Citation Nr: 21023137 Decision Date: 04/20/21 Archive Date: 04/20/21 DOCKET NO. 17-40 729 DATE: April 20, 2021 ORDER Entitlement to service connection for sleep apnea is denied. FINDING OF FACT The preponderance of the evidence is against finding that the Veteran’s sleep apnea began during active service or is otherwise etiologically related to service. CONCLUSION OF LAW The criteria for service connection for sleep apnea have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from December 1959 to February 1962. The matter comes before the Board of Veterans’ Appeals (Board) on appeal from a February 2015 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). In May 2019, the Veteran testified at a hearing before the undersigned Veterans Law Judge. A copy of the proceeding is associated with the electronic claims file. In August 2019 and December 2020, the Board remanded the case for further development. The Board finds there has been substantial compliance with its remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998). Service Connection for Sleep Apnea Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated during service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303. In order to establish service connection on a direct basis, the record must contain (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). The Veteran seeks service connection for sleep apnea. Specifically, he contends that his sleep apnea began during service. See May 2019 Board hearing transcript. The record shows that the Veteran has been diagnosed with obstructive sleep apnea and central sleep apnea. See January 2021 VA examination report. The Veteran’s service treatment records (STRs) note that he reported frequent trouble sleeping in his December 1958 pre-induction report of medical history and November 1961 separation report of medical history. The remainder of the Veteran’s STRs are negative for any complaints of, diagnoses of, or treatment for sleep apnea. A January 2021 VA examiner opined that the Veteran’s central sleep apnea is less likely than not incurred in or etiologically related to service as the Veteran had no complaints of sleep apnea during service or after service until many years later. The examiner also stated that the Veteran’s medical treatment records indicate that his central sleep apnea is secondary to his Alzheimer’s and opioid use. The examiner further opined that the Veteran’s obstructive sleep apnea is less likely than not incurred in or etiologically related to service. He reasoned that age and a high BMI are the primary risk factors of obstructive sleep apnea and that the Veteran’s BMI in 2014, the year he was diagnosed with obstructive sleep apnea, was over 30. Additionally, the examiner considered the Veteran’s 1961 report of frequent trouble sleeping and noted that the Veteran’s STRs are silent as to any symptoms of obstructive sleep apnea. The Board finds the examiner’s opinion to be probative because it is based on an accurate medical history and provides an explanation that contains clear conclusions and supporting data. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). Additionally, the Board finds that the examiner adequately considered the Veteran’s reports of snoring and trouble sleeping in service, to include the November 1961 report of medical history, and concluded that these reports are not indicative of sleep apnea. Accordingly, the Board accepts the VA examiner’s opinion as the most probative evidence as to whether it is less likely than not that the Veteran’s sleep apnea is related to service. The Board finds that the evidence weighs against a finding that sleep apnea was incurred in service. The only evidence of any relationship between sleep apnea and service are the Veteran’s statements of his belief that sleep apnea had military onset or is otherwise related to military service. Beyond the Veteran’s conclusory statements, however, there is no evidence in the record of any such relationship. He has not provided any evidence beyond his statements that his sleep apnea is related to service. Additionally, the Veteran does not have the requisite medical knowledge, training, or experience to be able to render a competent medical opinion regarding the cause of a medically complex disorder such as sleep apnea. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Thus, although the Board has carefully considered the lay contentions of record suggesting that the Veteran’s sleep apnea had its onset during service, the Board ultimately affords the objective medical evidence of record, which weighs against finding such a connection, with greater probative weight than the Veteran’s lay statements. As discussed above, the Board affords more probative weight to the competent medical evidence of the January 2021 VA examination report. In sum, the Board finds that the evidence weighs against a finding that the Veteran’s sleep apnea is related to service. Accordingly, as the preponderance of the evidence is against the claim, the benefit of the doubt rule does not apply, and the claim for service connection for sleep apnea must be denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski,1 Vet. App. 49, 55 (1990). Nathaniel J. Doan Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Robinson, 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.