Citation Nr: 18153704 Decision Date: 11/28/18 Archive Date: 11/28/18 DOCKET NO. 16-13 439 DATE: November 28, 2018 ORDER Entitlement to service connection for sleep apnea is granted. FINDING OF FACT The Veteran’s sleep apnea had its onset during active service. CONCLUSION OF LAW The criteria for service connection for sleep apnea have been met. 38 U.S.C. §§ 1110, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2018). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active naval service from October 1964 to April 1987. This case comes before the Board of Veterans’ Appeals (Board) on appeal from January 2015 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in San Diego, California. This case was previously before the Board, at which time additional medical evidence was obtained. The case has now been returned to the Board for further appellate action. Service Connection – Sleep Apnea The Veteran asserts that he has sleep apnea that is related to his active service. The Veteran’s service treatment records (STRs) reveal a 1985 complaint of sleep impairment during his period of active service. Additionally, the Veteran has reported sleep impairment and heavy snoring during his period of active service. A review of the record shows that the Veteran has a current diagnosis of sleep apnea. In April 2014, the Veteran submitted a private medical opinion in support of his claim. In it, Dr. J.R. opined that it was more likely than not that the Veteran experienced symptoms of sleep apnea while in service. In reaching that conclusion, Dr. J.R. indicated that the Veteran was diagnosed with obstructive sleep apnea in March 2013, and noted that the Veteran experienced in-service sleep disturbances, which were likely the onset of sleep apnea as sleep apnea often gradually progresses. The Board finds that the private opinion report submitted in April 2014 is adequate because the physician discussed relevant evidence, considered the contentions of the Veteran, and provided a thorough supporting rationale for the conclusions reached. Barr v. Nicholson, 21 Vet. App. 202 (2007). Moreover, although that physician did not specifically indicate that the Veteran’s currently diagnosed sleep apnea is the same as that which he experienced while in active service, the Board logically presumes such a nexus based on the entirety of evidence. Accordingly, the Board finds that the private examination and opinion report submitted in April 2014 is the most probative evidence of record. In an April 2015 statement, the Veteran’s daughter indicated that she observed the Veteran’s difficulty sleeping and periodic cessations in breathing while sleeping since service. An April 2015 statement from a fellow service member recounts similar in-service sleep impairment. The Board notes that lay evidence can be 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 supports a later diagnosis by a medical professional. In fact, competent medical evidence is not necessarily required when the determinative issue involves either medical etiology or a medical diagnosis. Jandreau, 492 F.3d 1372; Buchanan, 451 F.3d 1331. Here, although the Veteran is not competent to diagnose sleep apnea, the Veteran, his daughter, and his fellow service member are competent to identify sleep impairment and apneic events, and their statements have been found credible. The Board acknowledges that there are multiple VA medical opinions of record that are against the Veteran’s claim. However, a review of those opinions shows that the examiners failed to adequately consider the lay statements of record regarding the onset and continuity of the Veteran’s symptoms of sleep apnea. As the opinions are not adequate, they are not sufficient to serve as the basis of a denial of entitlement to service connection and are of limited probative value. In sum, the Veteran has competently and credibly reported that he began experiencing sleep impairment during active service. The Veteran’s daughter and a fellow service member have also competently and credibly reported that the Veteran experienced apneic events while he was in active service. Further, the private medical opinion submitted by the Veteran indicates that the Veteran experienced sleep apnea during active service. Additionally, the Veteran has a current diagnosis of sleep apnea. Moreover, there are no probative medical opinions against the claim. Therefore, the Board finds that the evidence for and against the claim of entitlement to service connection for sleep apnea is at least in equipoise and reasonable doubt must be resolved in the Veteran’s favor. Accordingly, entitlement to service connection for sleep apnea is warranted. 38 U.S.C. § 5107(b) (2012); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Kristin Haddock Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD C. O’Donnell, Associate Counsel