10-22 746, 10-22 746

Veteran served multiple active-duty periods (1984–1992; 1999–2000; 2001; 2003–2004; 2010–2011) and was honorably discharged.
Appeal from a June 2009 RO decision; Board hearing held Sept. 2015 and remand issued Nov. 2015 for medical opinions; skin disorder later granted service connection.
Veteran asserts sleep apnea caused by in-service exposure to burn pits during 2003 Iraq deployment; wife and veteran provided lay statements of post-deployment onset of snoring/sleep problems.
Record includes a May 2010 private opinion (Dr. H.) finding nexus between burn-pit exposure and sleep apnea, and a February 2016 VA opinion denying nexus but not addressing burn-pit exposure.
Board found the private opinion adequate and VA opinion inadequate for failing to consider burn-pit exposure; granted service connection for sleep apnea on the basis of equipoise.
Right-foot disorder (other than gout) claims were remanded for further development because existing private and VA opinions were inadequate or internally unclear; RO directed to obtain updated VA treatment records and new opinions.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Service connection for sleep apnea	Veteran: sleep apnea began after 2003 Iraq deployment due to burn-pit exposure; lay and private medical evidence support nexus	VA: no evidence of in-service onset or treatment for sleep apnea (February 2016 exam concluded no nexus)	Granted — Board found current diagnosis, in-service exposure, and a probative private nexus opinion; VA opinion inadequate and, on balance, evidence in equipoise favoring claimant
Service connection for right foot disorder (other than gout)	Veteran: ongoing right foot/ankle symptoms attributable to service (testified at hearing; private records show ankle problems)	VA: February 2016 examiner concluded no other foot condition besides gout (but examiner misstated/ignored relevant history)	Remanded — all opinions inadequate; new development ordered (obtain recent VA records, new exam/opinion addressing specific foot conditions and nexus)

D'Aries v. Peake, 22 Vet. App. 97 (discussing substantial compliance with Board remand orders)
Stegall v. West, 11 Vet. App. 268 (remand confers right to compliance with remand orders)
Shedden v. Principi, 381 F.3d 1163 (legal standards for service connection elements)
Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (requirements for probative medical opinion)
Dalton v. Nicholson, 21 Vet. App. 23 (examiner must address lay statements/symptom history)
Stefl v. Nicholson, 21 Vet. App. 120 (examiner must base opinion on review of records and consider veteran's complaints)
Gilbert v. Derwinski, 1 Vet. App. 49 (benefit of the doubt/evidence equipoise rule)
Barr v. Nicholson, 21 Vet. App. 303 (adequacy of VA medical examinations)
Bloom v. West, 12 Vet. App. 185 (medical nexus must reach at least as-likely-as-not certainty)
Kutscherousky v. West, 12 Vet. App. 369 (right to submit evidence after remand)