Citation Nr: 18140708 Decision Date: 10/05/18 Archive Date: 10/05/18 DOCKET NO. 17-42 124 DATE: October 5, 2018 ORDER Service connection for obstructive sleep apnea (OSA) is denied. FINDINGS OF FACT 1. The Veteran had service in the Southwest Asia Theater of Operations during the Persian Gulf War. 2. The Veteran’s symptoms have been attributed to a known clinical diagnosis of OSA. 3. OSA is not shown to be causally or etiologically related to any disease, injury, or incident during service. CONCLUSION OF LAW The criteria for service connection for OSA have not been met. 38 U.S.C. §§ 1110, 1117, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.317. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from August 1974 to August 1976, September 2002 to February 2003, January 2007 to April 2008, and July 2009 to September 2010. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a September 2016 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). Entitlement to service connection for OSA. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. §§ 1110; 1131; 38 C.F.R. § 3.303(a). Service connection may also be granted for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Direct service connection may not be granted without evidence of a current disability; in-service incurrence or aggravation of a disease or injury; and a nexus between the claimed in-service disease or injury and the present disease or injury. Id.; see also Caluza v. Brown, 7 Vet. App. 498, 506 (1995) aff’d, 78 F.3d 604 (Fed. Cir. 1996). Service connection may also be granted for a disability due to a qualifying chronic disability of a veteran who served in the Southwest Asia Theater of Operations during the Persian Gulf War, provided that such disability became manifest during either active service in the Southwest Asia Theater of Operations during the Persian Gulf War or to a degree of 10 percent or more, under the appropriate diagnostic code of 38 C.F.R. Part 4, not later than December 31, 2021, and by history, physical examination, and laboratory tests, the disability cannot be attributed to any known clinical diagnosis. 38 U.S.C. § 1117; 38 C.F.R. § 3.317 (a)(1). In this case, the record reflects that the Veteran had service in the Southwest Asia Theater of Operations during the Persian Gulf War; however, his symptoms have been attributed to a known clinical diagnosis of OSA. Therefore, 38 U.S.C. § 1117 and 38 C.F.R. § 3.317 are inapplicable to his claim. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). As an initial matter, the Board notes that the Veteran was diagnosed with OSA in a March 2016 sleep study. His service treatment records (STRs) are silent for any complaints, treatment, or diagnosis referable to OSA. In fact, in his 2008 and 2010 post-deployment notes, the Veteran indicated that he did not feel tired after sleeping. However, in light of his acknowledged in-service exposure to environmental hazards consistent with his service in Southwest Asia, he was afforded a VA examination in order to determine the nature and etiology of his OSA in September 2016. At such time, the examiner opined that the Veteran’s OSA was less likely than not incurred in or was caused by the claimed in-service exposure to the Persian Gulf environment. In this regard, he explained that OSA is a disease with a clear and specific etiology and diagnosis, and, according to the medical literature, there is no link between exposure to the Persian Gulf environment and OSA. The examiner further stated that the Veteran’s post-deployment notes of 2008 and 2010 revealed that he did not feel tired after sleeping. Moreover, he stated that the Veteran’s service treatment records were silent for OSA, difficulty to get at asleep, daytime sleepiness, not breathing while sleeping, or snoring during his active duty service periods. Therefore, the examiner concluded that it was less likely than not that the Veteran’s OSA incurred in or was caused by his active duty periods of service. The Board finds the September 2016 VA examiner’s opinion is highly probative as he considered all of the pertinent evidence of record and provided a complete rationale, relying on and citing to the records reviewed. Moreover, he offered clear conclusions with supporting data as well as reasoned medical explanations connecting the two. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) (“[A]medical opinion...must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions”). Notably, there is no medical opinion to the contrary. The Board has also considered the Veteran’s contention that his OSA began in service or is otherwise related to his in-service exposure to the Persian Gulf environment. However, while the Veteran, as a lay person, is competent to report observable symptomatology and events in service, he lacks the medical training and expertise necessary to relate his claimed symptoms to a specific diagnosis or provide an opinion on the medically complex issue regarding the etiology of OSA as such matters extend beyond an immediately observable cause-and-effect relationship. See Layno v. Brown, 6 Vet. App. 465 (1994); Jandreau v. Nicholson, 492 F. 3d 1372 (Fed. Cir. 2007); Woehlaert v. Nicholson, 21 Vet. App. 456 (2007). Therefore, as he lacks the competency to offer such an etiological opinion, the Board accords his statements as to the etiology of his OSA no probative weight. Consequently, the Board finds that OSA is not shown to be causally or etiologically related to any disease, injury, or incident during service. Therefore, service connection for such disorder is not warranted. In reaching such determination, the Board has considered the applicability of the benefit of the doubt doctrine. However, the preponderance of the evidence is against the Veteran’s claim of service connection for OSA. As such, that doctrine is not applicable in the instant appeal, and his claim must be denied. 38 U.S.C. 5107; 38 C.F.R. 3.102; Gilbert, supra. A. JAEGER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Brennae L. Brooks, Associate Counsel