Citation Nr: 21002428 Decision Date: 01/13/21 Archive Date: 01/13/21 DOCKET NO. 18-01 514 DATE: January 13, 2021 ORDER Entitlement to service connection for an acquired psychiatric disorder, to include depression and anxiety, is granted. Entitlement to service connection for headaches is granted. Entitlement to service connection for sinus condition is granted. Entitlement to service connection for sleep apnea is granted. FINDINGS OF FACT 1. Resolving reasonable doubt in the Veteran’s favor, his acquired psychiatric disorder, to include depression and anxiety, is at least as likely as not related to his active service. 2. Resolving reasonable doubt in the Veteran’s favor, his headache disorder is at least as likely as not related to his active service. 3. Resolving reasonable doubt in the Veteran’s favor, his sinus disability is at least as likely as not related to his active service. 4. Resolving reasonable doubt in the Veteran’s favor, his sleep apnea is at least as likely as not related to his active service. CONCLUSIONS OF LAW 1. The criteria for service connection for an acquired psychiatric disorder, to include depression and anxiety, are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for a headache disorder are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 3. The criteria for service connection for a sinus condition are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 4. The criteria for service connection for sleep apnea are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from July 1990 to February 1992. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from June 2015 and May 2016 rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO), in Indianapolis, Indiana. The Veteran testified before the undersigned Veterans Law Judge during a January 2020 Board hearing. As the issues can be granted in full, the Board has expedited the appeal and the hearing transcript will be associated with the claims folder at a later date. Service Connection Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Establishing service connection generally requires competent evidence of three things: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship, i.e., a nexus, between the claimed in-service disease or injury and the current disability. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009). The Board must analyze the credibility and probative value of the evidence, account for the evidence that it finds persuasive or unpersuasive, and provide the reasons for its rejection of any material evidence favorable to the claimant. Kahana v. Shinseki, 24 Vet. App. 428, 433 (2011). A Veteran bears the evidentiary burden to establish all elements of a service connection claim, including the nexus requirement. Fagan v. Shinseki, 573 F.3d 1282, 1287 (Fed. Cir. 2009). In making its ultimate determination, the Board must give a veteran the benefit of the doubt on any issue material to the claim when there is an approximate balance of positive and negative evidence. Id. at 1287 (quoting 38 U.S.C. § 5107(b)). 1. Entitlement to service connection for acquired psychiatric disorder, to include depression and anxiety. The Veteran contends that his currently diagnosed anxiety disorder is related to his period of military service. The Board concludes that the Veteran has a current disability that began during active service or is related to his military service. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). VA treatment records show the Veteran has current diagnoses of depression and anxiety. Thus, the question becomes whether the current disabilities are related to service. The evidence of record includes VA treatment notes indicating that the Veteran has had symptomology of depression and anxiety since service. See September 2015 treatment note. The VA treatment notes also indicate that the Veteran has symptoms related to his service-connected hand disability. The evidence of record also includes an April 2017 private medical opinion. The medical opinion found that the Veteran’s acquired psychiatric disorder is related to his service. The private medical doctor noted the evidence of consistent symptomology during and following service, as well as the Veteran’s complaints. Additionally, the medical doctor supported her opinion with a thorough rationale. The Board affords this opinion significant probative value. Upon review of the record, the Board finds the evidence to at least be in equipoise as to whether the Veteran’s current acquired psychiatric disorder, to include depression and anxiety, is related to service. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for anxiety is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. 2. Entitlement to service connection for headaches. The Veteran contends that his currently diagnosed headache condition is related to his period of military service. The Board concludes that the Veteran has a current disability that is related to his military service. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). VA and private treatment records show the Veteran has a current diagnosis of headaches. Thus, the question becomes whether the current disability is related to service. On this question there are probative opinions in favor of and against the claim. The evidence against the claim includes a June 2013 VA examination which found that the Veteran did not have a headache condition that was related to service. The examination, which failed to find a diagnosis of a headache disorder or a nexus between the Veteran’s headache condition and service. However, this examination failed to properly consider the Veteran’s contentions, and evidence of symptomology during and within one year of service. Additionally, this VA examination did not consider the evidence of diagnosis contained in the Veteran’s VA treatment records. As such, the Board finds that this opinion is of limited probative value. The evidence in favor of the claim includes a December 2020 private medical opinion. The medical opinion found that the Veteran’s headache disorder is related to his service. The private medical doctor noted the evidence of consistent symptomology during and following service, as well as the Veteran’s complaints. Additionally, the medical doctor supported his opinion with a thorough rationale. The Board affords this opinion significant probative value. Upon review of the record, the Board finds the evidence to at least be in equipoise as to whether the Veteran’s current headache disability is related to service. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for headache disability is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. 3. Entitlement to service connection for sinus condition. The Veteran contends that his currently diagnosed sinus condition is related to his period of military service. The Board concludes that the Veteran has a current disability that began during active service or is related to his military service. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). VA and private treatment records show the Veteran has a current diagnosis of chronic sinusitis. Thus, the question becomes whether the current disability is related to service. On this question there are probative opinions in favor of and against the claim. The evidence against the claim includes a June 2013 VA examination which found that the Veteran did not have a chronic sinus condition that was related to service. The examination, which failed to find a nexus between the Veteran’s sinus condition and service, relied on the lack of in-service chronicity and the time between service and diagnosis. However, this examination failed to properly consider the Veteran’s contentions, evidence of symptomology during and within one year of service, as well as the current diagnosis of chronic sinusitis contained in the Veteran’s VA treatment records. As such, the Board finds that this opinion is of limited probative value. The evidence in favor of the claim includes a December 2020 private medical opinion. The medical opinion found that the Veteran’s chronic sinusitis is related to his service. The private medical doctor noted the evidence of consistent symptomology during and following service, as well as the Veteran’s complaints. Additionally, the medical doctor supported his opinion with a thorough rationale. The Board affords this opinion significant probative value. Upon review of the record, the Board finds the evidence to at least be in equipoise as to whether the Veteran’s current chronic sinusitis arose in or is related to service. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for chronic sinusitis is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. 4. Entitlement to service connection for sleep apnea. The Veteran contends that his currently diagnosed sleep apnea is related to his period of military service. The Board concludes that the Veteran has a current disability of sleep apnea that began during active service or is related to his military service. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). VA and private treatment records show the Veteran has a current diagnosis of sleep apnea. Thus, the question becomes whether the current disability is related to service. On this question there are probative opinions in favor of and against the claim. The evidence against the claim includes a June 2013 VA examination which found that the Veteran’s sleep apnea was not related to service. The examination, which failed to find a nexus between the Veteran’s sleep apnea and service, relied on the lack of in-service complaints, and the time between service and diagnosis. However, this examination failed to properly consider the Veteran’s contentions, evidence of symptomology within one year of service, as well as a referral for a sleep study within one year of service. As such, the Board finds that this opinion is of limited probative value. The evidence in favor of the claim includes a December 2020 private medical opinion. The medical opinion found that the Veteran’s sleep apnea is related to his service. The private medical doctor noted the evidence of symptomology in December 1996, within one year of service, and the Veteran’s complaints. Additionally, the medical doctor supported his opinion with a thorough rationale. The Board affords this opinion significant probative value. Upon review of the record, the Board finds the evidence to at least be in equipoise as to whether the Veteran’s current sleep apnea disability is related to service. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for sleep apnea is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. T. MAINELLI Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Michael J. O’Connor 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.