SLEEP APNEA SYNDROMES (OBSTRUCTIVE CENTRAL MIXED)

Summary

The Veteran, a veteran who served from April 1982 to August 1992, appeals the denial of service connection for sleep apnea. The Veteran testified at a Board hearing in March 2020, asserting that his sleep apnea symptoms began during active duty, with his first wife observing snoring prior to discharge. Alternatively, the Veteran claimed sleep apnea developed secondary to service-connected back, knee, and left lower extremity disabilities, leading to obesity. The Board found the direct service connection claim dispositive and did not address the secondary claim. The December 2024 VA sleep apnea examination noted an onset in 1985 during active duty, which the Board found credible and afforded significant weight, aligning with the Veteran's testimony. Earlier VA examinations in July 2020 and July 2021 indicated post-service onset but were given less weight as they did not consider the Veteran's testimony. The Board concluded that the evidence persuasively favored a finding that the sleep apnea arose in service, granting service connection. The Board also noted that a right knee disability had been previously granted and was no longer on appeal.

Rationale

December 2024 VA examination noted onset in 1985; Veteran's testimony regarding onset during service is credible; Evidence weighs persuasively in favor of in-service onset

Full Decision Text

Citation Nr: 25009986
Decision Date: 08/01/25	Archive Date: 08/01/25

DOCKET NO. 17-17 930
DATE: August 1, 2025

ORDER

Service connection for sleep apnea is granted.

FINDING OF FACT

The Veteran's current sleep apnea disability began during active service.

CONCLUSION OF LAW

The criteria for service connection for sleep apnea are met.  38 U.S.C. §§ 1110, 1131; 38 C.F.R. §§ 3.303.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty from April 1982 to August 1992.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a May 2016 rating decision from the agency of original jurisdiction (AOJ).  In April 2017, the Veteran submitted a VA Form 9, in which the Veteran requested a Board hearing.

In March 2020, the Veteran testified at a Board hearing before the undersigned Acting Veterans Law Judge.  A transcript of the Board hearing has been associated with the Veteran's claims file. 

Thereafter, the Board remanded the matter for additional development in April 2020, January 2021, September 2024, and April 2025.  In addition, during the pendency of the appeal, an August 2020 rating decision granted service connection for a right knee disability.  As this represents a full grant of benefits as to the claim of service connection for a right knee condition, the Board will not further consider that issue.  See Grantham v. Brown, 114 F.3d 1156, 1158-59 (Fed. Cir. 1997).  The remaining issue returns to the Board for further appellate review in the instant matter.

The Veteran and his attorney assert that the AOJ committed errors regarding the duty to assist and compliance with the Board's previous remand directives as required by Stegall v. West, 11 Vet. App. 268, 271 (1998).  See June 2025 response to supplemental statement of the case (SSOC).  The decision below represents a full grant of benefits sought as to the issue on appeal, and any such errors are therefore harmless.  See Shinseki v. Sanders, 129 S. Ct. 1696 (2009).

Service connection for sleep apnea is granted.

The Veteran asserts his sleep apnea had its onset on active duty.  See March 2020 hearing testimony.  Alternatively, the Veteran asserts his service-connected disabilities of the back, bilateral knees, and left lower extremity have prevented him from exercising, which has caused him to become obese, leading to the development of sleep apnea.  See June 2025 response to SSOC.

Because the issue of direct service connection is dispositive, the Board will not address secondary service connection.

Service connection may be established for a disability resulting from disease or injury incurred in or aggravated by service.  38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303.  Regulations also provide that service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disability was incurred in service.  38 C.F.R. § 3.303(d).

Generally, in order to prove service connection, there must be competent, credible evidence of (1) a current disability, (2) in-service incurrence or aggravation of an injury or disease, and (3) a nexus, or link, between the current disability and the in-service disease or injury.  Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009).

The benefit of the doubt rule provides that an appellant will prevail in a case where the positive evidence is in approximate balance with the negative evidence.  38 U.S.C. § 5107(b); 38 C.F.R. § 3.102.  It is only when the weight of the evidence is persuasively against the claim that the claim must be denied.  Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

The Board concludes that the Veteran has a current disability that began during active service. 38 U.S.C. §§ 1110, 1131; Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a).

The December 2024 VA sleep apnea examination shows the Veteran has a current diagnosis
38 C.F.R. § 3.102.  It is only when the weight of the evidence is persuasively against the claim that the claim must be denied.  Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

The Board concludes that the Veteran has a current disability that began during active service. 38 U.S.C. §§ 1110, 1131; Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a).

The December 2024 VA sleep apnea examination shows the Veteran has a current diagnosis of sleep apnea. 

The evidence weighing in favor of finding that the Veteran's sleep apnea began during active service includes the medical history as detailed in the December 2024 VA sleep apnea examination, which states the Veteran's sleep apnea had its onset in 1985 on active duty.  The December 2024 VA sleep apnea examination was based upon consideration of the Veteran's pertinent medical history as well as lay assertions and current complaints, and it describes his sleep apnea history and symptoms in detail sufficient to allow the Board to make fully informed determinations.  Barr v. Nicholson, 21 Vet. App. 303 (2007) (citing Ardison v. Brown, 6 Vet. App. 405, 407 (1994)).  The Board therefore affords the finding of the December 2024 VA examiner that the Veteran's sleep apnea was onset in 1985 significant probative weight.

The medical history in the December 2024 VA sleep apnea examination is consistent with the Veteran's March 2020 hearing testimony that his first wife observed he snored prior to discharge.  The Veteran is competent to report his observable symptoms, including as they are related to him by others.  Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007).  The Board finds the Veteran's March 2020 hearing testimony regarding the onset of his sleep apnea symptoms credible and affords it significant probative weight.

Weighing against finding that the Veteran's sleep apnea began during active service are the medical histories contained in the July 2020 and July 2021 VA sleep apnea examinations, which noted the Veteran's sleep apnea had its onset after discharge.  However, neither examiner appears to have considered the testimony of the Veteran at the March 2020 hearing that the symptoms of his current sleep apnea disability began on active duty.  The Board therefore affords the medical histories contained in the July 2020 and July 2021 VA sleep apnea examinations little probative weight.

Upon review of the record, the Board finds the evidence weighs persuasively in favor of finding the Veteran's current sleep apnea disability arose in service.  Accordingly, service connection for sleep apnea is warranted. 

 

 

James DeFrank

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Carmichael, 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.