Citation Nr: 21011720 Decision Date: 03/02/21 Archive Date: 03/02/21 DOCKET NO. 17-34 205 DATE: March 2, 2021 ORDER Service connection for obstructive sleep apnea is denied. FINDING OF FACT Obstructive sleep apnea (OSA) was not shown in service, and the weight of the evidence fails to establish that the Veteran’s currently diagnosed OSA either began during or was otherwise caused by his active service. CONCLUSION OF LAW The criteria for service connection for OSA have not been met. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. §§ 3.303, 3.304. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from July 1987 to May 1991. In connection with this appeal, the Veteran testified at a hearing before the undersigned in January 2020. A transcript of that hearing is of record.  Service Connection 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 military service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. 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 under 38 C.F.R. § 3.303(b), where a condition in service is noted but is not, in fact, chronic, or where a diagnosis of chronicity may be legitimately questioned. The continuity of symptomatology provision of 38 C.F.R. § 3.303(b) has been interpreted as an alternative to service connection only for the specific chronic diseases listed in 38 C.F.R. § 3.309(a). See Walker v. Shinseki, 718 F.3d 1331 (Fed. Cir. 2013). Service connection may also be established with certain chronic diseases based upon a legal presumption by showing that the disorder manifested itself to a degree of 10 percent disabling or more within one year from the date of separation from service. Such disease shall be presumed to have been incurred in service, even though there is no evidence of such disease during the period of service. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309(a). While the disease need not be diagnosed within the presumption period, it must be shown, by acceptable lay or medical evidence, that there were characteristic manifestations of the disease to the required degree during that time. The Veteran filed a service connection claim for OSA, which was denied by a February 2014 rating decision. He asserts that his OSA began during his active service. At the January 2020 Board hearing, he testified that after he entered active service, he became a light sleeper, was easily woken, and could not get into a deep sleep. He testified that he was told he snored by other soldiers in his barracks. He testified that his symptoms included headaches and fatigue. In April 2020, the Board remanded the claim for further development. The Veteran’s STRs show that while he reported having headaches during his active service, his STRs do not show any complaints, treatment, or diagnosis for any sleep disorder during his active service. After his separation from active service, in December 2013, he reported that he was diagnosed with OSA. An April 2015 sleep study diagnosed the Veteran with OSA. In July 2020, a VA examiner reviewed the Veteran’s claims file. The examiner opined that the Veteran’s OSA was less likely than not due to his active service. The examiner reported that a review of the Veteran’s STRs did not identify OSA, obstructive sleep, or an apnea condition. The examiner reported that a 2015 sleep study showed OSA. The examiner reported that the Veteran’s conditions and treatments in service were not consistent with or supportive of OSA. The examiner reported that symptoms such as headaches, chronic fatigue, fainting spells, light sleeper, and deep sleep were not supportive of a diagnosis of OSA. The examiner reported that snoring was not specific or sufficient to diagnose OSA. The examiner reported that a diagnosis of OSA required a sleep study, which was performed years after the Veteran’s active service. The examiner reported that risk factors for OSA included the Veteran’s inherent upper airway anatomy, his habits, aging, and male gender. The examiner opined that these risk factors were more likely contributory/etiological factors to the Veteran’s OSA. After weighing all the evidence, the Board finds great probative value in the July 2020 VA examiner’s opinion. This opinion is sufficient to satisfy the statutory requirements of producing an adequate statement of reasons and bases where the expert has fairly considered material evidence which appears to support the Veteran’s position. Wray v. Brown, 7 Vet. App. 488, at 492-93 (1995). This opinion in particular provided substantial reasoning and explanation as to why the Veteran’s OSA was not due to the Veteran’s active service. The Veteran has not submitted any competent evidence supporting his assertion that his OSA was due to his active service. Therefore, after weighing all the evidence, the Board finds great probative value in the July 2020 VA examiner’s opinion, which explained that the Veteran’s reported symptoms during his active service were not symptoms of OSA and that the Veteran was not diagnosed with OSA until a 2015 sleep study. Consideration has been given to the Veteran’s assertion that his OSA was due to his active service. Although lay persons are competent to provide opinions on some medical issues, see Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011), the specific issues in this case, namely the etiology of the Veteran’s diagnosed OSA, falls outside the realm of common knowledge of a lay person. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007). OSA is not the type of condition that is readily amenable to mere lay diagnosis or probative comment regarding etiology, as the evidence shows that examinations that include objective medical tests, such as sleep studies, are needed to properly assess and diagnose the disorder. See Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). (Continued on the next page)   That is, although the Board readily acknowledges that Veteran is competent to report perceived symptoms of his OSA, to the extent they are identifiable by observation, he has not been shown to possess the requisite medical training, expertise, or credentials needed to render a diagnosis or a competent opinion as to medical causation. Nothing in the record demonstrates that he received any special training or acquired any medical expertise in evaluating sleep disorders. See King v. Shinseki, 700 F.3d 1339, 1345 (Fed. Cir. 2012). Accordingly, this lay evidence does not constitute competent medical evidence and lacks probative value. Accordingly, the criteria for service connection for OSA have not been met, and the claim is denied. Thomas H. O'Shay Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Berryman, 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.