Citation Nr: 18141912 Decision Date: 10/11/18 Archive Date: 10/11/18 DOCKET NO. 16-33 636 DATE: October 11, 2018 ORDER Service connection for obstructive sleep apnea (OSA) is granted. FINDING OF FACT The Veteran’s OSA was incurred during service. CONCLUSION OF LAW The criteria for service connection for OSA have been met. 38 U.S.C. §§ 1110, 1131, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.159, 3.303 (2017). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from March 1983 to July 2005. The Veteran appeals a July 2010 rating decision by the Agency of Original Jurisdiction (AOJ) denying entitlement to service connection for OSA. A Veteran is entitled to VA disability compensation if there is a disability resulting from personal injury suffered or disease contracted in the line of duty in active service, or for aggravation of a preexisting injury suffered or disease contracted in the line of duty in active service. 38 U.S.C. §§ 1110, 1131. Generally, to establish a right to compensation for a present disability, a veteran must show: (1) a present disability; (2) an 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, the so-called “nexus” requirement. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may be granted for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that a disease was incurred in service. 38 C.F.R. § 3.303(d). The Veteran contends that he had OSA in service, and a sleep study conducted 26 months after service confirmed his condition. See October 2010 notice of disagreement (NOD). The predicate issue in this case is whether the Veteran’s OSA began during active service. The Board first recognizes that the Veteran served on active duty continuously for over 20 years. Twenty six months after service, a sleep study confirmed that he had mild OSA. See September 2007 private treatment record. There, the medical professional recognized that the Veteran may be a good candidate for ongoing treatment with a CPAP. Importantly, the Veteran’s “comprehensive sleep disorders questionnaire demonstrates complaints of snoring, witnessed sleep apneas, and complaints of daytime sleepiness and fatigue.” Id. The Veteran has stated his symptoms manifested in service as sleepiness and fatigue, but that he had been “living alone and sleeping alone since 2001 and [his] sleeping condition was first brought to [his] attention by a female partner that shared the same house and bed with [him] in 2007.” See October 2010 NOD. E.H. corroborates this account, and attests to his loud snoring, ceased breathing, and choking during sleep. See March 2010 E.H. statement. C.M. also corroborates the Veteran’s symptoms. See March 2010 C.M. statement. In further support of his contentions, the Veteran submitted numerous articles standing for the proposition that most people do not know they have OSA because it only occurs during sleep, and that “[a] family member and/or bed partner may first notice the signs of sleep apnea.” See, e.g., National Heart Lung and Blood Institute: Sleep Apnea (submitted October 2010). Further, “someone with OSA may notice daytime sleepiness, irritability, or fatigue.” See American Academy of Family Physicians: What is Sleep Apnea? (submitted October 2010). The Veteran attested to these symptoms at the 2007 sleep study and they were further corroborated by E.H. and C.M. The record does not contain a negative medical opinion regarding symptoms onset date. After a careful review of the evidence, the Board finds that it is at least as likely as not that the Veteran’s OSA, although not formally diagnosed until after service, was incurred during active service. In reaching this conclusion, the Board finds the Veteran’s, E. H’s, and C. M’s statements describing his apnea symptoms competent, credible, and highly probative of the fact that the Veteran’s OSA sleep symptoms started in service and continued through his actual diagnosis. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). (CONTINUED ON THE NEXT PAGE) The same symptoms reported by the Veteran, E.H., and C.M. were later confirmed through a sleep study. Because the probative evidence of record is positive as to incurrence of OSA during service, service connection for OSA is warranted. DONNIE R. HACHEY Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. Salazar, Associate Counsel