Citation Nr: 18141404
Decision Date: 10/10/18	Archive Date: 10/10/18

DOCKET NO. 16-19 592A
DATE:	October 10, 2018
ORDER
Entitlement to service connection for obstructive sleep apnea is granted.
FINDING OF FACT
The evidence is in equipoise as to whether obstructive sleep apnea is related to active service.  
CONCLUSION OF LAW
Resolving all reasonable doubt in the Veteran’s favor, the criteria for obstructive sleep apnea have been met.  38 U.S.C. §§ 1110, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.304 (2017).
REASONS AND BASES FOR FINDING AND CONCLUSION
The Veteran had active service from July 1997 to July 2000, August 2005 to August 2012, and from February 2016 to August 2016. 
This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a December 2014 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO).  
1. Entitlement to service connection for obstructive sleep apnea 
Governing Law and Regulation
Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by service.  38 U.S.C. § 1110.
To establish service connection for a claimed disorder, there must be (1) medical evidence of a current disability; (2) medical or, in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between the claimed in-service disease or injury and the current disability.  See Hickson v. West, 12 Vet. App. 247, 253 (1999).
Analysis 
Private medical records show that sleep apnea was diagnosed in August 2013.
The Veteran claims that in-service snoring during his period of active duty from 2005 to 2012 was the initial manifestations of his sleep apnea.  His contention of in-service snoring is supported by statements from his spouse and a fellow soldier.  Thus, there is evidence of an in-service disease or injury.  These lay persons are competent to report the Veteran’s in-service snoring, and the Board finds them credible.
There is conflicting evidence on whether the sleep apnea is related to active service.
In a February 2016 statement, the Veteran’s treating doctor noted that according to the service treatment records and lay evidence provided by the Veteran’s spouse and a fellow soldier, the sleep apnea possibly started with the time frame of this military service from 1997 to 2013.  The doctor noted that the specific medical indicators of the onset of sleep apnea are evidenced in the form of esophageal dysphasia, morning tension headaches, hypertension, and sinus bradycardia.  The Board notes that service connection is in effect for migraine headaches (previously diagnosed as tension headaches), sinus bradycardia, and hypertension, but that service connection has been denied for dysphagia. 
A March 2016 VA examiner opined that it is less likely than not (less than 50 percent probability) that the sleep apnea was incurred in or caused by the claimed in-service injury, event, or illness.  The examiner’s basis was that there were no documented complaints of obstructive sleep apnea until over a year post discharge from the period of service ending in August 2012.  The examiner, however, noted that the letter supporting his history of snoring while in service may be suggestive of – but not diagnostic of – obstructive sleep apnea.
Though the Veteran’s treating physician merely used the term “possibly”, that doctor is an expert in sleep disorders and there is competent evidence of in-service snoring.  Therefore, the evidence is in equipoise as to whether obstructive sleep apnea is related to active service and service connection for that disorder is in order.  38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304.
 
MICHAEL LANE
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	D. Cherry, Counsel