Citation Nr: 21007778 Decision Date: 02/10/21 Archive Date: 02/10/21 DOCKET NO. 17-24 973 DATE: February 10, 2021 ORDER Service connection for sleep disturbance, to include as secondary to the Veteran’s service-connected adjustment disorder, is denied. FINDING OF FACT The weight of the evidence is against finding that the Veteran has a diagnosis for a sleep disorder, that is separate from her diagnosis for chronic adjustment disorder. CONCLUSION OF LAW The criteria for service connection for sleep disturbance, to include as secondary to her service-connected adjustment disorder, have not been met. 38 U.S.C. § 1131; 38 C.F.R. § 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from February 1977 to July 1985. The Veteran provided testimony before the undersigned Veterans Law Judge in an August 2019 Board hearing. A complete transcript is of record. This appeal was previously before the Board in November 2019. The Board remanded the service connection claim for sleep disturbance for further development. The Board decision explained that the Veteran had initially claimed that her sleep disturbance was due to low back pain. However, given that the Board denied the Veteran service connection for a low back disability in the same decision, found that she could not prevail, as the underlying disorder was not service-connected. Sabonis v. Brown, 6 Vet. App. 426, 430 (1994). The Board noted that she was granted service connection for chronic adjustment disorder, in part, based on complaints of flashbacks and nightmares that affected her sleep. The Board concluded that further development was required to obtain a medical opinion on whether the Veteran had a separate sleep disorder as a result of her service-connected psychiatric disability. The Veteran was afforded a VA examination in December 2019, which addressed the November 2019 Board remand directives. As such, the Board finds there has been substantial compliance as to all of the remand directives of the November 2019 Board decision. See Stegall v. West, 11 Vet. App. 268, 271 (1998). Service Connection Service connection requires competent evidence showing: (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. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may also be established on a secondary basis for a disability which is proximately due to, or the result of, a service-connected disability. 38 C.F.R. § 3.310(a). Secondary service connection may also be established for a disability which is aggravated by a service-connected disability. In order to prevail on the issue of secondary service connection, the record must show (1) evidence of a current disability; (2) evidence of a service-connected disability; and (3) competent evidence establishing that the service-connected disability caused or aggravated the nonservice-connected disability. See Allen v. Brown, 7 Vet. App. 439 (1995). Service connection for sleep disturbance is denied. The Veteran initially asserted that her sleep disturbance was due to her low back pain; however, as discussed, the November 2019 Board decision denied service connection for a low back disability and remanded for an opinion on whether the Veteran had a separate sleep disorder as a result of her service-connected psychiatric disability. The Veteran’s service treatment records (STRs) are silent for any complaints for any sleep problems. However, the Veteran’s theory of entitlement is based on secondary service connection. The Board notes that the Veteran’s VA treatment records show that she has complained of insomnia and that she has been treated for such symptoms. The Veteran provided testimony at the August 2019 Board hearing. However, the testimony regarding her sleep disturbance was related to her low back. She did not testify as to how her chronic adjustment disorder affected her sleep. As such, the hearing transcript does not provide much useful information regarding the current theory to entitlement to service connection. The Veteran was afforded a VA examination in December 2019. The examiner noted that the Veteran was diagnosed with adjustment disorder with depressed mood and noted that one of the symptoms was chronic sleep impairment. The Veteran reported that she was under a great deal of stress during her active duty and experienced depressed and anxious moods with sleep difficulties since that time. She also described having thoughts of the loss of her parents, as well as day to day worries that kept her up at night, and was unable to relax and fall asleep. The examiner opined that it appeared that her sleep difficulties coincided with her depressed mood, suggesting that the sleep problems to be a primary symptom of depression, and not a separate disorder. After an in-person examination and a review of the Veteran’s claims file, the examiner provided a negative nexus opinion. The examiner explained that it was less likely than not that the Veteran had a sleep disorder that was as separate disorder, because the sleep disturbances were a symptom of her service-connected psychiatric disability. The examiner reported that the Veteran endorsed sleep difficulties to be a result of problems performing duties she was not trained for and the loss of a close comrade. Here, the Veteran asserts that she has a distinct diagnosis for a sleep disorder; however, the diagnosis of sleep disorders requires medical expertise, and cannot simply be diagnosed by lay observation alone. In this case, the Veteran is not considered competent (meaning medically qualified by training or experience) to either diagnose a sleep condition, or to relate it to any service-connected disabilities. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). As such, although the Veteran’s statements and assertions are credible, they are not competent in this regard. Id. In the absence of proof of a current disability, there can be no valid claim for service connection. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). The requirement that a current disability be present is satisfied “when a claimant has a disability at the time a claim for VA disability compensation is filed or during the pendency of that claim...even though the disability resolves prior to the Secretary’s adjudication of the claim.” McClain v. Nicholson, 21 Vet. App. 319 (2007). The Board is sympathetic to the Veteran’s claim and the assertion that she should be granted service connection for a sleep disorder. However, the Veteran has not shown by medical evidence the presence of a separate and distinct diagnosis for a sleep disorder. Moreover, even if a sleep disorder were to be diagnosed, there has been no suggestion by any medically competent source that such a condition was caused by any of her service-connected disabilities, to include adjustment disorder. Here, the December 2019 VA examiner specifically found that her sleep difficulties coincided with her depressed mood, suggesting that the sleep problems to be a primary symptom of depression, and not a separate disorder. The Board notes that the Veteran has not offered any competent medical evidence suggesting that she has a distinct diagnosis for a sleep disorder, or that would otherwise undermine the findings of the December 2019 VA examiner.   Accordingly, the Board finds that the weight of the evidence is against the claim and service connection for a sleep disorder, is denied. MATTHEW W. BLACKWELDER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board E. Fu, 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.