Citation Nr: 18147789 Decision Date: 11/07/18 Archive Date: 11/06/18 DOCKET NO. 16-21 322 DATE: November 7, 2018 ORDER Entitlement to service connection for obstructive sleep apnea (OSA) is granted. FINDING OF FACT The evidence is at least evenly balanced as to whether the Veterans OSA manifested during service. CONCLUSION OF LAW The criteria for service connection for OSA have been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served in the Navy from July 1982 to July 2003. This case comes before the Board of Veteran’s Appeals (Board) on appeal from a March 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in St. Petersburg, Florida, in which the RO denied service connection for OSA. Service Connection for OSA Service treatment records do not contain complaints, treatment, or diagnosis of OSA however, on separate examination, the Veteran responded yes to symptoms consistent with sleep apnea, such as shortness of breath, and was prescribed an inhaler for pneumonia and bronchitis. Further, the Veteran was diagnosed with gastroesophageal reflux (GERD) during service, and service treatment records in 2003 note specific difficulties while sleeping. In May of 2012, after thorough examination and a sleep study, the Veteran was diagnosed with OSA. An additional private treatment record from August 2014 supports this diagnosis. The Veteran contends that he had symptoms of OSA that were misdiagnosed as GERD. A March 2015 VA examination did not resolve the discrepancy in diagnosis, but does further confirm the diagnosis of OSA. The physcian noted the Veteran’s claim that the GERD was misdiagnosed, but the medical opinion did not confirm or deny this theory. Two private physicians, Dr. Slack and Dr. Quirit, confirm the sleep apnea diagnosis, and Dr. Quirit additionally noted that “[H]is GERD… was due to OSA and is now completely resolved with Continuous Positive Airway Pressure (CPAP) therapy.” Further, one of the private physicians inidcated that the Veteran has suffered from OSA for a significant period of time, and that the GERD diagnosis during service was due to symptoms from OSA. In weighing medical opinions, the Board may consider all relevant reports. An adequate medical report must rest on correct facts and reasoned medical judgment so as to inform the Board on a medical question and facilitate the Board’s consideration and weighing of the report against any contrary reports. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008) (holding, in the context of weighing one medical opinion with another, that “[i]t is the factually accurate, fully articulated, sound reasoning for the conclusion... that contributes probative value to a medical opinion”). For the following reasons, the criteria for service connection for OSA are met. Service connection will be granted if the evidence demonstrates that current disability resulted from an injury or disease incurred in active military service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Establishing service connection generally requires competent evidence of three things: (1) current disability; (2) in-service incurrence of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018). Consistent with this framework, service connection is warranted for a disease first 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). Here, the Veteran has shown he has a current disability of OSA through private medical examination and VA examination. The Veteran further contends that the sleep apnea manifested itself during service and was misdiagnosed as GERD. Lay evidence may be deemed “competent and sufficient to establish a diagnosis of a condition when (1) a layperson is competent to identify the medical condition; (2) the layperson is reporting a contemporaneous medical diagnosis; or (3) lay testimony describing symptoms at the time suports a later diagnosis by a medical professional.” Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). The Veteran is competent to describe the symptoms he experienced. Moreover, the subsequent medical opinions indicated that the symptoms he experienced were likely inidcative of OSA and were misdiagnosed as GERD. The evidence is thus at least evenly balanced as to whether the Veteran’s OSA manifested during service and was thus incurred ccoincident with service. 38 C.F.R. § 38 C.F.R. § 3.303(a) (“service connection connotes many factors but basically it means that the facts, shown by evidence, establish that a particular injury or disease resulting in disability was incurred coincident with service in the Armed Forces”). As the reasonable doubt created by this relative equipoise in the evidence must be resolved in favor of the Veteran, entitlement to service connection for OSA is warranted. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. Jonathan Hager Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Laura A. Saracina, Law Clerk