Citation Nr: 21007312 Decision Date: 02/09/21 Archive Date: 02/09/21 DOCKET NO. 18-55 217 DATE: February 9, 2021 ORDER Service connection for obstructive sleep apnea (OSA) is granted. FINDING OF FACT The Veteran’s OSA is aggravated beyond its natural progression by his service-connected posttraumatic stress disorder (PTSD). CONCLUSION OF LAW The criteria for service connection for OSA as secondary to PTSD are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served honorably on active duty in the United States Army from August 1967 to April 1969. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a May 2017 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). In April 2020, the Board remanded this matter for further development. The Veteran attended a videoconference hearing before the undersigned in March 2020. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. To establish service connection for a disability, a Veteran must show: (1) the existence of a present disability; (2) in-service 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. Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). Service connection may also be granted for a disability that is proximately due to or aggravated by a service-connected disease or injury. 38 C.F.R. § 3.310. The Veteran contends that his OSA is related to his service-connected PTSD. For the following reasons, the Board agrees and finds that service connection is warranted. The Veteran has a diagnosis of OSA and he is currently service connected for PTSD. After remand, VA obtained an opinion from as to whether the Veteran’s OSA was caused or aggravated by his PTSD. In an October 2020 opinion, the physician opined it was less likely than not that the Veteran’s OSA was caused or aggravated by his PTSD. The physician did refer to evidence submitted by the Veteran on the relationship between PTSD and OSA but did not discuss these articles in relation to the Veteran’s condition. As such, the Board finds this opinion to be inadequate and affords it little probative weight. In November 2020, VA sought an addendum opinion from a different physician. This physician again found it was less likely than not that the Veteran’s OSA was caused or aggravated by his PTSD. In their rationale, the physician provided a discussion of the articles submitted by the Veteran on the relationship between PTSD and OSA. The physician noted that none of the articles submitted established a causal or permanent aggravation beyond natural progression between PTSD and OSA. This is not the correct standard for secondary service connection. For secondary service connection to be warranted based on aggravation, there has to be any increase in the disability regardless of permanence. See Ward v. Wilkie, 31 Vet. App. 233, 239 (2019). As the examiner relied on an incorrect standard in providing their opinion, the Board affords their opinion little probative weight. The Veteran submitted a December 2020 letter from the physician who diagnosed him with OSA and treats his OSA. His physician opined that it was more likely than not that that the Veteran’s OSA was exacerbated by his PTSD. The physician is competent to provide this opinion, the Board finds him to be credible, and affords the opinion great probative weight. The Board finds the evidence to show that the Veteran’s OSA was aggravated by his service-connected PTSD. Accordingly, service connection for OSA is granted. 38 C.F.R. § 3.310. JOHN Z. JONES Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Michael Chandeck, Associate 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.