SPINAL FUSION

Summary

The veteran, who served from November 2020 to July 2021 and again from October 2022 to December 2023, appeals the rating decision concerning a thoracic sprain and obstructive sleep apnea. The Board granted service connection for the thoracic sprain, finding that the veteran's reported back pain onset during service, consistent with his MOS as a supply clerk, established the elements of service connection. The Board noted the veteran's credible lay reports of pain since December 2022, establishing continuity of symptomatology. Although a VA examiner opined negatively, the Board found this opinion inadequate as it ignored the veteran's consistent reports of pain. Service connection for obstructive sleep apnea was denied because the evidence did not demonstrate a current diagnosis. While the veteran used a CPAP for snoring, sleep studies did not confirm the presence of obstructive sleep apnea, and a physician confirmed no OSA diagnosis. The Board found the veteran lacked the medical expertise to self-diagnose the condition, and without a current diagnosis, service connection could not be granted.

Rationale

Competent lay reports of pain onset during service; Continuity of symptomatology established; Negative VA opinion found inadequate

Full Decision Text

Citation Nr: A26037939
Decision Date: 04/22/26	Archive Date: 04/22/26

DOCKET NO. 250510-542689
DATE: April 22, 2026

ORDER

Entitlement to service connection for a thoracic sprain is granted.

Entitlement to service connection for obstructive sleep apnea is denied.

FINDINGS OF FACT

1. The Veteran's back pain onset during service and has manifested as the currently diagnosed thoracic sprain; it is etiologically related to his military service.

2. The evidence does not demonstrate a current diagnosis of obstructive sleep apnea.

CONCLUSIONS OF LAW

1. The criteria for service connection for a thoracic sprain have been met.  38 U.S.C. §§ 1110, 5107;?38 C.F.R. §§ 3.102, 3.303.

2. The criteria for service connection for obstructive sleep apnea have not been met.  38 U.S.C. §§ 1110, 5107;?38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from November 2020 to July 2021 and from October 2022 to December 2023.

The rating decision on appeal was issued in April 2025 and constitutes an initial decision; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies.

In the May 2025 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 April 2025 agency of original jurisdiction (AOJ) 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. 

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 claims, considering the new evidence in addition to the evidence previously considered.  Id.  Specific instructions for filing a Supplemental Claim are included with this decision. 

Service Connection

Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated during active military service. ?38 U.S.C. § 1110;?38 C.F.R. § 3.303(a).? Service connection may also be granted for any disability 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).?Entitlement to service connection on a direct basis requires competent?medical or lay evidence of: (1) a current disability; (2) an in-service incurrence or?injury, and (3) a nexus between the current disability and the in-service incurrence or injury.??38 C.F.R. § 3.303.

1. Entitlement to service connection for a thoracic sprain is granted.

The Veteran seeks service connection for back pain he reports onset during service.  See VA Form 21-525, Veteran's Application for Compensation or Pension, February 2025.  The Board finds service connection is warranted.

Regarding the first element of service connection, the AOJ rating decision on appeal favorably found the Veteran to have a current diagnosis of a thoracic spine sprain.  See Rating Decision - Narrative, April 2025.  Indeed, the Veteran was diagnosed with a thoracic sprain at this March 2025 VA examination.  See C&P Exam, March 2025.  Accordingly, the first element of service connection has been met.

Regarding the second element of service connection, the Veteran reports that his back began hurting during service as a result of military exercises and his military occupational specialty as a supply clerk.  See VA Form 21-526, Veteran's Application for Compensation or Pension, February 2025 (reporting that his back has hurt "since [he] started working during [his] deployment and putting on [his] vest and plates on every shift."), and C&P Exam, March 2025 (reporting a gradual onset of back pain around December 2022 that has stayed the same and is currently treated with a muscle relaxer). 
 See C&P Exam, March 2025.  Accordingly, the first element of service connection has been met.

Regarding the second element of service connection, the Veteran reports that his back began hurting during service as a result of military exercises and his military occupational specialty as a supply clerk.  See VA Form 21-526, Veteran's Application for Compensation or Pension, February 2025 (reporting that his back has hurt "since [he] started working during [his] deployment and putting on [his] vest and plates on every shift."), and C&P Exam, March 2025 (reporting a gradual onset of back pain around December 2022 that has stayed the same and is currently treated with a muscle relaxer).  A periodic health assessment conducted in October 2024 also shows that since a prior periodic health assessment in October 2023, he experienced recurring low back pain that impacted his performance but that he did not seek treatment for.  See STR, received March 2025, dated October 2024.  Notably, veterans, even those without medical training, are competent to report the existence of pain.  See Layno v. Brown, 6 Vet. App. 465, 470 (1994) (a veteran is competent to report on that of which he or she has personal knowledge).  Given that the Veteran's reported onset of back pain is consistent with the circumstances of his service as a supply clerk, which would inherently involved lifting, carrying, bending, and twisting, the Board finds his reported onset of back pain during service to be credible.  Accordingly, the second element of service connection has been met.

Regarding the third element of service connection, a nexus between the currently diagnosed thoracic sprain and his military service, the Board again notes that at his March 2025 VA examination, the Veteran reported that his back pain gradually onset sometime around December 2022, during his service, that is has continued since service, and that his continuous back pain since service is currently treated with a muscle relaxer.  Given the close temporal proximity of the Veteran's separating from service in December 2023 to his February 2025 filing for service connection for a back disability and his March 2025 report of having back pain since December 2022, the Board finds his lay reports adequately establish a continuity of symptomatology of back pain during service to the present such that the currently diagnosed thoracic sprain is a current manifestation of his competently and credibly reported in-service back pain.  38 C.F.R. § 3.303(d).  Accordingly, the third element of service connection has been met.

The Board acknowledges the negative VA opinion from March 2025, which found that the Veteran's currently diagnosed thoracic sprain is less likely than not due to service.  However, it was based entirely on a lack of documented back pain during service and ignored the Veteran's reports of pain in December 2022.  Accordingly, the opinion is inadequate and does not weigh against the herein award of service connection.  Dalton v. Nicholson, 21 Vet. App. 23, 39 (2007) (finding that a clinician impermissibly ignored the Veteran's lay assertions); Buchanan v. Nicholson, 451 F.3d 1331, 1336, n.1 (Fed Cir. 2006) (stating that a clinician's opinion failed to consider whether lay statements presented sufficient evidence of the etiology of the Veteran's disability such that his claim could be proven without contemporaneous medical evidence).

With all three elements of service connection met for the Veteran's currently diagnosed thoracic sprain, service connection is warranted.  The claim is granted.

2. Entitlement to service connection for obstructive sleep apnea is denied.

The Veteran seeks service connection for obstructive sleep apnea.  See VA Form 21-525, Veteran's Application for Compensation or Pension, February 2025.  The Board finds service connection is not warranted.  Specifically, as to the first element of service connection, the evidence does not demonstrate a "current disability" of obstructive sleep apnea.

In this regard, the Veteran submitted a privately conducted sleep study completed in March 2024 which shows that although he required use of a CPAP due to severe snoring, he did not exhibit enough apnea events to be diagnosed with any level of obstructive sleep apnea.  See Medical Treatment Record - Non-Government Facility, received February 2025, dated March 2024.  A reevaluation done in April 2024 shows that a physician reviewed the results of his sleep study and confirmed "no OSA but recommended CPAP due to snoring and improved sleep pattern with CPAP."  See Medical Treatment Record - Non-Government Facility, received November 2024, dated April 2024.

The Board is sympathetic to
In this regard, the Veteran submitted a privately conducted sleep study completed in March 2024 which shows that although he required use of a CPAP due to severe snoring, he did not exhibit enough apnea events to be diagnosed with any level of obstructive sleep apnea.  See Medical Treatment Record - Non-Government Facility, received February 2025, dated March 2024.  A reevaluation done in April 2024 shows that a physician reviewed the results of his sleep study and confirmed "no OSA but recommended CPAP due to snoring and improved sleep pattern with CPAP."  See Medical Treatment Record - Non-Government Facility, received November 2024, dated April 2024.

The Board is sympathetic to the Veteran's documented sleeping problems; however, the evidence simply does not demonstrate a current diagnosis of obstructive sleep apnea.  While the Veteran believes he may have the disability, the record does not show that he possesses the requisite medical knowledge or expertise to render such a diagnosis.  Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007).

Accordingly, the evidence does not support a currently diagnosed obstructive sleep apnea disability.  Without a current disability, service connection may not be granted.  Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992) ("In the absence of proof of a present disability there can be no valid claim.").  The claim is denied.

 

 

A. S. CARACCIOLO

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Infante, Peter

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.