SLEEP APNEA SYNDROMES (OBSTRUCTIVE CENTRAL MIXED)
DONNIE R. HACHEY · 2025 · Case ID: A25005012
Summary
The Veteran served from November 2011 to January 2013 and again from April 2017 to December 2017. He appeals the denial of service connection for obstructive sleep apnea (OSA). The Board reviewed the evidence of record at the time of the Agency of Original Jurisdiction's June 2023 rating decision. The Veteran has OSA and is already service-connected for PTSD, lumbosacral strain, and bilateral lower extremity radiculopathy. A May 2023 medical opinion from Dr. Z.M., a Board-Certified specialist in Psychiatry, Neurology, and Sleep Medicine, found a distinct clinical correlation between the Veteran's PTSD symptoms and his OSA. Dr. Z.M. opined that the Veteran developed PTSD after severe trauma in service, which then caused his OSA. Furthermore, Dr. Z.M. concluded that the service-connected PTSD, lumbosacral strain, and radiculopathy contributed to the Veteran's obesity, which in turn led to his OSA. Citing relevant case law, the Board found that probative medical evidence links the Veteran's service-connected disabilities to his current OSA. Therefore, service connection for OSA was granted.
Rationale
Probative medical evidence links service-connected disabilities to current OSA; Dr. Z.M. opined OSA secondary to PTSD; Dr. Z.M. concluded PTSD, strain, radiculopathy led to obesity, contributing to OSA
Full Decision Text
Citation Nr: A25005012 Decision Date: 01/21/25 Archive Date: 01/21/25 DOCKET NO. 230727-364962 DATE: January 21, 2025 ORDER Entitlement to service connection for obstructive sleep apnea (OSA) is granted. FINDING OF FACT The Veteran's OSA is related to his service-connected posttraumatic stress order (PTSD), lumbosacral strain, and bilateral lower extremity radiculopathy. CONCLUSION OF LAW The criteria for entitlement to service connection for OSA have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from November 2011 to January 2013, and April 2017 to December 2017. He appeals a June 2023 rating decision by the Agency of Original Jurisdiction (AOJ) denying service connection for OSA. In the July 2023 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket. Therefore, the Board may only consider the evidence of record at the time of the June 2023 rating decision on appeal. 38 C.F.R. § 20.301. Any evidence submitted after the AOJ decision on appeal cannot be considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 20.801. A veteran is entitled to VA disability compensation if there is a disability resulting from personal injury suffered or disease contracted in the line of duty in active service, or for aggravation of a preexisting injury suffered or disease contracted in the line of duty in active service. 38 U.S.C. § 1110. Generally, to establish a right to compensation for a present disability, a veteran must show: (1) a present disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service, the so-called "nexus" requirement. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). A disability which is the result of a service-connected disease or injury shall be service connected. See 38 U.S.C. § 1110; 38 C.F.R. § 3.110(a). In Spicer v. McDonough, the Federal Circuit held that § 1110 plainly requires compensation when a service-connected disease or injury is a "but-for cause of a present-day disability." Further, nothing in the statute limits § 1110 to onset or etiological causes of a worsening in functionality. 61 F.4th 1360 (Fed. Cir. 2023). The Veteran has OSA and is service connected for PTSD, lumbosacral strain, and bilateral lower extremity radiculopathy of the sciatic nerve. See, e.g., February 2023 VA Medical Opinion, Dr. Z.M. medical opinion received in May 2023. In a May 2023 medical opinion, Dr. Z.M. opined that the Veteran's OSA was at least as likely as not secondary to his service-connected disabilities. Dr. Z.M. is Board Certified by the American Board of Psychiatry and Neurology and Sleep Medicine. After noting a distinct clinical correlation between the symptomology experienced by the Veteran from PTSD, the correlated symptomology of the Veteran's OSA, and citing medical literature, Dr. Z.M. opined that the Veteran developed PTSD after experiencing severe trauma in service; then, the Veteran's PTSD caused his OSA. Id. Additionally, Dr. Z.M. concluded that the Veteran's service-connected PTSD, lumbosacral strain, and radiculopathy led to obesity, which in turn contributed to OSA. Id.; see 61 F.4th 1360 (Fed. Cir. 2023). As there is probative medical evidence linking the Veteran's service-connected disabilities to his current OSA in this particular case, service connection is warranted. See Lynch v. McDonough, 21 F.4th 776, 781-82 (Fed. Cir. 2021); 38 C.F.R. § 3.102. DONNIE R. HACHEY Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Moyer, Shane A. The Board's decision ral strain, and radiculopathy led to obesity, which in turn contributed to OSA. Id.; see 61 F.4th 1360 (Fed. Cir. 2023). As there is probative medical evidence linking the Veteran's service-connected disabilities to his current OSA in this particular case, service connection is warranted. See Lynch v. McDonough, 21 F.4th 776, 781-82 (Fed. Cir. 2021); 38 C.F.R. § 3.102. DONNIE R. HACHEY Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Moyer, Shane A. 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.