidence that the stressor claimed to be the cause of the disorder occurred in service, and established medical evidence connecting the current disability to the stressor. 38 C.F.R. § 3.304(f); 38 C.F.R. § 4.125(a); Cohen v. Brown, 10 Vet. App. 128, 138 (1997). A stressor may be proven with lay statements alone if the veteran claims a stressor due to fear of hostile military or terrorist activity, the claimed stressor is consistent with the circumstances of service, and a VA or VA-contracted psychiatrist or psychologist confirms that the claimed stressor is adequate to support a PTSD diagnosis and that the veteran's symptoms are related to the claimed stressor. 38 C.F.R. § 3.304(f)(3). First, the Board finds a diagnosis of PTSD conforming to the requirements of 38 C.F.R. § 4.125(a). See December 2019 VA examination. Second, the Board finds evidence of stressors related to fear of hostile military or terrorist activity consistent with the circumstances of his service. Specifically, the Veteran reported while serving in Puerto Rico in 1984 during a mission called Ocean Venture, he was shot at while working nighttime security. Additionally, he reported while stationed in Turkey at Incirlik Air Base, he was guarding airplanes carrying nuclear weapons. He reported he stopped a bus of local police, they got out of the bus and surrounded him with weapons drawn. See January 2018 Statement in Support of Claim for PTSD; November 2020 Statement in Support of Claim for PTSD. A December 2019 VA examination found these stressors were adequate to support the diagnosis of PTSD and were related to fear of hostile military or terrorist activity. These reported stressors are consistent with the circumstances of the Veteran's service. The Veteran's DD-214 shows he worked for 11 years on the security force. Personnel records include a performance report from February 1984 to February 1985, duty title was alarm response team member, duties included responding to alarms and security incidents emanating from launch facilities or launch control facilities. The report noted the Veteran's skills were put to the test in May 1984 while deployed to Ramey AFB in Puerto Rico for support of Ocean Venture 84, serving as a Security Response Member. Performance reports from February 1985 to February 1987 show the Veteran was stationed at Incirlik Air Base in Turkey under the 39th Security Police Flight, duty title was a response force member and area supervisor, duties included providing quick response to actual or possible hostile action, conducts periodic checks of base and restricted area fence lines for tampering or intrusion, providing security support for all non-alarmed priority resources, apprehend and detain anyone attempting to penetrate area, challenge anyone approaching his post during the hours of darkness, directing and managing security operations of priority resources within a restricted area, and implement immediate compensatory security measures for any security deficiency within his area. The performance reviews noted his participation in numerous ORI/NATO tactical evaluations and nuclear surety inspections. Lastly, a nexus was confirmed by the December 2019 VA examiner finding it is at least as likely as not the Veteran's PTSD is caused by fear of hostile military action during active duty. Accordingly, service connection for PTSD is granted. REASONS FOR REMAND Service connection for OSA is remanded. A July 2020 Board remand requested a medical opinion addressing whether the Veteran's OSA was caused or aggravated by the Veteran's service-connected lumbar degenerative disc disease and/or bilateral lumbar radiculopathy of the lower extremities, to include the pain caused by these disabilities.The remand instructed the opinion must address: (1) the June 2016 treatment record that found that the Veteran's lumbar pain interfered with his sleep and (2) the April 2012 surgery note that indicated that the Veteran's sleep issues may be caused by pain. VA obtained an April 2021 medical opinion. First, the April 2021 VA examiner's rationale was the same for causation and aggravation, only addressing causation. See El-Amin v. Shinseki, 26 Vet. App. 136, 140-41 (2013). Second, the examiner's rationale was based solely on general articles about OSA causal and risk factors, but did not discuss any facts pertaining to the Veteran's individual circumstances. See Bailey v. O'Rourke, 30 Vet. App. 54 (2018). The Board requests an addendum opinion. The matters are REMANDED for the following action: Obtain an addendum opinion from an appropriate clinician regarding the Veteran's OSA. (a.) Is it at least as likely as not (50 percent or greater probability) the Veteran's OSA is proximately due to service-connected lumbar degenerative disc disease and/or bilateral lumbar radiculopathy of the lower extremities? (b.) Is it at least as likely as not his OSA is aggravated beyond its natural progression by service-connected lumbar degenerative disc disease and/or bilateral lumbar radiculopathy of the lower extremities? The examiner should address: (1) the June 2016 treatment record that found his lumbar pain interfered with his sleep and (2) the April 2012 surgery note that indicated his sleep issues may be caused by pain. Separate rationale for causation and aggravation should be provided. If citing to medical literature, the clinician is asked to discuss the findings in relation to the Veteran's individual condition and circumstances. K. MILLIKAN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Winkler, 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.