Back to BVA DecisionsMIXEDSpecial Benefit NO SPECIAL BENEFIT Docket No. 201028-118171
KNEE IMPAIRMENT OF
HARVEY P. ROBERTS · 2026 · Case ID: A26024725
Summary
The Veteran served on active duty from May 2000 to December 2000. The Veteran appeals the denial of service connection for left knee, left ankle, and obstructive sleep apnea conditions. The claims for the left knee and left ankle were asserted as secondary to service-connected pes planus. The claim for obstructive sleep apnea was asserted as secondary to service-connected asthma. The Board found a May 2024 private medical opinion from an orthopedic surgeon to be highly probative, stating that service-connected pes planus contributed to the Veteran's left knee and left ankle injuries. This opinion included medical literature supporting its conclusion. While VA examination reports conflicted, they lacked supporting medical literature. The Board assigned greater weight to the private opinion due to its thorough rationale and persuasive value, finding the evidence supported service connection for the left knee and ankle disabilities secondary to pes planus. For the obstructive sleep apnea claim, the Veteran's service medical records did not show findings related to sleep apnea, nor did the Veteran assert it was service-related. A private doctor attributed the condition to obesity. A VA examiner in August 2020 opined that sleep apnea was not related to asthma, explaining it was a structural airway issue unaffected by asthma. The Veteran testified at a Board hearing that asthma aggravated his sleep apnea. The Board found the August 2020 VA examination report persuasive, noting the lack of competent contrary opinions and assigning greater weight to the VA examiner's expertise over the Veteran's lay assertions. The Board concluded the evidence did not support a link between sleep apnea and asthma, and that the Veteran's own doctor attributed it to obesity. Therefore, the claim for sleep apnea secondary to asthma was denied. Service connection for the left knee and left ankle disabilities, secondary to pes planus, was granted. Service connection for obstructive sleep apnea, secondary to asthma, was denied.
Rationale
Private medical opinion found pes planus contributed to knee injury; VA exam conflicted but lacked supporting literature; Board found private opinion highly persuasive due to rationale
Full Decision Text
Citation Nr: A26024725 Decision Date: 03/19/26 Archive Date: 03/19/26 DOCKET NO. 201028-118171 DATE: March 19, 2026 ORDER Entitlement to service connection for a left knee disability, secondary to service-connected pes planus, is granted. Entitlement to service connection for a left ankle disability, secondary to service-connected pes planus, is granted. Entitlement to service connection for obstructive sleep apnea, to include as secondary to service-connected asthma, is denied. FINDINGS OF FACT 1. The persuasive weight of the evidence supports a finding that a left knee disability is the result of service-connected pes planus. 2. The persuasive weight of the evidence supports a finding that a left ankle disability is the result of service-connected pes planus. 3. The persuasive weight of the evidence is against a finding that obstructive sleep apnea is related to service or caused or aggravated by service-connected asthma. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for a left knee disability have been met. 38 U.S.C. § 1110, 5107; 38 C.F.R. § 3.310. 2. The criteria for entitlement to service connection for a left ankle disability have been met. 38 U.S.C. § 1110, 5107; 38 C.F.R. § 3.310. 3. The criteria for entitlement to service connection for obstructive sleep apnea have not been met. 38 U.S.C. § 1110, 5107; 38 C.F.R. § 3.310 REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from May 2000 to December 2000. This matter comes before the Board of Veterans' Appeals (Board) from June, August, and October 2020 rating decisions issued by a Regional Office (RO) of the Department of Veterans Affairs (VA), which is the Agency of Original Jurisdiction (AOJ). On October 28, 2020, the Veteran filed a timely appeal of that decision using VA Form 10182, Board Appeal (Notice of Disagreement) and elected to have a Board hearing. 38 C.F.R. § 19.2. On May 17, 2024, the Veteran testified at a hearing before the undersigned Veterans Law Judge. A transcript of the hearing is associated with the claims file. Because of the Veteran's election of review through the Board's hearing docket, the Board may only consider evidence submitted at the time of the rating decision on appeal, additional testimony during the Board hearing, and evidence submitted within 90 days after the Board hearing. 38 C.F.R. § 20.301. Remand is permitted only to cure pre-decisional errors in VA's duty to assist the Veteran in substantiating the claim, and to correct errors in VA's duty to satisfy a regulatory or statutory duty, if correction of the error would have a reasonable possibility of aiding in substantiating the Veteran's claim. 38 C.F.R. § 20.802. Although the Board has an obligation to provide reasons and bases supporting its decision, there is no obligation to discuss, in detail, the extensive evidence of record. Gonzales v. West, 218 F.3d 1378, (Fed. Cir. 2000). 1. Entitlement to service connection for a left knee disability 2. Entitlement to service connection for a left ankle disability The Veteran asserts entitlement to service connection for left knee and left ankle disabilities. Service connection may be established for disability caused by disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. §§ 3.303, 3.310. In order to establish service connection for a claimed disability, there must be (1) medical evidence of a current disability; (2) medical, or in certain circumstances, lay evidence of incurrence or aggravation of a disease or injury in service; and (3) evidence, generally medical, of a causal relationship between the disease or injury in service and the current disability. Hickson v. West, 12 Vet. App. 247 (1999). Service connection may also be established for any disease initially diagnosed after service, when the evidence establishes that the disease was incurred in service. 38 U.S.C. § 1113(b); 38 C.F.R. § 3.303(d); Cosman v. Principi, 3 Vet. App. 503 (1992). The disease entity for which service connection (2) medical, or in certain circumstances, lay evidence of incurrence or aggravation of a disease or injury in service; and (3) evidence, generally medical, of a causal relationship between the disease or injury in service and the current disability. Hickson v. West, 12 Vet. App. 247 (1999). Service connection may also be established for any disease initially diagnosed after service, when the evidence establishes that the disease was incurred in service. 38 U.S.C. § 1113(b); 38 C.F.R. § 3.303(d); Cosman v. Principi, 3 Vet. App. 503 (1992). The disease entity for which service connection is sought must be chronic rather than acute and transitory in nature. For the showing of chronic disease in service, a combination of manifestations must exist sufficient to identify the disease entity and sufficient observation to establish chronicity at the time, as distinguished from merely isolated findings or a diagnosis including the word chronic. Furthermore, service incurrence will be presumed for certain chronic diseases if manifest to a compensable degree within the year after active service. 38 U.S.C. § 1112; 38 C.F.R. §§ 3.307, 3.309. A disability that is proximately due to or the result of a service-connected disease or injury shall be service-connected. When service connection is established for a secondary disability, the secondary disability shall be considered a part of the original disability. 38 C.F.R. § 3.310(a). Secondary service connection may also be established for a nonservice-connected disability, which is aggravated by a service-connected disability. In that instance, the Veteran is compensated for the degree of disability over and above the degree of disability existing prior to the aggravation. 38 C.F.R. § 3.310(b); Allen v. Brown, 7 Vet. App. 439 (1995). The Board finds that entitlement to service connection for left knee and ankle disabilities is warranted. The Board finds a May 2024 private medical opinion by an orthopedic surgeon to be highly probative. The surgeon opined that service-connected pes planus contributed to the left knee and left ankle injuries. The surgeon submitted medical literature in support of that conclusion. The Board notes that the record contains VA examination reports which conflict with the May 2024 private medical opinion. However, the VA examination reports did not include any medical literature to support the findings. Because the May 2024 opinion included a more thorough rationale, the Board finds the opinion highly persuasive and the most probative of the issues at hand. The probative value of medical evidence is based on the physician's knowledge and skill in analyzing the data, and the medical conclusions reached; as is true of any evidence, the credibility and weight to be attached to medical opinions are within the province of the Board. Guerrieri v. Brown, 4 Vet. App. 467 (1993). Therefore, the Board finds that the most persuasive evidence of record supports a finding that left knee and left ankle disabilities are due to, the result, or caused by service-connected pes planus. Accordingly, as the persuasive weight of the evidence supports entitlement to service connection for a left knee disability and a left ankle disability, secondary to service-connected pes planus, and the claims are granted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021). 3. Entitlement to service connection for obstructive sleep apnea, to include as secondary to service-connected asthma The Veteran asserts entitlement to service connection for sleep apnea, to include as secondary to service-connected asthma. The service medical records do not show any findings related to sleep apnea, and the Veteran has not asserted that sleep apnea was present during service or caused by service. In June 2019, the Veteran's private doctor stated that the Veteran had multiple associated co-morbidities including obstructive sleep apnea, related to the Veteran's obesity. An August 2020 VA examiner opined that the Veteran's obstructive sleep apnea was not the result of service-connected asthma. The examiner explained that obstructive sleep apnea was a structural issue of the upper airway and was not affected by asthma, a disability affecting the lower airway. The examiner identified obesity as a more likely risk factor for obstructive sleep apnea. At a May 2024 Board hearing, the Veteran testified that he believed that service-connected asthma was a significant aggravating factor for sleep apnea due to its respiratory nature. The Board finds that entitlement to service connection for sleep the Veteran had multiple associated co-morbidities including obstructive sleep apnea, related to the Veteran's obesity. An August 2020 VA examiner opined that the Veteran's obstructive sleep apnea was not the result of service-connected asthma. The examiner explained that obstructive sleep apnea was a structural issue of the upper airway and was not affected by asthma, a disability affecting the lower airway. The examiner identified obesity as a more likely risk factor for obstructive sleep apnea. At a May 2024 Board hearing, the Veteran testified that he believed that service-connected asthma was a significant aggravating factor for sleep apnea due to its respiratory nature. The Board finds that entitlement to service connection for sleep apnea secondary to service-connected asthma is not warranted. The Board finds the August 2020 VA examination report to be persuasive and the most probative of the issue at hand. Guerrieri v. Brown, 4 Vet. App. 467 (1993). There is no competent opinion to the contrary. The Board assigns greater probative weight to the August 2020 VA examination report than the Veteran's lay assertions because the Veteran has not been shown to possess the medical training and expertise necessary to address etiology in the present case. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Greater probative or persuasive value or weight is assigned to the August 2024 VA examination report because the opinion was provided by a medical professional with knowledge, training, and expertise after a review of the claims file and consideration of the Veteran's lay reports. Moreover, the August 2020 report is supported by the evidence of record. Specifically, records show that the Veteran's own doctor attributed the Veteran's sleep apnea to the Veteran's obesity, and not to service or any service-connected disability. Therefore, the Board finds that there is no persuasive evidence of record that supports a finding that obstructive sleep apnea is related to service, or is caused or aggravated by service-connected asthma. Accordingly, the Board finds that the persuasive weight of the evidence is against the claim of entitlement to service connection for sleep apnea. The Board finds that the evidence is not in approximate balance and that there is no reasonable doubt to resolve in favor of the Veteran. Therefore, the claim is denied. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021). Harvey P. Roberts Veterans Law Judge Board of Veterans' Appeals Attorney for the Board E.O., Counsel 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.