Citation Nr: 21024008 Decision Date: 04/21/21 Archive Date: 04/21/21 DOCKET NO. 17-17 974 DATE: April 21, 2021 ORDER Service connection for sleep apnea is granted.   FINDING OF FACT The Veteran’s sleep apnea is related to service. CONCLUSION OF LAW The criteria for service connection for sleep apnea have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from July 1992 to January 1996. The case is on appeal from an August 2016 rating decision. In April 2021, the Veteran testified at a Board hearing. The Board has limited the discussion below to the relevant evidence required to support its finding of fact and conclusion of law, as well as to the specific contentions regarding the case as raised directly by the Veteran and those reasonably raised by the record. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015); Robinson v. Peake, 21 Vet. App. 545, 552 (2008). Service connection for sleep apnea Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. See 38 U.S.C. § 1110; 38 C.F.R. § 3.303. A veteran seeking compensation under these provisions must establish three elements: “(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.” Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). A private sleep study in August 2004 confirmed a diagnosis of sleep apnea. The Veteran credibly testified that he had relevant symptoms during service. His ex-wife also submitted a statement in December 2016 stating that the Veteran suffered many sleepless nights due to snoring and stopped breathing during service. Generally, it is within the common knowledge and ordinary experience of lay persons to know that some symptoms, such as snoring, temporary cessation of breathing during sleep, and daytime sleepiness, are associated with sleep apnea. Hence, the lay statements are some evidence supporting the claim. Consistent with the lay evidence, the Veteran’s service treatment records (STRs) show treatment for symptoms diagnosed as sinusitis, bronchitis, upper respiratory infections, throughout service. Hence, there is supporting evidence of in-service symptoms. Thus, the question becomes whether the current disability is related to service. On this question there are probative opinions in favor of and against the claim. In January 2019, a private otolaryngologist opined that it is likely that the Veteran’s sleep apnea is related to service. The provider noted the Veteran’s report of nasal obstruction, severe allergies, and recurrent sinus infections during service, and possibly a nasal injury as well causing obstruction. The doctor explained that this can certainly precipitate, provoke, or exacerbate his sleep apnea syndrome. The examiner’s opinion is probative as it is understandable, is based on an accurate factual foundation, and contains clear conclusions. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). A VA examiner in February 2017 came to the opposite conclusion. The VA examiner opined that the condition was less likely than not incurred in or caused by service. The VA examiner reasoned that there was no supporting evidence in the Veteran’s service treatment records (STRs) of any symptoms associated with sleep apnea, nor any evidence of any complaints, nor a diagnosis of sleep apnea while in service nor within one year of discharge. This VA examiner’s opinion is of limited probative value because it rejected the lay statements of symptoms during service and instead relied on an absence of documented evidence of symptoms during service without explaining why, as a medical matter, the Veteran would have sought treatment or complained of the symptoms during service, or why an absence of treatment or documented symptoms was otherwise medically significant. Upon review of the record, the Board finds the evidence to at least be in equipoise as to whether the Veteran’s current disability is related to service. Accordingly, after resolving reasonable doubt in favor of the Veteran, the Board finds that his sleep apnea is related to service. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. Therefore, service connection for sleep apnea is warranted. RYAN T. KESSEL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Bosely, 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.