Citation Nr: 21021685 Decision Date: 04/13/21 Archive Date: 04/13/21 DOCKET NO. 16-23 606 DATE: April 13, 2021 ORDER Entitlement to service connection for sleep apnea is granted. FINDING OF FACT Sleep apnea was incurred during the Veteran’s active service. CONCLUSION OF LAW The criteria for service connection for sleep apnea have been met. 38 U.S.C. §§ 1110, 1112, 1131, 1137, 5107 (2018); 38 C.F.R. §§ 3.303, 3.307, 3.309 (2020). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active naval service from October 1976 until January 1997. This matter is before the Board of Veterans’ Appeals (Board) on appeal from a January 2015 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). This case was previously before the Board in December 2019, at which time the issues currently before the Board were remanded for additional development. The case has now been returned to the Board for appellate review. Service Connection — Sleep Apnea The Veteran asserts that his sleep apnea had its onset during active service. Specifically, he contends that his OSA became manifest in September 1987 (during his military service), when he was seen for difficulty sleeping. The Board notes that the Veteran is competent to report when he first experienced symptoms associated with a later diagnosis of sleep apnea, and that those symptoms have continued since service. Moreover, the Board finds the Veteran credible in that respect. The Veteran’s service treatment records (STRs) note trouble sleeping in September 1987 and in his August 1996 service separation examination report. Post service evidence of record shows that the Veteran was diagnosed with mild sleep apnea after an April 2014 sleep study. In a January 2017 letter a nurse practitioner supported the assertion that the Veteran had sleep apnea (undiagnosed) on active duty prior to the post service documented diagnosis. Further, of record are lay statements from the Veteran’s wife, and two fellow service members in which it was reported that the Veteran had symptoms of sleep apnea while he was in active service. Specifically, it was reported that the Veteran snored loudly and struggled to breathe while sleeping during and following active service. Pursuant to the December 2019 Board remand, a January 2020 VA examiner opined that it was less likely as not that the Veteran’s sleep apnea had its onset in, or is otherwise etiologically related to his active duty service, and sleep problems, reported apneic episodes, and snoring therein. Of record is a February 2020 letter from the Veteran’s treating physician, Dr. A.P. At that time, Dr. A.P. opined that it was at least as likely as not that the Veteran’s sleep apnea was a result of his active service. In so finding, Dr. A.P. noted that the Veteran has no other known risk factor that may have precipitated his current sleep apnea. Although there is evidence against the claim, the Board notes that lay evidence can be competent and sufficient to establish a diagnosis of a condition when (1) a layperson is competent to identify the medical condition, (2) the layperson is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. In fact, competent medical evidence is not necessarily required when the determinative issue involves either medical etiology or a medical diagnosis. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006). In this case, the Veteran and the other laypersons are competent to identify symptoms related to sleep apnea, and report on the chronicity of symptomatology since active service. Moreover, their statements have been found credible. Accordingly, the Board finds that the evidence for and against the claim of entitlement to service connection for sleep apnea is at least in equipoise. Therefore, reasonable doubt must be resolved in favor of the Veteran and entitlement to service connection for sleep apnea is granted. 38 U.S.C. § 5107 (b) (2018); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). John Kitlas Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board I. Umez-Eronini, 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.