Citation Nr: 21010960 Decision Date: 02/26/21 Archive Date: 02/26/21 DOCKET NO. 14-22 776 DATE: February 26, 2021 ORDER Service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD) and/or generalized anxiety disorder (GAD) is denied. Service connection for obstructive sleep apnea (OSA) is denied. FINDINGS OF FACT 1. The preponderance of the evidence is against finding that the Veteran’s diagnosed anxiety and depressive disorders are related to active service. The evidence does not reflect a diagnosis of PTSD. 2. The preponderance of the evidence is against finding that OSA began during active service or is otherwise related to an in-service injury or disease. CONCLUSIONS OF LAW 1. The criteria for service connection for an acquired psychiatric disorder, to include PTSD and/or GAD, are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304. 2. The criteria for service connection for OSA are not 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 in the United States Navy from September 1989 to November 1992. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2011 rating decision. The Board remanded the claim in August 2020 to obtain additional medical records and medical opinions. The Board finds that there has been substantial compliance with the remand directives. Stegall v. West, 11 Vet. App. 268 (1998). Service Connection Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004). Additionally, entitlement to service connection for PTSD requires (1) medical evidence diagnosing the condition in accordance with 38 C.F.R. § 4.125(a); (2) credible supporting evidence that a claimed in-service stressor occurred; and (3) a link, established by medical evidence, between current symptoms and the in-service stressor. 38 C.F.R. §§ 3.304(f) and 4.125. Acquired Psychiatric Disorder The Veteran contends that he has an anxiety disorder and/or PTSD that is the result of his active duty service. The Board has recharacterized the Veteran’s claim as an acquired psychiatric disability so that consideration may be given to any mental health disability, however diagnosed. Clemons v. Shinseki, 23 Vet. App. 1, 5-8 (2009). The Veteran underwent a VA examination in March 2011. The examiner noted a diagnosis of depressive disorder, anxiety disorder, and alcohol abuse. The Veteran subsequently underwent another VA examination in May 2015. The examiner noted the Veteran to have depressed mood, anxiety, and chronic sleep impairment. VA medical records also note anxiety and depression. Therefore, the Veteran has established a current diagnosis, fulfilling the first element of a service connection claim. Regarding the second element of a service connection claim, the Veteran contends that his anxiety is the result of several stressors that occurred during active duty. This included remaining at his post during several severe storms while at sea. Although, there is no documentation of this stressor within the Veteran’s service records, the Board finds the Veteran’s statements credible and therefore the second element has been met. However, the Board finds that there is no causal relationship between the current depression disability and the Veteran’s service. In November 2020, a VA examiner ultimately concluded that although the Veteran currently has a diagnosis of an unspecified anxiety disorder, the anxiety was not the result of his time in the military. Rather, the examiner stated that the Veteran’s claimed stressors do not support a claim for an acquired psychological disorder. The examiner noted that there are no notes in the record pertaining to any mental health issues/symptoms during the Veteran’s service. Further, the examiner noted that the Veteran’s separation examination was silent for any mental health complaints. This conclusion is corroborated in the March 2011 VA examination which stated that the Veteran was first referred for mental health treatment for his anxiety in September 2010, approximately 18 years after the Veteran’s service. There is no competent medical opinion to refute this conclusion or otherwise link the Veteran’s anxiety/depression to his service. To the extent that the Veteran himself has asserted such a link, he does not possess the requisite medical knowledge or training to render such an opinion. As no causal connection between the Veteran’s anxiety/depression and his military service has been established service connection is not warranted. The Board has also considered whether service connection is warranted for PTSD, however, the November 2020 VA examiner concluded that the Veteran’s symptoms were not consistent with a diagnosis of PTSD. Specifically, addressing the Veteran’s previous diagnosis, the examiner stated that the claimed stressors are not sufficient to establish a diagnosis under the DSM-V criteria. Without a diagnosis, the first element required for service connection has not been met. OSA As stated previously, service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004). The Board concludes that, while the Veteran has a diagnosis of OSA, the preponderance of the evidence is against finding that it began during active service, or is otherwise related to an in-service injury, event, or disease. The Veteran reported in a May 2009 private medical record that he had chronic insomnia. In a January 2020 VA medical note, the Veteran was diagnosed with mild OSA. This diagnosis was confirmed in an October 2020 VA examination. The examiner confirmed the Veteran first sought treatment in 2009 when he was referred for a sleep study that was never subsequently set up. The examiner also noted in January 2020 that the Veteran was first diagnosed with sleep apnea and was issued a CPAP machine. The October 2020 examiner ultimately concluded that it was less likely than not that the Veteran’s sleep apnea was incurred in or caused by the claimed in-service injury, event, or illness. Specifically, the examiner stated that the Veteran did not report any symptoms related to sleep apnea until 2004, over 10 years after the Veteran’s service. Further, the examiner noted that the sleep disturbances first reported by the Veteran are more likely the result of documented excessive alcohol use rather than sleep apnea. Lastly, the examiner noted that the Veteran’s service records as well as his separation exam were silent for any complaints of sleep apnea. There is no competent medical opinion to refute this conclusion or otherwise link the Veteran’s sleep apnea to his service. To the extent that the Veteran himself has asserted such a link, he does not possess the requisite medical knowledge or training to render such an opinion. As no causal connection between the Veteran’s OSA and his military service has been established service connection is not warranted. JOHN Z. JONES Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Jorge Barroso, 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.