Citation Nr: 18149766 Decision Date: 11/13/18 Archive Date: 11/13/18 DOCKET NO. 15-21 550 DATE: November 13, 2018 ORDER Service connection for sleep apnea is granted. FINDING OF FACT The Veteran has currently diagnosed obstructive sleep apnea which is related to the Veteran’s active duty service. CONCLUSION OF LAW The criteria for entitlement to service connection for sleep apnea have been met. 38 U.S.C. §§ 1110, 5107(b) (2012); 38 C.F.R. §§ 3.102, 3.303, 3.304 (2017). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from April 1985 to April 2005. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a November 2012 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) which denied service connection for sleep apnea. The Veteran attended a November 2018 travel board hearing before the undersigned Veterans Law Judge. 1. Entitlement to service connection for sleep apnea Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active military, naval, or air service. 38 U.S.C § 1110; 38 C.F.R. § 3.303 (a). Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303 (d). Only chronic diseases listed under 38 C.F.R. § 3.309 (a) (2017) are entitled to the presumptive service connection provisions of 38 C.F.R. § 3.303 (b). Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). Establishing service connection generally requires (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 present disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). When all the evidence is assembled, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the veteran prevailing in either event, or whether a preponderance of the evidence is against a claim, in which case, the claim is denied. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102. The Veteran maintains that his sleep apnea was incurred in service as his symptoms began while he was on active duty and have continued to the present. Private and VA medical treatment records reflect that the Veteran has been diagnosed with sleep apnea and currently uses a CPAP machine. The Board therefore finds that the Veteran has a current diagnosis of obstructive sleep apnea. The Veteran’s Service Treatment Records (STRs) reflect that the Veteran sought treatment for loud snoring during service. The report of that August 2004 sleep study concluded there was demonstrated moderate snoring but otherwise normal breathing during sleep. Medical records subsequent to the sleep study reflect that the Veteran was diagnosed with obstructive sleep apnea in September 2004 by a doctor at Portsmouth Naval Medical Center. The Veteran also testified that he had no snoring problems before service and started experiencing loud snoring while serving on board the USS Austin. The Veteran was told by bunkmates that he snored too much to the point that he needed to seek out an isolated bunker. The Veteran reported that he underwent a sleep study and was told by the person conducting the study that he had borderline sleep apnea. The Veteran’s private physician submitted a written statement in which he opined that the Veteran first developed the “cardinal symptoms” of sleep apnea while on service which included severe snoring, witnessed apnea, daytime sleepiness and sleep disturbance. The Veteran’s physician further noted that recent studies have demonstrated that soldiers deployed on active duty suffer a range of sleep disorders at rates higher than those not deployed due in part to the erratic sleep schedule required. The Veteran’s physician further opined that it was more likely than not that the Veteran’s sleep apnea was caused by his active duty service. The Veteran’s former wife also provided a written statement indicating that the Veteran has trouble sleeping and is groggy and has difficulty focusing when he has difficulty sleeping. She observed the Veteran experience brief moments where he would stop breathing and then resume breathing after coughing. The Board acknowledges that the Veteran underwent a VA examination in October 2012 and that the VA examiner opined that it was less likely than not that the Veteran’s sleep apnea was related to his active duty service. However, the Board finds that the Veteran’s private physician’s opinion is competent, credible and supported by a reasoned rationale. Similarly, the Veteran’s testimony regarding sleep difficulties he had in service was credible and supported by his in-service treatment for snoring and diagnosis for sleep apnea. Finally, the Veteran’s former wife submitted a statement that is competent to report what she observed of his sleep habits, and it is consistent with the Veteran’s testimony regarding his snoring and breathing pauses. There is no basis upon which to question their credibility. Moreover, the symptoms manifested in service were ultimately diagnosed as sleep apnea. When, after consideration of all evidence and material of record in a case, there is an approximate balance of positive and negative evidence regarding any material issue, the benefit of the doubt in resolving each such issue shall be given to the claimant. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102; Gilbert, 1 Vet. App. 49. Thus, following a full review of the record, and applying the benefit of the doubt doctrine, all doubt is resolved in favor of the Veteran. See 38 C.F.R. § 3.102. The Veteran’s claim for service connection for sleep apnea is granted. H. SEESEL Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Boal, Associate Counsel