SLEEP APNEA SYNDROMES (OBSTRUCTIVE CENTRAL MIXED)

Summary

The Veteran, an Army Veteran who served from August 1972 to August 1974, appeals the denial of service connection for sleep apnea. The Board found that the Veteran has a current diagnosis of sleep apnea, satisfying the first element for service connection. The second element was met through the Veteran's testimony regarding exposure to organic solvents such as diesel fuel and motor oils due to his military occupational specialties as a wheel vehicle mechanic and motor transportation operator. The Board found this lay testimony competent as it related to matters of personal knowledge. For the third element, a nexus between the in-service exposure and the current sleep apnea, the Board relied on a March 2026 private nexus opinion. This opinion, provided by a qualified medical professional after an in-person examination and review of records, concluded that the sleep apnea was "at least as likely as not" a direct result of the in-service organic solvent exposure, citing supporting medical literature. The Board found this opinion persuasive and well-reasoned. Consequently, the Board found that the Veteran met the criteria for direct service connection, and the appeal was granted.

Rationale

Current diagnosis of sleep apnea established.; In-service exposure to organic solvents confirmed by Veteran's testimony.; Private medical opinion provided a favorable nexus between exposure and sleep apnea.

Full Decision Text

Citation Nr: A26040657
Decision Date: 04/30/26	Archive Date: 04/30/26

DOCKET NO. 221205-300873
DATE: April 30, 2026

ISSUE

Entitlement to service connection for sleep apnea.

ORDER

Entitlement to service connection for sleep apnea is GRANTED.

FINDINGS OF FACT

1. The Veteran was exposed to organic solvents such as diesel fuel, diesel exhaust, and motor oils due to his military occupational specialties of wheel vehicle mechanic and motor transportation operator.

2. The Veteran's sleep apnea is related to his in-service exposure to organic solvents.

CONCLUSION OF LAW

The criteria for service connection for sleep apnea are met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

FACTUAL AND PROCEDURAL HISTORY

The Veteran served on active duty in the United States Army from August 1972 to August 1974. The matter comes to the Board of Veterans' Appeals (Board) on appeal from a May 2022 rating decision issued by a Regional Office (RO) of the Department of Veterans Affairs (VA).

In the December 2022 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A Board hearing was held on January 16, 2026.

Therefore, the Board may only consider the evidence of record at the time of the May 2022 RO 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 RO 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. Specific instructions for filing a Supplemental Claim are included with this Decision. 

This appeal is advanced on the docket due to the Veteran's age. 38 U.S.C. § 7107(a)(2); 38 C.F.R. § 20.900(c).

REASONS AND BASES FOR THE FINDINGS AND CONCLUSION

Legal Criteria-Service Connection

Service connection can be established on a presumptive, direct, or secondary basis. Generally, to prevail on a claim of direct service connection on the merits, there must be competent evidence of: (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004).

The Board must assess the credibility and weight of all the evidence, including the medical evidence, to determine its probative value, accounting for the evidence which it finds to be persuasive or unpersuasive, and providing reasons for rejecting any evidence favorable to the claimant. See Masors v. Derwinski, 2 Vet. App. 181 (1992). Equal weight is not accorded to each piece of evidence contained in the record; every item of evidence does not have the same probative value.

Competent medical evidence is evidence provided by a person who is qualified through education, training, or experience to offer medical diagnoses, statements, or opinions. Competent medical evidence may also include statements conveying sound medical principles found in medical treatises. It also includes statements contained in authoritative writings, such as medical and scientific articles and research reports or analyses. 38 C.F.R. § 3.159(a)(1).

Competent lay evidence is any evidence not requiring that the proponent have specialized education, training, or experience. Id. § 3.159(a)(2). Lay evidence is competent if it is provided by a person who has knowledge of facts or circumstances and conveys matters that can be observed and described by a lay person. Id. This may include some medical matters, such as describing symptoms or relating a contemporaneous medical diagnosis. Jandreau v. Nicholson, 492 F
ent medical evidence may also include statements conveying sound medical principles found in medical treatises. It also includes statements contained in authoritative writings, such as medical and scientific articles and research reports or analyses. 38 C.F.R. § 3.159(a)(1).

Competent lay evidence is any evidence not requiring that the proponent have specialized education, training, or experience. Id. § 3.159(a)(2). Lay evidence is competent if it is provided by a person who has knowledge of facts or circumstances and conveys matters that can be observed and described by a lay person. Id. This may include some medical matters, such as describing symptoms or relating a contemporaneous medical diagnosis. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). Lay evidence concerning continuity of symptoms after service, if credible, is ultimately competent, regardless of the lack of contemporaneous medical evidence. Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006).

In assessing the credibility and probative weight of all relevant evidence, the Board may consider factors such as facial plausibility, bias, self-interest, and consistency with other evidence of record. McClain v. Nicholson, 21 Vet. App. 319, 325 (2007) (Greene, J., concurring in part and dissenting in part) (noting that the Board has the duty to assess credibility and probative weight of evidence); see Jandreau, 492 F.3d at 1376 (affirming that the Board retains discretion to make credibility determinations and otherwise weigh the evidence submitted, including lay evidence); Buchanan, 451 F.3d at 1337 (holding that the Board, as fact finder, is obligated to, and fully justified in, determining whether lay evidence is credible in and of itself, i.e., because of possible bias, conflicting statements, etc.). The court has also held that contemporaneous records are more probative than history reported by an appellant. See Curry v. Brown, 7 Vet. App. 59, 68 (1994).

In evaluating the probative value of competent medical evidence, the court has stated that the probative value of medical opinion evidence is based on the medical expert's personal examination of the patient, the physician's knowledge, and skill in analyzing the data, and the medical conclusion that the physician reaches. Guerrieri v. Brown, 4 Vet. App. 467, 470-71 (1993).

While VA has a duty to assist the veteran in developing evidence to support their claim, the veteran ultimately bears the burden of demonstrating his or her entitlement to a particular benefit. 38 U.S.C. § 5107(a) (a claimant has the responsibility to present and support a claim for benefits); Skoczen v. Shinseki, 564 F.3d 1319, 1324 (Fed. Cir. 2009) (recognizing that, the responsibilities of developing the evidence aside, the claimant bears the burden of establishing his or her entitlement to the benefits sought); Ortiz v. Principi, 274 F.3d 1361, 1365 (Fed. Cir. 2001) (explaining that the evidence must demonstrate entitlement to the benefit).

Analysis

In the May 2022 rating decision, the RO denied the Veteran's claim for service connection but in doing so made the favorable finding that the Veteran has a current diagnosis of sleep apnea. The Board will not disturb this favorable finding. 38 C.F.R. § 3.104(c). Therefore, the first element of service connection is met.

As to the second element of service connection, the evidence shows that the Veteran participated in toxic exposure risk activities due to his military occupational specialties of wheel vehicle mechanic and motor transportation operator. See DD Form 214. Specifically, the Veteran recalls direct exposure to organic solvents such as "diesel fuel, diesel exhaust, fumes from the diesel fuel, direct skin contact with diesel fuel with spent motor oils and with particulate matter from the diesel exhaust." See H'rg Tr. at 4-5. Because the Veteran is competent to report matters of which he has personal knowledge, his lay testimony regarding toxic exposure risk activities establishes the second element of service connection. Layno v. Brown, 6 Vet. App. 465, 470 (1994).

The only remaining question is whether there is a nexus between the Veteran's in-service injury and his active-duty service. On this issue, there is only one probative medical opinion of record, a March 2026 private nexus opinion. 

The March 2026 private examiner opined "it is as least as likely as not that this Veteran's [sleep apnea] is the
 with particulate matter from the diesel exhaust." See H'rg Tr. at 4-5. Because the Veteran is competent to report matters of which he has personal knowledge, his lay testimony regarding toxic exposure risk activities establishes the second element of service connection. Layno v. Brown, 6 Vet. App. 465, 470 (1994).

The only remaining question is whether there is a nexus between the Veteran's in-service injury and his active-duty service. On this issue, there is only one probative medical opinion of record, a March 2026 private nexus opinion. 

The March 2026 private examiner opined "it is as least as likely as not that this Veteran's [sleep apnea] is the direct result of his in-service organic solvents exposure." (alteration added). In support of this finding, the examiner cited to several studies that show a nexus between sleep apnea and occupational exposure organic solvents and found that the medical literature supported a "causal connection between organic solvent exposure and...[sleep apnea]." (alteration added).

The Board finds that the March 2026 nexus opinion was provided by a medical professional who possesses the necessary education, training, and expertise to provide a nexus opinion on the Veteran's sleep apnea. The opinion is based on an in-person examination, knowledge of past treatment, and a review of the Veteran's service records, including his in-service exposure to organic solvents. And it contains detailed and thoroughly explained conclusions resting upon clearly articulated findings. 

For these reasons, the Board relies on the March 2026 medical opinion and gives it probative weight. 

Based upon the foregoing evidence, the Board finds that the March 2026 private medical opinion, alongside the Veteran's credible testimony, persuasively establishes that the Veteran's sleep apnea is causally linked to organic solvent exposure during the Veteran's active-duty service. Thus, the Veteran meets the criteria for direct service connection, and the appeal is granted. 38 CFR § 3.303.

 

STEVEN V. ADLER

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	K.P. Blackburn

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.