SLEEP APNEA SYNDROMES (OBSTRUCTIVE CENTRAL MIXED)

Summary

The veteran, who served from July 1988 to July 1992, appeals the denial of service connection for sleep apnea and the grant of service connection for bilateral hearing loss and tinnitus. The veteran claimed sleep apnea was directly related to service or secondary to PTSD, but the Board found his statements regarding sleep apnea inconsistent with treatment records and not credible. The Board noted that while the veteran's military occupational specialty was mess management specialist, which has a low probability of noise exposure, the circumstances of his service on a ship were considered. The Board found the evidence regarding hearing loss and tinnitus to be in equipoise, resolving doubt in the veteran's favor to grant service connection for both conditions. The Board noted that the veteran was already rated 100% disabled for individual unemployability. Service connection for sleep apnea was denied due to lack of credible evidence and nexus to service. Service connection for bilateral hearing loss and tinnitus was granted based on the benefit of the doubt applied to the noise exposure during service.

Rationale

Veteran's statements regarding sleep apnea inconsistent with treatment records; Credibility concerns raised by conflicting accounts of sleep study; No evidence of nexus to service or service-connected disability

Full Decision Text

Citation Nr: A26037665
Decision Date: 04/22/26	Archive Date: 04/22/26

DOCKET NO. 211018-194477
DATE: April 22, 2026

ORDER

Entitlement to service connection for sleep apnea is denied.

Entitlement to service connection for bilateral hearing loss is granted.

Entitlement to service connection for tinnitus is granted.

FINDINGS OF FACT

1. The evidence weighs against a finding that sleep apnea began during active service or for many years thereafter, and sleep apnea is not otherwise shown to be related to service or a service-connected disability.

2. Resolving all doubt in favor of the Veteran, his bilateral hearing loss is related to hazardous noise exposure incurred during active-duty service.

3. Resolving all doubt in favor of the Veteran, his tinnitus is related to hazardous noise exposure incurred during active-duty service.

CONCLUSIONS OF LAW

1. The criteria for entitlement to service connection for sleep apnea have not been met.  38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.303, 3.310. 

2. The criteria for entitlement to service connection for bilateral hearing loss have been met.  38 U.S.C. §§ 1110, 1113, 5107; 38 C.F.R. §§ 3.102, 3.303.

3. The criteria for entitlement to service connection for tinnitus have been met.  38 U.S.C. §§ 1110, 1113, 5107; 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from July 1988 to July 1992.

In the October 2021 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket.  A Board hearing was held on May 13, 2025. 

Therefore, the Board may only consider the evidence of record at the time of the August 2021 agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran at the hearing or within 90 days following the hearing.  38 C.F.R. § 20.302 (a).  If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the Board hearing, or (2) more than 90 days following the hearing, the Board did not consider it in its decision.  38 C.F.R. §§ 20.300, 20.302 (a), 20.801. 

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence.  38 C.F.R. § 3.2501.  If the evidence is new and relevant, VA will issue another decision on the claim, considering the new evidence in addition to the evidence previously considered.  Id. 

The August 2021 rating decision found that new and relevant evidence had been received to readjudicate the claims of service connection for sleep apnea, bilateral hearing loss, and tinnitus.  This is a favorable finding by the agency of original jurisdiction (AOJ) and the Board will proceed to the address the claims on the merits.  See 38?U.S.C. § 5104A; 38?C.F.R. § 3.104 (c).

It is valuable to note that the Veteran has already been found to be 100 percent disabled by VA.  The Veteran has been in receipt of a total disability rating based on individual unemployability since April 4, 2023.  In this case, the Board is only dealing with the limited outstanding issues that it must address under the law.

1. Entitlement to service connection for sleep apnea.

The Veteran contends that his sleep apnea is directly related to his military service, as he was diagnosed with sleep apnea in 1993 after getting out of service.  See May 2025 Hearing Transcript.  Alternatively, he contends that his sleep apnea is due to his PTSD.  Id.  

As an initial matter, an August 2021 rating decision favorably found a diagnosis of obstructive sleep apnea and that the claimed primary disability of PTSD is service connected.  Furthermore, the Veteran has sufficient service to meet the minimum requirements for presumptive service connection and that sleep apnea is a chronic disease which may be presumptively linked to military service.  

Generally, to prevail on a claim
 connection for sleep apnea.

The Veteran contends that his sleep apnea is directly related to his military service, as he was diagnosed with sleep apnea in 1993 after getting out of service.  See May 2025 Hearing Transcript.  Alternatively, he contends that his sleep apnea is due to his PTSD.  Id.  

As an initial matter, an August 2021 rating decision favorably found a diagnosis of obstructive sleep apnea and that the claimed primary disability of PTSD is service connected.  Furthermore, the Veteran has sufficient service to meet the minimum requirements for presumptive service connection and that sleep apnea is a chronic disease which may be presumptively linked to military service.  

Generally, to prevail on a claim of service connection on the merits, there must be competent evidence of (1) a current disability, (2) medical, or in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury, and (3) medical evidence or other competent evidence of a nexus between the claimed in-service disease or injury and the present disease or injury.  See Hickson v. West, 12 Vet. App. 247 (1999); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007).

Establishing service connection on a secondary basis requires evidence sufficient to show (1) that a current disability exists and (2) that the current disability was either (a) proximately caused by or (b) aggravated by a service-connected disease or injury.  38 C.F.R. § 3.310; Allen v. Brown, 7 Vet. App. 439, 448 (1995) (en banc).

Certain chronic diseases may be presumed to have been incurred during service if they become manifested to a compensable degree within one year of separation from active duty.  38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309.

If a condition noted during service is not shown to be chronic, then a showing of continuity of symptomatology after service is generally required for service connection, but only if the disability is one that is listed in 38 C.F.R. § 3.309 (a).  38 C.F.R. § 3.303 (b); see also Walker v. Shinseki, 708 F.3d 1331, 1335 (Fed. Cir. 2013).

During the May 2025 Board Hearing, the Veteran testified that he had a sleep apnea test right after getting out of the military, around the beginning of 1993.  Furthermore, the Veteran reported that people on the ship would catch him snoring and he went to medical after.  For secondary service connection, the Veteran's primary care physician told him that PTSD leads to sleep apnea.  

The Board notes the Veteran's recollection of events concerning his sleep apnea are inconsistent with the record.  Within a May 2008 emergency room report, the Veteran reported that he was told to be checked for obstructive sleep apnea in the past because he has multiple family members with this problem.  See May 2008 Oklahoma Heart Hospital, Emergency Room Documentation.  The Veteran also stated that he had never had a sleep study because of insurance problems.  These treatment records are inconsistent with the Veteran's hearing testimony that he had a sleep study right after getting out of the military and raises concerns as to his credibility.  

In July 2010, the Veteran underwent a sleep study after being referred for an evaluation of excessive daytime sleepiness.  See July 2010 Sleep Institute of Enid, Report of Polysomnography.  The study found no significant obstructive sleep apnea.  After a home sleep test report in 2018, the Veteran was diagnosed with obstructive sleep apnea.  See April 2018 Integris, Home Sleep Test Report.  

In a September 2020 telephone call, the Veteran wanted to speak with his provider about his PTSD.  See September 2020 Telephone Encounter Note.  The Veteran stated he was trying to get more disability and voiced that he needed "a note or something stating that his PTSD is causing him problems with health including sleep apnea."  Id.  

Overall, based on a detailed review of the record and the Veteran's statements, the Board must unfortunately find that the Veteran's statements regarding his sleep apnea are not credible and cannot be afforded any probative weight. 

In weighing the evidence, the Board finds the Veteran's service treatment records and statements rendered in connection with treatment as documented in the post service treatment records, are more probative than assertions he made many years after service for compensation purposes.  See Curry v. Brown
 about his PTSD.  See September 2020 Telephone Encounter Note.  The Veteran stated he was trying to get more disability and voiced that he needed "a note or something stating that his PTSD is causing him problems with health including sleep apnea."  Id.  

Overall, based on a detailed review of the record and the Veteran's statements, the Board must unfortunately find that the Veteran's statements regarding his sleep apnea are not credible and cannot be afforded any probative weight. 

In weighing the evidence, the Board finds the Veteran's service treatment records and statements rendered in connection with treatment as documented in the post service treatment records, are more probative than assertions he made many years after service for compensation purposes.  See Curry v. Brown, 7 Vet. App. 59 (1994); Cartwright v. Derwinski, 2 Vet. App. 24, 25-26 (1991) (a pecuniary interest may affect the credibility of a claimant's lay testimony); See Caluza v. Brown, 7 Vet. App. 498, 511 (1995) (noting that the credibility of a witness may be impeached by a showing of interest, bias, inconsistent statements, consistency with other evidence), aff'd, 78 F.3d 604 (Fed. Cir. 1996). 

Here, the Veteran has provided nothing beyond a bare assertion to trigger VA's duty to assist.  Service and post service treatment records do not in any way suggest or indicate that his sleep apnea is etiologically related to service or a service-connected disability.  38 C.F.R. § 3.159 (c)(4); See McLendon v. Nicolson, 20 Vet. App. App. 76, 81-82 (2006).  

Accordingly, service connection for sleep apnea is denied.  See 38 U.S.C. § 5107 (b). 

2. Entitlement to service connection for bilateral hearing loss.

3. Entitlement to service connection for tinnitus.

The Veteran contends, in substance, that his bilateral hearing loss and tinnitus are due to the nearly constant high-noise exposure during service.  See May 2025 Hearing Transcript.  

The August 2021 rating decision favorably found that the Veteran has been diagnosed with bilateral sensorineural hearing loss and recurrent tinnitus.  Furthermore, the Veteran's tinnitus is at least as likely as not a symptom associated with hearing loss.  Lastly, the hearing loss and tinnitus are chronic diseases which may be presumptively linked to the Veteran's military service.  

During the May 2025 Board Hearing, the Veteran testified as to the different instances and magnitudes of his noise exposure while working on a ship.  While the Veteran's military occupational specialty of mess management specialist had a low probability of noise exposure, the circumstances of the Veteran's service are also considered.  

The Veteran has undergone multiple VA examinations for his bilateral hearing loss and tinnitus.  Most recently, an August 2021 VA examiner found that the Veteran's bilateral hearing loss is less likely than not caused by or a result of an event in military service.  They noted that the military occupational specialty as a mess management specialist had a low probability of exposure to hazardous noise.  The Veteran's February 1988 enlistment examination, July 1989 reference examination, and June 1992 separation examination show normal hearing with no significant threshold shifts.  No report of hearing loss is shown until over 20 years after military service.  The Institute of Medicine concluded that based on current knowledge of cochlear physiology there is insufficient scientific evidence for delayed onset of hearing loss secondary to military noise exposure.  Hearing loss should occur at the time of the exposure.  Therefore, a nexus is not established between hearing loss and military service. 

While the August 2021 VA examiner noted some of the specific noise exposures reported by the Veteran during service, they generally relied on the Veteran's military occupational specialty to determine hazardous noise exposure levels in reaching their rationale.  

As previously noted, the credibility of the Veteran's lay statements is afforded minimal probative weight.  However, given the nature of the Veteran's service on a ship, it is reasonable for the Board to find that he had problems with ringing in his ears and difficulty hearing during and since being exposed to constant noise. 

Therefore, the Board finds that the evidence, both positive and negative, as to whether the Veteran had problems with bilateral hearing loss and tinnitus since service is at least in equipoise.  Under such circumstances, and with granting the Veteran the benefit of any doubt in this matter, the Board concludes that he did.  See 38 U.S.C. § 5107; 38 C.F.R. § 3.102. 

Accordingly, the Board finds that the criteria to grant service
 probative weight.  However, given the nature of the Veteran's service on a ship, it is reasonable for the Board to find that he had problems with ringing in his ears and difficulty hearing during and since being exposed to constant noise. 

Therefore, the Board finds that the evidence, both positive and negative, as to whether the Veteran had problems with bilateral hearing loss and tinnitus since service is at least in equipoise.  Under such circumstances, and with granting the Veteran the benefit of any doubt in this matter, the Board concludes that he did.  See 38 U.S.C. § 5107; 38 C.F.R. § 3.102. 

Accordingly, the Board finds that the criteria to grant service connection for bilateral hearing loss and tinnitus have been met.  See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. §§ 3.303, 3.385.  

 

 

John J. Crowley

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Cochran, Laura

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.