Citation Nr: 21010547 Decision Date: 02/25/21 Archive Date: 02/25/21 DOCKET NO. 16-18 225 DATE: February 25, 2021 ORDER Entitlement to service connection for sleep apnea, to include as secondary to service-connected cervical spine strain, is denied. FINDING OF FACT The Veteran’s sleep apnea was not present in service or for many years thereafter and is not otherwise etiologically related to service, or service connected disability. CONCLUSION OF LAW The criteria for service connection for obstructive sleep apnea due to service or service-connected injury are not 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 on active duty from September 1996 to July 2008, and from January 2010 to January 2011, with additional periods of service in the Reserves. This matter comes before the Board of Veterans' Appeals (Board) from a February 2014 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In February 2019, the Veteran appeared before the undersigned Veterans Law Judge (VLJ) via live videoconference hearing and a transcript of the proceeding has been associated with the record. Entitlement to service connection for sleep apnea, to include as secondary to service-connected cervical spine strain. The Veteran contends that his sleep apnea was incurred due to service. Specifically, he believes that his sleep apnea was caused by his cervical spine disability and accompanying fusion surgery. Because the Veteran has not raised, and the record does not reasonably raise, entitlement to direct service connection, the Board’s adjudication will consider only entitlement to secondary service connection. Service connection may be granted for a disability that is proximately due to, or aggravated by, service-connected disease or injury. 38 C.F.R. § 3.310. The Board concludes that, while the Veteran has a current disability of obstructive sleep apnea, the preponderance of the evidence is against finding that the Veteran’s obstructive sleep apnea is proximately due to or the result of, or aggravated beyond its natural progression by service-connected disability. 38 U.S.C. §§ 1110, 1131; Allen v. Brown, 7 Vet. App. 439 (1995) (en banc); 38 C.F.R. § 3.310(a). A May 2016 VA examiner opined that the Veteran’s obstructive sleep apnea was less likely as not due to his cervical spine disability and subsequent fusion surgery. The rationale was that the skeletally reduced range of motion due to his fusion surgery does not impact the soft tissue architecture of the upper airway. Further, a December 2019 VA examiner opined that the Veteran’s obstructive sleep apnea was less likely as not due to other noted in-service injuries, such as a facial laceration, as these would not be causative of obstructive sleep apnea. The examiner also noted that the Veteran’s history was silent for any in-service nasal trauma that could have caused a deviated septum. The Veteran believes his obstructive sleep apnea is proximately due to or the result of a service-connected disability. The Veteran in this case is not competent to provide a nexus opinion regarding this issue. The issue is medically complex, as it requires knowledge of anatomical relationships. Therefore, it is outside the competence of the Veteran in this case because the record does not show that he has the skills or medical training to make such a determination. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007); see also Kahana v. Shinseki, 24. Vet. App. 428 (2011). Consequently, the Board gives more probative weight to the multiple VA examiner opinions that found no relationship between the Veteran’s in-service injuries and his obstructive sleep apnea. MICHAEL E. KILCOYNE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Uller, 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.