Citation NR: 9717351 Decision Date: 05/15/97 Archive Date: 05/29/97 DOCKET NO. 95-34 903 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Indianapolis, Indiana THE ISSUE Entitlement to service connection for insomnia. REPRESENTATION Appellant represented by: Veterans of Foreign Wars of the United States WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD Deborah J. Drucker, Associate Counsel INTRODUCTION The veteran had active service from September 1960 to September 1965 and from September 1990 to July 1992 and apparently had numerous periods of active duty for training. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a June 1995 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Indianapolis, Indiana. CONTENTIONS OF APPELLANT ON APPEAL The veteran contends that he suffers from insomnia incurred during his second period of active military service. He asserts that his insomnia began while he was stationed in Southwest Asia during the Persian Gulf war. Reference is made to the evidence of record and a favorable decision is requested. DECISION OF THE BOARD The Board, in accordance with the provisions of 38 U.S.C.A. § 7104 (West 1991 & Supp. 1996), has reviewed and considered all of the evidence and material of record in the veteran's claims file. Based on its review of the relevant evidence in this matter, and for the following reasons and bases, it is the decision of the Board that the evidence supports a grant of service connection for insomnia. FINDINGS OF FACT 1. All relevant evidence necessary for an equitable disposition of the veteran’s claim has been obtained by the RO. 2. The veteran had verified service in Southwest Asia during the Persian Gulf war. 3. The veteran’s statements that he had insomnia during and after his return from Southwest Asia are consistent with the circumstances of his service. 4. Qualified medical evidence establishes that in May 1995 the veteran was diagnosed by VA as having primary insomnia related to Persian Gulf service CONCLUSION OF LAW Insomnia was incurred in active wartime service. 38 U.S.C.A. §§ 1110, 1131, 5107 (West 1991 & Supp. 1996); 38 C.F.R. § 3.102, 3.303, 3.304 (1996). REASONS AND BASES FOR FINDINGS AND CONCLUSION I. Factual Background Initially, the Board finds that the veteran’s claim is well grounded; that is, it is plausible. 38 U.S.C.A. § 5107(a). The Board finds that the relevant facts have been properly developed and, accordingly, the statutory obligation of VA to assist in the development of the appellant’s claim has been satisfied. The veteran’s DD Form 214 (Certificate of Release or Discharge from Active Duty) and DD Form 215 (Corrections to DD Form 214) indicate that he was ordered to active duty in support of Operation Desert Shield/Desert Storm in September 1990 and served in southwest Asia during the Persian Gulf war from November 1990 to June 1991. His occupational specialties during this period were construction equipment repairer and motor transport operator. Among his commendations, the veteran was awarded the Southwest Asia Service Medal with three bronze service stars, the Kuwait Liberation Medal and the National Defense Service Medal with one bronze star. While medical records for the veteran’s first period of active service and his periods of active duty for training into 1990 are entirely negative for complaints of sleep related problems, in June 1991 the veteran indicated on a report of medical history that he was a very light sleeper and awoke three or four times nightly. When examined for demobilization in June 1991 and in March 1992, there was no finding of sleep related abnormality, but in a June 1992 report of medical history, the veteran again stated that he was a light sleeper and awoke two or three times a night. Moreover, the veteran testified at his December 1995 personal hearing at the RO that he experienced sleep problems due to SCUD missile alerts while stationed in Saudi Arabia during the Persian Gulf war. Subsequent to service, a September 1994 letter to the veteran indicates his participation in the VA Persian Gulf Registry and reflects examination findings of an adjustment disorder with depressed mood and a sleep disorder. A VA examination for miscellaneous neurological disorders in May 1995 found no evidence of narcolepsy, epilepsy or sleep apnea. In the examination report, the VA physician opined that the veteran’s sleep disability was secondary to some depressive symptomatology and was evidenced by depression. However, in a VA examination report for mental disorders, also dated in May 1995, the veteran said he was a platoon sergeant not involved in combat during Desert Storm and began having sleep difficulties following his service in the Persian Gulf. He said he found it difficult to stay asleep and woke up frequently during the night and described minimal improvement since taking Trazodone. The veteran also reported having recently lost the job he had held for twenty years and described a decreased mood that was improving. Diagnoses at Axis I were primary insomnia related to Persian Gulf service and a history of adjustment disorder with depressed mood. At Axis III the diagnosis was problems of unknown etiology that included loss of feeling in his left side, pain in his left foot and diverticula. II. Legal Analysis Service connection may be established for a chronic disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C.A. §§ 1110, 1131; 38 C.F.R. § 3.303. In addition, service connection may also be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, established that the disease was incurred in service. 38 C.F.R. § 3.303(d). Where the issue involves medical causation, competent medical evidence that indicates that the claim is plausible or possible is required to set forth a well-grounded claim. See Grottveit v. Brown, 5 Vet.App. 91, 93 (1993). In this case, the veteran’s active duty included service in Saudi Arabia during the Persian Gulf war, and he contends that he developed insomnia during that period of time as a consequence of SCUD missile alerts. Medical history records dated during that time reflect the veteran’s complaints of sleep problems and records dated years after service show he gave a history of sleep problems that developed during the Persian Gulf war. However, the contemporaneous medical records do not confirm the presence of insomnia or other sleep disorder during service. Nevertheless, service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, established that the disease was incurred in service. 38 C.F.R. § 3.303(d). In this case, the development of insomnia would be consistent with the circumstances of the veteran’s service. The Board notes that the veteran served seven months of duty in southwest Asia and was awarded the Southwest Asia Service Medal with three bronze service stars, the Kuwait Liberation Medal and the National Defense Service Medal with one bronze star for his service in the Persian Gulf. Between 1994 and 1995 two VA examiners diagnosed the veteran with sleep disorder and insomnia. As such, the Board is of the view that the opinions of the VA examiners consistent with a history of insomnia makes it more likely than not that the veteran’s insomnia was a residual of his active military service during the Persian Gulf war. 38 U.S.C.A. § 5107; 38 C.F.R. § 3.102. In this regard, the two medical opinions were apparently based on the same evidence, specifically, the veteran’s history and clinical observations, and the 1995 VA psychiatric examiner specifically attributed the veteran’s insomnia to his Persian Gulf service. Moreover, the one VA examiner who did not diagnose insomnia said that a psychiatric evaluation would yield the best assessment. Consequently, the Board finds that it is not unreasonable to conclude that insomnia had its onset during the veteran’s period of military service and thus warrants service connection. 38 U.S.C.A. §§ 1110, 1131; 38 C.F.R. §§ 3.303, 3.304. ORDER Service connection for insomnia is granted. WAYNE M. BRAEUER Member, Board of Veterans' Appeals 38 U.S.C.A. § 7102 (West Supp. 1996) permits a proceeding instituted before the Board to be assigned to an individual member of the Board for a determination. This proceeding has been assigned to an individual member of the Board. NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.A. § 7266 (West 1991 & Supp. 1996), a decision of the Board of Veterans' Appeals granting less than the complete benefit, or benefits, sought on appeal is appealable to the United States Court of Veterans Appeals within 120 days from the date of mailing of notice of the decision, provided that a Notice of Disagreement concerning an issue which was before the Board was filed with the agency of original jurisdiction on or after November 18, 1988. Veterans' Judicial Review Act, Pub. L. No. 100-687, § 402, 102 Stat. 4105, 4122 (1988). The date which appears on the face of this decision constitutes the date of mailing and the copy of this decision which you have received is your notice of the action taken on your appeal by the Board of Veterans' Appeals. - 2 -