{"page":"https://casescribe.ai/explorer/secondary/sleep-apnea-secondary-to-hypertension","generated_at":"2026-10-03T18:34:29.641Z","data_as_of":{"decisions":944125,"first_year":2017,"last_year":2026,"latest_decision":"2026-04-30","cfr":"2026-10-01","m21":"2026-09-29"},"about":{"publisher":"CaseScribe AI (VA Law Explorer)","source":"Public Board of Veterans' Appeals decisions (appeals of VA decisions, not VA's first decisions), M21-1 Adjudication Procedures Manual, 38 CFR Parts 3 and 4.","method":"Outcomes are issue-level: each condition the Board decided in a decision counts once. Decision data is extracted by AI and can contain errors. Rates describe past appeals and do not predict any claim.","disclaimer":"For research only. CaseScribe AI is not a law firm and this is not legal advice. Verify figures against the source decisions and regulations.","attribution":"Cite as: VA Law Explorer, CaseScribe AI, with the page URL."},"data":{"claim":"Sleep apnea secondary to hypertension","secondary_condition":"Sleep apnea","service_connected_disability":"hypertension","decisions":819,"years":"2017-2026","granted_pct":14.3,"denied_pct":14.5,"remanded_pct":70.2,"granted_on_merits_pct":49.6,"by_year":[{"year":2017,"issues":44,"granted_pct":4.5,"denied_pct":43.2,"remanded_pct":50},{"year":2018,"issues":58,"granted_pct":3.4,"denied_pct":15.5,"remanded_pct":79.3},{"year":2019,"issues":65,"granted_pct":9.2,"denied_pct":15.4,"remanded_pct":73.8},{"year":2020,"issues":76,"granted_pct":10.5,"denied_pct":22.4,"remanded_pct":65.8},{"year":2021,"issues":97,"granted_pct":7.2,"denied_pct":18.6,"remanded_pct":74.2},{"year":2022,"issues":94,"granted_pct":20.2,"denied_pct":10.6,"remanded_pct":69.1},{"year":2023,"issues":85,"granted_pct":14.1,"denied_pct":10.6,"remanded_pct":75.3},{"year":2024,"issues":110,"granted_pct":20.9,"denied_pct":8.2,"remanded_pct":70},{"year":2025,"issues":146,"granted_pct":19.9,"denied_pct":8.2,"remanded_pct":71.2},{"year":2026,"issues":45,"granted_pct":20,"denied_pct":13.3,"remanded_pct":62.2}],"benefit_of_doubt_in_grants_pct":77.8,"evidence_on_merits":[{"evidence":"va_exam_favorable","decisions_with":57,"granted_pct_with":80.6,"granted_pct_without":44.9},{"evidence":"va_exam_unfavorable","decisions_with":669,"granted_pct_with":47.2,"granted_pct_without":72.7},{"evidence":"nexus_positive","decisions_with":133,"granted_pct_with":91.7,"granted_pct_without":26.3},{"evidence":"nexus_negative","decisions_with":589,"granted_pct_with":43.2,"granted_pct_without":77.3},{"evidence":"private_opinion","decisions_with":285,"granted_pct_with":62.4,"granted_pct_without":38.6},{"evidence":"lay_statement","decisions_with":611,"granted_pct_with":42,"granted_pct_without":79.2},{"evidence":"buddy_statement","decisions_with":58,"granted_pct_with":42.1,"granted_pct_without":50.2}],"top_reasons":{"granted":[{"reason":"current diagnosis established","decisions":20},{"reason":"caused by the service-connected disability","decisions":12},{"reason":"service connection established","decisions":11},{"reason":"aggravated by the service-connected disability","decisions":6},{"reason":"va examiner: less likely than not related to service","decisions":3},{"reason":"service records negative or silent","decisions":2}],"denied":[{"reason":"no in-service complaints, treatment or diagnosis","decisions":34},{"reason":"va examiner: less likely than not related to service","decisions":25},{"reason":"service records negative or silent","decisions":19},{"reason":"preponderance of the evidence against the claim","decisions":14},{"reason":"aggravated by the service-connected disability","decisions":5},{"reason":"current diagnosis established","decisions":4}]},"recent_examples":{"granted":[{"case_id":"A26038060","year":2026,"judge":"J. PARKER","rationale":"Secondary to service-connected hypertension; Evidence in relative equipoise; Reasonable doubt resolved in veteran's favor"},{"case_id":"A26037116","year":2026,"judge":"M. C. WILSON","rationale":"Secondary to service-connected hypertension; Private medical opinion provided positive nexus; DeLisio duty to investigate secondary conditions applied"},{"case_id":"A26021490","year":2026,"judge":"B. D. WATSON","rationale":"In-service hypertension noted in STRs; Veteran and wife testimony of OSA symptoms; Private physician nexus opinion linking OSA to hypertension/service; Benefit of the doubt applied due to approximate balance of evidence"}],"denied":[{"case_id":"A26027584","year":2026,"judge":"A. JAEGER","rationale":"Private physician opinions lacked rationale.; VA examiners opined no nexus between OSA and hypertension.; Weight of evidence against claim."},{"case_id":"A26023252","year":2026,"judge":"L. B. CRYAN","rationale":"Not a presumptive illness for herbicide exposure; Late onset over 45 years after service; Unfavorable VA medical opinions regarding nexus"},{"case_id":"A26020764","year":2026,"judge":"H. SEESEL","rationale":"Current diagnosis of OSA; No nexus to herbicide exposure; No nexus to hypertension; VA opinions found OSA not related to TERA/AO exposure; OSA not presumed for toxic exposures; OSA due to anatomical changes, not toxic exposure; Medical literature does not support nexus; No nexus to hypertension; Hyp… [truncated, 56 chars omitted]"}]},"how_argued":{"note":"From keyword matches in each issue's AI summary and rationale, not the full decision. Only issues whose text names a medical link are counted under pathways; one issue can name several. A link named in a denial was often the argument the Board rejected.","issues":820,"aggravation_discussed":{"issues":391,"granted_pct":6.6},"causation_only":{"issues":429,"granted_pct":21.2},"issues_naming_a_pathway_pct":25.9,"pathways":[{"pathway":"Weight gain or obesity","issues":161,"granted_pct":6.2,"examples":[{"case_id":"24018466","year":2024,"outcome":"GRANTED","quote":"VA examiner provided negative nexus for obesity/age but suggested link to PTSD, hypertension, diabetes."},{"case_id":"A26001133","year":2026,"outcome":"DENIED","quote":"A March 2013 sleep study confirmed the diagnosis, noting risk factors like obesity."}]},{"pathway":"Sleep disruption","issues":50,"granted_pct":14,"examples":[{"case_id":"A25053853","year":2025,"outcome":"GRANTED","quote":"Service connection for sleep disturbed breathing, including sleep apnea, was granted secondary to service-connected labile hypertension."},{"case_id":"A26018563","year":2026,"outcome":"DENIED","quote":"Service treatment records negative for sleep disturbances."}]},{"pathway":"Nerve involvement","issues":11,"granted_pct":9.1,"examples":[{"case_id":"22031615","year":2022,"outcome":"GRANTED","quote":"Mitchell opined OSA is more likely than not secondary to service-connected cervical spine pain, hypertension, upper extremity nerve pain, and tinnitus."}]}]},"how_va_rates":{"citation":"38 CFR 4.97","diagnostic_code":"6847","name":"Sleep Apnea Syndromes (Obstructive, Central, Mixed)","url":"https://www.ecfr.gov/current/title-38/section-4.97","levels":[{"criteria":"Chronic respiratory failure with carbon dioxide retention or cor pulmonale, or; requires tracheostomy","rating":100},{"criteria":"Requires use of breathing assistance device such as continuous airway pressure (CPAP) machine","rating":50},{"criteria":"Persistent day-time hypersomnolence","rating":30},{"criteria":"Asymptomatic but with documented sleep disorder breathing","rating":0}],"notes":[]},"requirements":"38 CFR 3.310: a current diagnosis, a service-connected disability, and medical evidence that it caused (3.310(a)) or aggravated (3.310(b)) the condition."}}