SLEEP APNEA SYNDROMES (OBSTRUCTIVE CENTRAL MIXED)

Summary

The veteran, who served from September 1996 to January 2004, including service in Southwest Asia as a helicopter pilot, appeals the denial of service connection for obstructive sleep apnea (OSA), a neck disability, and bilateral upper extremity radiculopathy. The Board reviewed the evidence, including service treatment records (STRs), VA examinations, a co-service member statement, and a private medical opinion. For OSA, the veteran reported symptoms during service, and STRs showed weight gain and fatigue after sleep. A co-service member corroborated loud snoring and breathing pauses during service. While a VA examiner opined OSA was less likely than not service-related, citing risk factors like obesity, the Board found the evidence, including the weight gain and in-service symptoms, persuasive enough to grant service connection, applying the benefit of the doubt. For the neck disability, the veteran reported neck strain from wearing heavy helmet and goggles during helicopter missions. VA examiners provided negative nexus opinions, citing lack of evidence. However, a private physician provided a more persuasive opinion, linking the neck disability to service due to the reported strain from flying, weight gain, and medical literature on neck pain from prolonged forced postures and vibration. The Board found this private opinion more persuasive, granting service connection for the neck disability. Bilateral upper extremity radiculopathy was found to be related to the granted neck disability, leading to service connection for this condition as well. Service connection for OSA, neck disability, and bilateral upper extremity radiculopathy were all granted.

Rationale

In-service symptoms reported; Co-service member statement corroborates symptoms; Weight gain during service noted as risk factor; Benefit of the doubt applied

Full Decision Text

Citation Nr: A26040681
Decision Date: 04/30/26	Archive Date: 04/30/26

DOCKET NO. 250827-579860
DATE: April 30, 2026

ORDER

Service connection for obstructive sleep apnea (OSA) is granted.

Service connection for a neck disability is granted.

Service connection for bilateral upper extremity radiculopathy is granted. 

FINDINGS OF FACT

1. The evidence persuasively favors the conclusion that it is at least as likely as not that the Veteran's OSA either began during or was otherwise caused by his active service. 

2. The evidence persuasively favors the conclusion that it is at least as likely as not that the Veteran's neck disability is the result of his active service.   

3. The Veteran's bilateral upper extremity radiculopathy is the result of his neck disability.  

CONCLUSIONS OF LAW

1. The criteria for service connection for OSA have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309.

2. The criteria for service connection for a neck disability have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R.§§ 3.102, 3.303, 3.304, 3.307, 3.309.

3. The criteria for service connection for bilateral upper extremity radiculopathy have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R.§§ 3.102, 3.303, 3.304, 3.307, 3.309, 3.310.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran had active service from September 1996 to January 2004, including service in Southwest Asia. His military specialty was helicopter pilot.  

A rating decision in March 2025 denied service connection for OSA and a neck disability.  In August 2025, the Veteran timely appealed to the Board by filing a VA Form 10182 and selecting the Direct Docket, a process in which the Board by operation of law is only allowed to consider evidence as of the March 2025 rating decision.

Service connection

Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303.  Service connection requires competent evidence showing: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service (nexus). Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).

The nexus requirement, in pertinent part, can be established through objective medical evidence; the application of statutory presumptions for chronic diseases like sensorineural hearing loss, when manifested to a compensable degree within a year of separation from service; or based on a continuity of symptomatology. 38 U.S.C. §§ 1101, 1112; 38 C.F.R. §§ 3.307, 3.309; Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013).

Service connection may also be established on a secondary basis for a disability which is proximately due to, or aggravated by, a service connected disability. 38 C.F.R.§3.310

1. OSA

VA examinations in June 2023, November 2023 and January 2025 diagnosed the Veteran with OSA. The Veteran reported that the onset of his OSA was between 2002 and 2004 with initial symptoms of loud snoring and non-restful sleep. 

His co-service member provided a statement in March 2025, stating that he noticed that during their service in Iraq, the Veteran experienced excessive loud snoring with episodes of brief stops of breathing followed by gasping and choking sounds.

A VA medical opinion in November 2023 concluded that it is less likely than not that the Veteran's OSA was due to toxic exposure risk activities during service. The examiner listed risk factors of OSA to include male sex, old age, obesity, and history of smoking. 

Service treatment records (STRs) show that the Veteran reported feeling tired after sleeping on his Post-Deployment Health Assessment in July 2003. STRs
2004 with initial symptoms of loud snoring and non-restful sleep. 

His co-service member provided a statement in March 2025, stating that he noticed that during their service in Iraq, the Veteran experienced excessive loud snoring with episodes of brief stops of breathing followed by gasping and choking sounds.

A VA medical opinion in November 2023 concluded that it is less likely than not that the Veteran's OSA was due to toxic exposure risk activities during service. The examiner listed risk factors of OSA to include male sex, old age, obesity, and history of smoking. 

Service treatment records (STRs) show that the Veteran reported feeling tired after sleeping on his Post-Deployment Health Assessment in July 2003. STRs also show that the Veteran had significant weight gain during service. The enlistment physical in May 1996 showed that the Veteran weighed 193 lbs (his height was 73 inches). The STRs showed that he weighed 220 lbs in November 2003 (approximately two months prior to separation) with increase of 27 lbs during service. 

As obesity was a risk factor for OSA, and evidence shows that the Veteran had significant weight gain during service, along with evidence showing that he experienced symptoms of OSA (such as snoring, breathing stops during sleep and being tired after sleep) during service, the Board finds that it is at least as likely as not that the Veteran's OSA began during or was otherwise caused by his active service. 

Service connection for OSA is granted. 

2. Neck disability and bilateral upper extremity radiculopathy 

A VA examination in March 2023 diagnosed the Veteran with cervical strain. The Veteran reported that he was a helicopter pilot and was required to wear a helmet and night vision goggle during flying missions, and that he strained his neck from making sharp turns with the helmet on.  However, the VA examiner opined that it is less likely than not that the Veteran's neck disability was caused by his active service due to lack of evidence supporting a nexus between the current diagnosis and military service.

A VA examination in March 2024 diagnosed the Veteran with cervical strain and right upper extremity radiculopathy. The examiner provided a negative nexus opinion.

A VA examination in January 2025 diagnosed the Veteran with degenerative disc disease of cervical spine; spinal stenosis; and bilateral upper extremity   radiculopathy. The examiner again provided a negative nexus opinion.

The Veteran provided a private opinion in August 2023, which concluded that it is at least as likely as not that the Veteran's neck disability was the result of his active service. The private physician pointed out that the Veteran reported that he wore heavy helmet and goggles when flying helicopters and the fights were very bumpy, causing wear and tear to his cervical spine. The Veteran also reported the onset of his neck pain during service. The physician indicated that medical research shows risk factors of neck strain/ neck pain include prolonged forced neck postures, vibration from vehicles (airplanes, helicopters, etc.), and equipment carried on one's head. 

The Board finds that that private opinion was more persuasive than the VA medical opinions. As such, service connection for a neck disability is granted. 

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As VA examination in January 2025 shows that bilateral upper extremity radiculopathy was related to the Veteran's neck disability, service connection for bilateral upper extremity radiculopathy is also granted. 

 

 

MATTHEW W. BLACKWELDER

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Q. Wang, 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.