SLEEP APNEA SYNDROMES (OBSTRUCTIVE CENTRAL MIXED)

Summary

The Veteran served on active duty from February 1981 to February 1984. This case comes before the Board of Veterans' Appeals (Board) on appeal from an August 2021 rating decision that denied service connection for sleep apnea. The Veteran initially requested a hearing but later withdrew the request, limiting the Board's review to evidence of record at the time of the August 2021 decision and evidence submitted within 90 days of the hearing withdrawal. The Veteran claims sleep apnea is related to service-connected PTSD, but the Board found evidence supporting an in-service onset. While the Veteran's service treatment records (STRs) were negative for sleep apnea complaints, the Veteran reported continuous sleep-related symptoms since service, with a formal diagnosis of sleep apnea following a July 2018 sleep study. The Board found the Veteran's lay statements credible and consistent, establishing the in-service disease element, citing Buchanan v. Nicholson. The Board also noted that lay evidence can be sufficient for sleep apnea claims, referencing Maples v. Wilkie. The Board concluded that the evidence was evenly balanced regarding the in-service onset of sleep apnea. Applying the benefit of the doubt doctrine, the Board resolved this equipoise in favor of the Veteran. Therefore, service connection for sleep apnea is granted.

Rationale

Credible lay statements regarding in-service symptoms and continuity of symptoms since service.; Evidence evenly balanced regarding in-service onset.; Benefit of the doubt resolved in Veteran's favor.

Full Decision Text

Citation Nr: A26040608
Decision Date: 04/30/26	Archive Date: 04/30/26

DOCKET NO. 211019-192713
DATE: April 30, 2026

ORDER

Entitlement to service connection for sleep apnea is granted.

FINDING OF FACT

The evidence is approximately evenly balanced as to whether the Veteran's sleep apnea had its onset during her active duty service.

CONCLUSION OF LAW

With reasonable doubt resolved in favor of the Veteran, the criteria for service connection for sleep apnea are met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty from February 1981 to February 1984.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from an August 2021 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO) that denied service connection for sleep apnea. 

In the October 2021 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. In May 2025, the Veteran withdrew the hearing request.

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 or representative within 90 days following receipt of the withdrawal of the hearing request. 38 C.F.R. § 20.302(b). If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to receipt of the withdrawal, or (2) more than 90 days following receipt of the withdrawal, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(b), 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. Specific instructions for filing a Supplemental Claim are included with this decision. 

Service Connection

Service connection will be granted if the evidence demonstrates that current disability resulted from an injury suffered or disease contracted in active military, naval, air, or space service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303 (a). Establishing service connection generally requires competent evidence of three things: (1) current disability; (2) in-service injury or disease; and (3) a relationship between the two. Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018). Consistent with this framework, service connection is warranted for a disease first diagnosed after service when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303 (d).

As noted in the June 2025 attorney's brief, the Veteran asserts that her sleep apnea is related to her service-connected PTSD. However, as discussed below, evidence supports a finding that sleep apnea had onset in service.

VA treatment records show treatment for sleep related issues in 2002, and a July 2018 sleep study shows a diagnosis of sleep apnea. The Veteran has thus met the current disability requirement.

Although the Veteran's service treatment records (STRs) are negative of complaints, treatment, or findings of sleep apnea, there is evidence of sleep-related symptoms in service and evidence of continuous symptoms in the years since service. In this regard, the Veteran that she has sleep related symptoms in service that have continued since separation. In VA treatment records show that the Veteran complained of sleep related symptoms as early as 2002, and was subsequently diagnosed with sleep apnea in 2018 following a sleep study.

The Board finds the Veteran's reports credible and therefore competent as they have been consistent throughout the appeal period.  Buchanan v. Nicholson, 451 F.3d 1331, 1337 (holding lay evidence concerning continuity of symptoms after service, if credible, is ultimately competent, regardless of the lack of contemporaneous medical evidence).  Thus, the in-service disease or injury element has been met and continuous symptoms since service shown.

The Veteran's statements indicating sleep-related symptoms, both in and since separation from service
 symptoms in service that have continued since separation. In VA treatment records show that the Veteran complained of sleep related symptoms as early as 2002, and was subsequently diagnosed with sleep apnea in 2018 following a sleep study.

The Board finds the Veteran's reports credible and therefore competent as they have been consistent throughout the appeal period.  Buchanan v. Nicholson, 451 F.3d 1331, 1337 (holding lay evidence concerning continuity of symptoms after service, if credible, is ultimately competent, regardless of the lack of contemporaneous medical evidence).  Thus, the in-service disease or injury element has been met and continuous symptoms since service shown.

The Veteran's statements indicating sleep-related symptoms, both in and since separation from service, combined with the diagnosis of sleep apnea, are sufficient to establish that the Veteran's sleep apnea had its onset in service. Furthermore, as was reasoned in Maples v. Wilkie, No. 18-2016, 2019 U.S. App. Vet. Claims LEXIS 199 (Feb. 11, 2019) (mem dec) (Falvey, J.), sleep apnea is the type of disability for which lay evidence can be sufficient to support a claim for service connection for sleep apnea. Bethea v. Derwinski, 2 Vet. App. 252, 254 (1992) (single judge decisions may be relied upon for any persuasiveness or reasoning they contain).

While the Board could remand the claim for a medical opinion, a request for another opinion could be construed as obtaining additional evidence for the sole purpose of denying a claim, which is impermissible.  38 C.F.R. § 3.304(c) ("The development of evidence in connection with claims for service connection will be accomplished when deemed necessary but it should not be undertaken when evidence present is sufficient for this determination"); Andrews v. McDonough, 34 Vet. App. 216, 225 (2021) ("Remand is inappropriate where the predominant purpose is not to allow the Board to make a fully informed decision unencumbered by error but to allow VA to obtain more evidence so that it can properly deny the claim").

For the foregoing reasons, the evidence is at least evenly balanced as to whether the Veteran's sleep apnea had onset in service. As the reasonable doubt created by this relative equipoise in the evidence must be resolved in favor of the Veteran, entitlement to service connection for sleep apnea is warranted. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102.

 

 

Jonathan Hager

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	A. Hemphill, 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.