Citation Nr: 21042215 Decision Date: 07/12/21 Archive Date: 07/12/21 DOCKET NO. 15-33 962 DATE: July 12, 2021 ORDER Entitlement to service connection for obstructive sleep apnea, to include as secondary to a service-connected disability, is denied. FINDING OF FACT The Veteran's obstructive sleep apnea did not have its onset in service, shortly after service, is not related to service, and is not secondary to a service-connected disability. CONCLUSION OF LAW The criteria for service connection for obstructive sleep apnea are not 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 had active duty service with the U.S. Air Force from February 1974 to August 1977. This case comes before the Board of Veteran's Appeals (Board) on appeal from a July 2014 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The Board remanded this claim for additional development in September 2018 and November 2020. Service Connection The Veteran seeks service connection for obstructive sleep apnea. Service connection may be granted for a disability resulting in a disease or injury that is incurred in or aggravated by active military service. 38 U.S.C. §1110; 38 U.S.C. §3.303. To establish service connection for the claimed disorder, the following criteria must be met: (1) evidence of a current disability; (2) evidence of an in-service incurrence or aggravation of a disease or injury; and (3) evidence of a nexus between the claimed in-service disease or injury and current disability. See 38 C.F.R. § 3.303; see also Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009); Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004); Hickson v. West, 12 Vet. App. 247, 253 (1999). Service connection may also be established on a secondary basis for a disability which is proximately due to or the result of a service connected disease or injury, or for any increase in severity of a nonservice-connected disease or injury which is proximately due to or the result of a service-connected disease or injury, and due to the natural progress of the nonservice-connected condition. 38 C.F.R. § 3.310 (a)-(b). Establishing service connection on a secondary basis requires evidence sufficient to show (1) that a current disability exists, and (2) that the current disability was either (a) proximately caused by or (b) proximately aggravated by a service-connected disability. Allen v. Brown, 7 Vet. App. 439, 448 (1995) (en banc). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the benefit of the doubt shall be given to the claimant. 38 U.S.C.A. § 5107(b). When a reasonable doubt arises regarding service origin, such doubt will be resolved in the favor of the claimant. Reasonable doubt is doubt which exists because of an approximate balance of positive and negative evidence which does not satisfactorily prove or disprove the claim. 38 C.F.R. § 3.102. The question is whether the evidence supports the claim or is in relative equipoise, with the claimant prevailing in either event, or whether a fair preponderance of the evidence is against the claim, in which event the claim must be denied. Gilbert v. Derwinski, 1 Vet. App. 49, 54 (1990). 1. Obstructive Sleep Apnea (OSA) The Veteran contends that his OSA is a direct result of his military service. Specifically, he contends that his diagnosed OSA is a result of his duties performed on the flight line that resulted in his exposure to large amounts of jet exhaust, as he transported crews to and from planes. See September 2015 Veteran Lay Statement. The Veteran further contends that his OSA is related to his service-connected chronic obstructive pulmonary disease (COPD) via a condition called overlap syndrome (OVS). See September 2015 Veteran Lay Statement. Lastly, the Veteran asserts that he developed OSA as secondary to his service-connected COPD. Id. The Veteran has a current diagnosis of OSA. See August 2019 VA Examination. The Veteran was first diagnosed with OSA in 2008. Id. The Board notes that the Veteran is service connected for COPD from September 2012. Review of the Veteran's enlistment examination reveals he reported frequent trouble sleeping, the examiner noted the Veteran has mild insomnia. See January 1974 Service Treatment Records at 10. In August 1976 the Veteran reported difficulty getting to sleep while in-service. See August 1976 Military Personnel Records at 18. The clinician noted the Veteran had been experiencing anxiety for the prior two weeks and requested Valium. Id. The August 2019 VA examiner opined, that the Veteran's OSA is less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The examiner noted that OSA can occur in patients who have COPD and this condition is referred to as OVS. The examiner went on to opine, that there are studies that relate OSA and COPD; however, there is no competent evidence that suggest COPD causes OSA. The April 2021 VA examination addendum opinion concluded that sleep apnea is less likely than not aggravated by COPD. See April 2021 VA Examination. The examiner opined, that OSA is a condition of the upper airway and COPD is a lung disease. The examiner concluded, that because OSA is an obstruction of the airway and COPD is caused by damage to the lung, the Veteran's OSA was not aggravated by his service-connected COPD. The Board acknowledges and has considered the Veteran's contentions that he believes his OSA was caused by his military service; specifically, his exposure to jet fuel exhaust and service-connected COPD. See September 2015 Veteran Lay Statement. Additionally, the Board considered the Veteran's reports of his duties during active duty service. Id. While the Veteran is competent to report his symptoms, lay persons are not competent to provide opinions on some medical issues, see Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011), and the issue in this case falls outside the realm of common knowledge of a lay person. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007). As a result of the above findings, the Board finds service connection for OSA must be denied. Sleep disturbances related to the Veteran's OSA did not have its onset in service, his OSA disability did not have its onset in service, he did not have OSA symptoms shortly after service, and his OSA is not related to the circumstances of his service. Furthermore, the Veteran's OSA is not the result of his service-connected COPD nor has it been aggravated by his COPD. As a result, service connection is not warranted. (Continued on the next page) The Board is grateful to the Veteran for his service, and regrets that it cannot render a favorable decision in this matter. As a preponderance of the evidence is against the claim, the benefit-of-the-doubt doctrine is not applicable in the instant appeal. See 38 U.S.C. § 5107(b); Ortiz v. Principi, 274 F.3d 1361 (Fed. Cir. 2001); Gilbert v. Derwinski, 1 Vet. App. 49, 55-57 (1991). Accordingly, the claim is denied. K. Anderson Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board David B. Scheirich, 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.