Citation Nr: 20007702
Decision Date: 01/30/20	Archive Date: 01/29/20

DOCKET NO. 16-22 407
DATE: January 30, 2020

ORDER

Entitlement to service connection for obstructive sleep apnea, as secondary to service-connected lumbosacral strain and intervertebral disc syndrome and paravertebral muscular strain, is granted.

FINDING OF FACT

The Veteran’s obstructive sleep apnea is related to pain associated with his service-connected lumbosacral strain and intervertebral disc syndrome and paravertebral muscular strain.

CONCLUSION OF LAW

The criteria for entitlement to service connection for obstructive sleep apnea, as secondary to service-connected lumbosacral strain and intervertebral disc syndrome and paravertebral muscular strain have been met. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.310(a).

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty from July 1992 to April 2002.  

This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a March 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Seattle, Washington. 

1. Entitlement to service connection for obstructive sleep apnea, as secondary to service-connected lumbosacral strain and intervertebral disc syndrome and paravertebral muscular strain, is granted. 

Service connection may be established on a secondary basis for a disability proximately due to or aggravated by a service-connected disease or injury. 38 C.F.R. § 3.310; see also Ward v. Wilkie, 17-1204 (holding that a "permanent worsening" of a non-service-connected disability is not required to establish secondary service connection on the basis of aggravation (i.e., aggravation may include temporary worsening of a disability); Allen v. Brown, 7 Vet. App. 439 (1995) (en banc). To establish secondary service connection, a veteran must show: (1) the existence of a present disability; (2) the existence of a service-connected disability; and (3) a causal relationship between the present disability and the service-connected disability. See Wallin v. West, 11 Vet. App. 509, 512 (1998).

The Veteran has a current diagnosis of obstructive sleep apnea. See February 2014 Private Medical Treatment Records. He is also service-connected for lumbosacral strain and intervertebral disc syndrome and paravertebral muscular strain. See April 2019 Rating Code Sheet. Thus, the first and second elements of a claim for secondary service connection have been satisfied, as the Veteran has a present disability as well as a service-connected disability.  Wallin, 11 Vet. App. at 512. The crux of the case concerns whether there is a nexus between the two.

In regard to the Veteran’s diagnosed obstructive sleep apnea, his private physician who treats him for his chronic low back condition stated that “there is a decided correlation between chronic back pain and sleep disruption…a bidirectional relationship exists between pain and sleep disturbances which can worsen over time. See April 2016 Private Physician Letter. The private physician went on to explain that “pain fragments sleep continuity, impairs sleep quality, and disrupts normal sleep architecture thereby inhibiting normal sleep patterns. See id. She explained that “chronic pain is associated with the appearance of alpha waves superimposed on slower EEG frequencies, or ‘alpha-delta’ sleep… in short, pain produces a state of shallow sleep while disrupting restorative slow-wave sleep…” See id. The Board notes that no alternate cause for the Veteran’s obstructive sleep apnea appears in his medical record.  Given the private physician’s medical opinion, the Board finds that the Veteran’s diagnosed obstructive sleep apnea is secondary to pain associated with his service-connected lumbosacral strain and intervertebral disc syndrome and paravertebral muscular strain.  Accordingly, entitlement to service connection for obstructive sleep apnea as secondary to service-connected lumbosacral strain and intervertebral disc syndrome and paravertebral muscular strain is granted. 

 

P.M. DILORENZO

Veterans Law Judge

Board of Veterans’ Appeals

Attorney for the Board	T. Mohammad

The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.