Citation Nr: 21031765 Decision Date: 05/24/21 Archive Date: 05/24/21 DOCKET NO. 15-10 660 DATE: May 24, 2021 ORDER Entitlement to service connection for obstructive sleep apnea is granted. FINDING OF FACT The Veteran's obstructive sleep apnea is related to his active duty service. CONCLUSION OF LAW The criteria for entitlement to service connection for obstructive sleep apnea have been met. 38 U.S.C. §§ 1110, 5107(b) (2018); 38 C.F.R. §§ 3.102, 3.303, 3.304 (2020). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from January 2003 to April 2004, with service in Iraq. He also served on active duty for training from October 1991 to July 1992. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a September 2011 rating decision by the Department of Veterans Affairs (VA). This case was remanded in July 2018 for further development; it has since been re-assigned to the undersigned. Since the Board's remand, the issue of service connection for erectile dysfunction was granted in a February 2021 rating decision. Because that decision is considered a full grant of the benefit sought, the issue is no longer on appeal. Entitlement to service connection for obstructive sleep apnea. Service connection may be established for a disability resulting from a disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. Service connection requires evidence showing: (1) a current disability; (2) incurrence or aggravation of a disease or injury in service; and (3) a nexus between the current disability and the disease or injury incurred or aggravated in service. See Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disability was incurred in service. 38 C.F.R. § 3.303(d). The Veteran was first diagnosed with obstructive sleep apnea in November 2009. See, e.g., July 2011 VA examination. Although a July 2011 VA examiner noted that the date of onset was November 2009, the Veteran previously reported that he had an onset of symptoms in 2003, while in Iraq. See February 2011 claim. The July 2011 VA examiner opined that the Veteran's obstructive sleep apnea was not caused by or a result of a specific exposure event experienced by the Veteran in Iraq. The opinion is inadequate because it used the incorrect legal standard. Moreover, the opinion does not discuss incurrence or a relationship to service other than environmental exposures. As a result, the opinion is given no probative weight. A February 2021 VA examiner opined it was less likely than not that the Veteran's disability was related to service, but the opinion is inadequate because it relied solely on an absence of evidence in service treatment records (STRs). Thus, the opinion is also given no probative weight. In February 2012, a private physician opined that the Veteran's obstructive sleep apnea was at least as likely as not related to his active duty service. The physician noted that the Veteran reported that his symptoms of loud snoring and waking up while gasping for air started during active service. The physician discussed that the Veteran was under a great deal of stress while serving during the Gulf War and that such stress is a contributor to the anatomical factors that decrease the cross-sectional area of the upper airway and increase the pressure surrounding the airway, both of which predispose the airway to collapse. This opinion is considered adequate for appellate review because the physician provided a full and detailed rationale that included discussion of the Veteran's diagnosed disability and lay statements of reported history. As a result, the opinion is given significant probative weight. After considering the Veteran's lay report of symptoms starting during active service and the February 2012 private opinion, the probative evidence reflects that the Veteran's obstructive sleep apnea is related to his active duty service. Thus, service connection is warranted, and the claim is granted. E. I. VELEZ Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Sandler, 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.