Citation Nr: 21042381 Decision Date: 07/12/21 Archive Date: 07/12/21 DOCKET NO. 14-43 578 DATE: July 12, 2021 ORDER Entitlement to service connection for obstructive sleep apnea (OSA) is granted. FINDING OF FACT The Veteran's OSA was incurred during service. CONCLUSION OF LAW The criteria to establish service connection for OSA have been met. 38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from October 1989 to March 2001. He appealed a June 2013 rating decision by the Agency of Original Jurisdiction (AOJ). This case was remanded by the Board for additional development in December 2018, September 2020, and April 2021. The Veteran asserts that his OSA is related to service or is caused or aggravated by his service-connected posttraumatic stress disorder (PTSD). See, e.g., December 2014 VA Form 9 and September 2020 Appellate Brief. Generally, to establish a right to compensation for a present disability, a veteran must show: (1) a present disability; (2) an 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, the so-called "nexus" requirement. 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 a disease was incurred in service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(d). The Veteran has a current diagnosis of OSA. See November 2012 sleep study and November 2019 examination report. In-service reports of medical history, dated in October 1996 and January 2001, show the Veteran endorsed frequent trouble sleeping, which was noted to have resolved. After service, the Veteran reported he snored for many years and remembered that his wife at that time complained of his snoring. See September 2012 VA medical record. The remaining question is whether the Veteran's OSA began during or is otherwise related to service. VA obtained opinions in November 2019, January 2021, and June 2021, all of which concluded that the Veteran's OSA was not related to service or to his service-connected PTSD. The November 2019 opinion on direct service connection was based on a finding that aside from the Veteran's resolved sleep difficulties noted in January 2001, his service treatment records contained no evidence of signs or symptoms consistent with OSA. Additionally, the June 2021 opinion concluded that the Veteran's statements as to the onset of his OSA were inconsistent with medical evidence but failed to explain why that was the case. As noted above, the Veteran's service treatment records indicate he reported frequent trouble sleeping during service, and following service he reported snoring for many years. The Board finds the Veteran's statements in this regard to be credible. As the Veteran reported sleep apnea symptoms during service which continued thereafter, it is reasonable to conclude that his OSA began during service. Given these facts, the Board concludes that the evidence is in approximate balance as to whether the Veteran's OSA began in service. Resolving reasonable doubt in favor of the Veteran, the Board finds that service connection for OSA is warranted. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. DONNIE R. HACHEY Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Pelican, Luke H. 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.