Citation Nr: 18124011
Decision Date: 08/03/18	Archive Date: 08/03/18

DOCKET NO. 15-22 216
DATE:	August 3, 2018
ORDER
Entitlement to service connection for anxiety disorder is granted.
REMANDED
Entitlement to service connection for sleep apnea is remanded.
FINDING OF FACT
Resolving reasonable doubt in the Veteran’s favor, his anxiety disorder is secondary to his service-connected posttraumatic stress disorder (PTSD).
CONCLUSION OF LAW
The criteria for service connection for anxiety disorder are met.  38 U.S.C. §§ 1110, 1131, 5107(b); (2012) 38 C.F.R. §§ 3.102, 3.310(a) (2017).


REASONS AND BASES FOR FINDING AND CONCLUSION
1. Entitlement to service connection for anxiety
In July 2014, the Agency of Original Jurisdiction (AOJ) denied service connection for anxiety.  The Veteran appealed this decision.  Subsequently, in May 2016, the AOJ granted the Veteran’s claim for service connection for PTSD.
The Board notes that, when a claimant makes a claim, he is seeking service connection for symptoms regardless of how those symptoms are diagnosed or labeled.  Clemmons v. Shinseki, 23 Vet. App. 1 (2009).  Hence, the Veteran seeks compensation for anxiety whether this is a component of PTSD or another acquired psychiatric disorder.  In this case, the medical evidence clearly reflects that the Veteran has anxiety symptoms that are part-and-parcel of his PTSD.  However, the record further reflects that, during the pendency of this appeal, the Veteran has been diagnosed with “ anxiety NOS” (not otherwise specified) and that PTSD has been routinely coupled with anxiety disorder as the prevailing diagnoses in VA treatment records.  It appears that anxiety disorder is linked to PTSD based on a review of the treatment records.
Therefore, resolving any reasonable doubt in the Veteran’s favor, the Board concludes that anxiety disorder is secondary to service-connected PTSD.  38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.310(a).  Accordingly, the claim is granted.
The Veteran is reminded that his anxiety symptoms have been contemplated by the assigned evaluation for his service-connected PTSD, and that all mental disorders regardless of diagnosis are evaluated based on their symptomatology under VA’s General Rating Formula for Mental Disorders, 38 C.F.R. § 4.130.  Consequently, he is entitled to a single disability rating encompassing all his mental disorders.

REASONS FOR REMAND
1. Entitlement to service connection for sleep apnea is remanded.
The Veteran contends that he has sleep apnea due to anxiety.  The AOJ denied his claim because anxiety was not a service connected disability.  Since that denial, service connection has been established for PTSD and anxiety.  Therefore, to ensure that VA has met its duty to assist the Veteran, remand is necessary to obtain a medical opinion on the etiology of his sleep apnea.  38 C.F.R. § 3.159(c)(4).
The matter is REMANDED for the following action:
1. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of his sleep apnea to include whether it is linked to anxiety as theorized.  The examiner must opine whether it is at least as likely as not related to an in-service injury, event, or disease, including environmental conditions during his Southwest Asia service.  The examiner must further opine on whether it is at least as likely as not (a) proximately due to service-connected disability, or (b) aggravated beyond its natural progression by service-connected disability.  The examiner must address the Veteran's theory that his condition is due to anxiety and discuss the most common cause of sleep apnea in adults.
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2. Ensure that the VA medical opinion obtained include a complete rationale for the conclusions reached.  The medical opinion must support the conclusions reached with an analysis that is adequate for the Board to consider and weigh against other evidence of record; medical opinions must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two.
 
KRISTI L. GUNN
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	C.A. Skow, Counsel 

For A Complete Guide To VA Disability Claims and to find out more about your potential VA disability case and how to obtain favorable VA Rating Decision! Visit: VA-Claims.org

For More Information on Veterans Disability Compensation Benefits! Visit: DisableVeteran.org ~ A Non-Profit Non Governmental Agency


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