Citation Nr: 21075432 Decision Date: 12/20/21 Archive Date: 12/20/21 DOCKET NO. 20-03 437 DATE: December 20, 2021 ORDER Entitlement to service connection for obstructive sleep apnea is granted. FINDING OF FACT Resolving any reasonable doubt in the Veteran's favor, her currently diagnosed obstructive sleep apnea had its onset during active military service. CONCLUSION OF LAW The criteria for service connection for obstructive sleep apnea are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from November 1983 to June 1984 and from May 2003 to February 2005. She had additional periods of active duty and inactive duty for training. In October 2021, the Veteran testified in a virtual hearing before the undersigned Veterans Law Judge. A copy of the hearing transcript is of record and has been reviewed. Service Connection for Sleep Apnea 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, 1131; 38 C.F.R. § 3.303(a). Service connection may also be granted for any injury or disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease or injury was incurred in service. 38 C.F.R. § 3.303(d). 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). Here, the Veteran asserts that her sleep apnea symptoms were present during service and continuous until she received a formal diagnosis of sleep apnea in 2017. The Veteran has a current diagnosis of obstructive sleep apnea. See e.g., 2017 sleep study and subsequent VA and private treatment records. The Veteran's post-deployment questionnaire in January 2005 showed that the Veteran complained of feeling tired after sleeping. During the October 2021 hearing, the Veteran competently and credibly testified that symptoms of her sleep apnea were present at the very least during her second period of active duty. She explained that she was never aware of the concept of sleep apnea but continuously complained of sleep issues. This testimony is supported by the medical evidence of record showing continuous complaints of sleep problems until it was suspected in 2015 that the Veteran had sleep apnea, which was later confirmed by a 2017 sleep study. On review, the Board resolves reasonable doubt in the Veteran's favor in finding that her sleep apnea had its onset during active service. While the Veteran is not shown to possess the necessary medical expertise to diagnose sleep apnea or render an opinion regarding the etiology of the current sleep apnea, she is competent to report what she observed firsthand. See Layno v. Brown, 6 Vet. App. 465 (1994). Furthermore, the Board finds no reason to doubt the credibility of her lay assertions. Significantly, the Veteran reported symptoms that may be suggestive of sleep apnea at the time of separation from service. Proof of symptoms in service that are later diagnosed may be evidence of service "incurrence." See 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a), (d); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007) (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 this case, the finding that the Veteran has had sleep apnea symptoms, particularly in service and since separation from service, is supportive of the claim overall, because it tends to show that the same symptoms that began in service were the basis for the later diagnosed sleep apnea. See Horowitz v. Brown, 5 Vet. App. 217, 221-22 (1993) (lay statements are competent on in-service and post-service symptoms - dizziness, loss of balance, hearing trouble, stumble and fall, and tinnitus - that were later diagnosed as Meniere's disease). Although the Veteran was not provided with a VA examination in this case despite a current diagnosis and documented symptoms at the very least during her post-deployment questionnaire, the Board finds that under the facts of this case a medical opinion is not necessary. Accordingly, based on the competent and credible lay and medical evidence on record, and resolving all reasonable doubt in favor of the Veteran, the Board finds that her sleep apnea had its onset during active service. S. B. MAYS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Yaffe, Counsel 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.