Citation Nr: 21031799 Decision Date: 05/24/21 Archive Date: 05/24/21 DOCKET NO. 16-46 828 DATE: May 24, 2021 ORDER Service connection for sleep apnea is denied. FINDING OF FACT The Veteran's sleep apnea began many years after service and is not caused or aggravated by the service-connected PTSD. 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, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from January 1973 to January 1993. The matter is before the Board of Veterans' Appeals (Board) on appeal from an October 2014 rating decision. Initially, the Board notes that the Veteran filed a claim of service connection for sleep apnea in June 2012 and it was denied in a December 2012 rating decision. The Veteran did not appeal this decision and it became final. New and material evidence has been received since the December 2012 decision and the claim is considered reopened. As the RO reopened the claim and denied it on the merits in the October 2014 decision on appeal, the Board may proceed to the merits without prejudice to the Veteran. The Veteran seeks service connection for sleep apnea. He contends that his sleep apnea began in service in approximately the early 1980s or, in the alternative, is secondary to his service-connected PTSD. The Board finds, however, that service connection is not warranted. The Veteran's service treatment records are associated with the claims file and appear to be complete. Despite treatment for various conditions in service, there is no evidence of complaints or treatment for a sleep disorder. March 1978, December 1982, and September 1992 examinations were negative for relevant conditions and, while the Veteran reported nervous trouble on his September 1992 report of medical history, he denied frequent trouble sleeping and no other relevant symptoms were noted. Post-service treatment records dating to 1996 are associated with the claims file and do not show sleep apnea-related complaints until approximately 2009. In June 2003, the Veteran reported experiencing sleep difficulty and tiredness after waking related to pain during a private treatment visit. Records from Sheppard Air Force Base show that the Veteran denied sleep disturbances and tiredness from 2005 to 2008. Instead, VA treatment records show that he first reported that, according to his wife, he snored severely and stopped breathing during sleep in April 2009. After these complaints, he was referred for a sleep study and he was diagnosed with obstructive sleep apnea in July 2010. The Board has considered the lay statements submitted by the Veteran's family members in which they allege that the Veteran has experienced snoring and apneas since the 1980s. The Board finds that these statements are contradicted by the service and post-service medical records and the Veteran's statements made therein. Specifically, despite seeking treatment for various conditions in service and after service, the Veteran did not report snoring and apneas until 2009, almost 20 years after service. He also denied sleeping issues in service, at separation from service, and through 2008. This is not a situation in which there is a lack of post-service medical records, but one in which the Veteran was consistently receiving medical care for a variety of conditions for over 20 years, yet raised no concerns related to sleep apnea. Indeed, the Veteran's spouse alleged that his sleep apnea was diagnosed by Sheppard Air Force Base after moving to Texas. His records, however, show that he regularly denied relevant symptoms for four years while being treated at Sheppard and was not referred for a sleep apnea consultation until he reported snoring and apneas during a VA medical visit. The Board thus finds that these contemporaneous medical records and statements contradict and outweigh the supporting lay statements, and the Board did not afford them probative value. In August 2020, after a telephone evaluation and review of the record, including the favorable lay evidence, a VA examiner opined that the Veteran's sleep apnea did not begin in service. The examiner noted that the evidence does not support the lay statements and instead shows that sleep apnea began in approximately 2009. The examiner stated the "objective medical record" but cited to the Veteran's statements made while seeking medical treatment, as well as his medical records, in support of the conclusion. The Board thus finds that the examiner's opinion is probative. Accordingly, the weight of the competent and credible evidence shows that the Veteran's sleep apnea manifested many years after service, and direct service connection is not warranted. The Board further finds that the Veteran's PTSD did not cause nor aggravate the Veteran's sleep apnea, and secondary service connection is not warranted. His medical records do not show that his treating providers have related it to his service-connected PTSD. Additionally, the August 2020 VA examiner concluded that the Veteran's sleep apnea was not caused or aggravated by his PTSD. In support of the conclusion, the examiner cited medical literature which stated, "obstructive sleep apnea (OSA) is characterized by recurrent obstruction of the pharyngeal airway during sleep, with resultant hypoxia and sleep fragmentation." The literature further stated that the "clinical risk factors associated with OSA are increasing age, male gender, obesity, and craniofacial and upper airway abnormalities . . . not alcohol dependence or PTSD with depression." The Board find that this medical opinion is highly probative because the examiner considered the favorable lay evidence, relied on the medical literature, and provided alternative etiologies. The Veteran has not submitted any competent evidence to support his claim for secondary service connection. To the extent he contends his sleep apnea is caused or aggravated by his PTSD, as a layperson without any demonstrated expertise, training, or education, he is not competent to render such an opinion. The Board thus finds that the weight of the competent and credible evidence shows the Veteran's sleep apnea was not caused or aggravated by his service-connected PTSD and the claim for service connection for sleep apnea is denied. MICHELLE L. KANE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Lavan 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.