Citation Nr: 18161074 Decision Date: 12/28/18 Archive Date: 12/28/18 DOCKET NO. 17-48 784 DATE: December 28, 2018 ORDER Entitlement to service connection for sleep apnea, to include secondary to post-traumatic stress disorder, is denied. FINDING OF FACT Sleep apnea is not related to an inservice injury or disease, and it is neither proximately due to nor aggravated beyond its natural progression by post-traumatic stress disorder. CONCLUSION OF LAW Sleep apnea was not incurred or aggravated inservice, and such a disability was not caused and is not permanently aggravated by post-traumatic stress disorder. 38 U.S.C. §§ 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from October 1978 to April 1988. The Veteran contends that he is entitled to service connection for his sleep apnea condition, and that it is secondary to his service-connected post-traumatic stress disorder. Service connection may be established for a disability resulting from disease or injury incurred in or aggravated by active duty service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303. To establish entitlement to service connection for a disability, a veteran must show: (1) the existence of a present disability; (2) inservice 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). The requirement that a current disability exists is satisfied if the claimant had a disability at the time his claim for VA disability compensation was filed or during the pendency of the claim. McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). Service connection may be established on a secondary basis for a disability which is proximately due to or the result of a service connected disease or injury; or, for any increase in severity of a nonservice-connected disease or injury that is proximately due to or the result of a service-connected disease or injury, and not due to the natural progression of the nonservice-connected disease. 38 C.F.R. § 3.310; Allen v. Brown, 7 Vet. App. 439 (1995) (en banc). 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 Board concludes that while the Veteran has sleep apnea, the disorder was not incurred or aggravated inservice, and it is not secondary to post-traumatic stress disorder. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. § 3.303 (a), 3.310 (a). The Veteran claims that sleep apnea began while on active duty. A review of his service records does not reflect any complaints, findings or diagnoses pertaining to any sleep disorder to include sleep apnea. Indeed, the appellant states that he was not aware that sleep apnea was a medical condition. Since the inservice element has not been met in this case, service connection on a direct basis is not warranted. Numerous VA outpatient records dating from at least 2009 note that the appellant’s body mass index was 35 and that because he was overweight he was at risk for developing sleep apnea. In November 2012 and September 2013, the appellant’s former spouse wrote that the claimant snored; sometimes “pretty loud.” She stated that she could not offer an opinion how long the appellant would stop breathing at night, but she did recall that the Veteran would snore, stop and then start snoring again. In October 2013 VA received statements from the appellant’s sons. They wrote that the claimant snored when he slept, that he was an extremely light sleeper, and that the Veteran would frequently complain of feeling fatigued. In December 2012, the appellant was seen by Jeffrey Dickerson, M.D., and after undergoing a sleep study was diagnosed with sleep apnea. A VA examination in March 2014 notes the appellant’s report that he was diagnosed with sleep apnea in 2012. The VA examiner opined, however, that sleep apnea was less likely than not related to the claimant’s post-traumatic stress disorder. The examiner observed that sleep apnea occurs when throat muscles intermittently relax and block airways while sleeping. The examiner opined that there was no pathology that the appellant’s stress would lead to a blocking of the airway resulting in sleep apnea. Hence, the examiner opined that it was less likely than not that sleep apnea was proximately due to the claimant’s service connected disorder. There is no competent evidence to the contrary. The Board has considered the Veteran’s reported history of symptomatology related to his sleep apnea. He is competent to report observable symptoms and observations because this requires only personal knowledge as it comes through one’s senses. Layno v. Brown, 6 Vet. App. 465, 470 (1994). Additionally, the Board considered lay statements testifying to the Veteran’s post-service symptoms. The Board finds, however, that a lay person the claimant is not competent to offer an opinion as to the etiology of sleep apnea. Rather, the most probative evidence concerning the nature of his sleep apnea is the opinion provided by the March 2014 VA examiner who using their professional expertise opined that there was no relationship between sleep apnea and posttraumatic stress disorder. As the preponderance of the evidence is against the Veteran’s claim, the benefit-of-the-doubt rule does not apply. The appeal is denied. DEREK R. BROWN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD C. Ferrando, Associate Counsel