Sleep apnea decisions — 2020

The Veteran's service-connected obstructive sleep apnea has not resulted in chronic respiratory failure with carbon dioxide retention or cor pulmonale, and does not require a tracheostomy. Therefore, an initial disability rating in excess of 50 percent for this condition is denied.,The Veteran’s service-connected low back disability has not manifested in forward flexion limited to 30 degrees or less, ankylosis (favorable or unfavorable) of the thoracolumbar spine, or incapacitating episodes. Therefore, an initial disability rating in excess of 20 percent for this condition is denied.,The Veteran’s service-connected right leg radiculopathy has most closely approximated moderate incomplete paralysis of the sciatic nerve. Therefore, an initial disability rating in excess of 20 percent for this condition is denied.

The Board denied the reopening of claims for service connection for bilateral carpel tunnel syndrome and sleep apnea, finding no new and material evidence to support these claims.

The Veteran's acquired psychiatric disability, diagnosed as depressive disorder, is granted due to its increase in severity being proximately due to his service-connected disabilities. His tinnitus and basal cell carcinoma are not related to service or any incident therein. The voiding dysfunction, DM2 with hypertension and erectile dysfunction, peripheral neuropathy of the bilateral upper extremities and lower extremities, and non-Hodgkin's lymphoma have been found to aggravate his depressive disorder.

The Board has remanded the cases of service connection for headaches and obstructive sleep apnea due to new evidence submitted by the appellant's attorney, including a medical opinion from Dr. Skaggs regarding both conditions. The appellant is requested to submit any additional evidence that was included in the transmission but not received.

The Veteran's claim for higher ratings for his service-connected lumbosacral degenerative disc disease (DDD) with spondylolisthesis and associated radiculopathy was denied. The Board found that the evidence did not support a rating in excess of 40 percent prior to November 8, 2010, or from November 8, 2010 onwards.

The Veteran's OSA was not incurred during service, and his lumbar spine disability is rated at 40 percent disabling. The Board granted a rating of 20 percent for LLE radiculopathy from May 31, 2018 onwards and denied ratings in excess of 40 percent. For RLE radiculopathy, the Veteran received a 10 percent rating prior to December 18, 2012, and a 20 percent rating thereafter.

The Veteran's claim for an earlier effective date for PTSD is denied as no indication of intent to apply prior to November 26, 2014 was found.,Service connection for asthma (claimed as a lung inhalational injury) is granted based on the onset during service and continued since then.,The Veteran's TBI claim requires clarification due to insufficient rationale in the August 2017 VA examination report.,A new VA examination is needed to determine the current severity of the low back disability (DDD at L4-L5).,Left wrist and left shoulder conditions require a new VA examination for proper assessment.,Hypertension, gastroenteritis, and sleep apnea are remanded issues as no specific service connection theory or exposure basis is provided.,Service connection for asthma (claimed as a lung inhalational injury) is granted based on the onset during service and continued since then.

The Veteran seeks an earlier effective date for the grant of a total disability rating based upon individual unemployability (TDIU) due to his service-connected lumbosacral spine disability. The Board has decided that the application was not filed before May 12, 2008 and is remanded to provide notice about potential earlier dates.

The Board has remanded the case due to insufficient evidence regarding whether the Veteran's obstructive sleep apnea is secondary to his service-connected insomnia.

The Veteran's service connection claim for sleep apnea is granted as secondary to his service-connected PTSD, DM II, and diabetic peripheral neuropathy. The claims for hypertension (high blood pressure), Barrett’s syndrome, and essential tremors are remanded for further development.,VA will obtain the Veteran's private medical records from his PCP and cardiologist regarding his essential tremors. If these records are not available, VA should explain why they cannot be obtained. VA will also arrange for a VA examination to assess whether the Veteran has hypertension due to service-connected disabilities or exposure to herbicide agents.,VA will obtain the Veteran's private medical records from his PCP and cardiologist regarding his essential tremors. If these records are not available, VA should explain why they cannot be obtained. VA will also arrange for a VA examination to assess whether the Veteran has Barrett’s syndrome due to service-connected disabilities or exposure to herbicide agents.,VA will obtain the Veteran's private medical records from his PCP and cardiologist regarding his essential tremors. If these records are not available, VA should explain why they cannot be obtained. VA will also arrange for a VA examination to assess whether the Veteran has essential tremors due to service-connected disabilities or exposure to herbicide agents.

The Veteran's petition to reopen claims for service connection for various conditions were denied, and the rating for his lumbosacral strain and intervertebral disc syndrome was also denied.

The Board has remanded the case due to the need for additional medical opinions regarding the relationship between the Veteran's service-connected knee and back disabilities and his obesity, as well as whether obesity is aggravated by these conditions.

The Board has remanded the cases due to the need for additional examinations and opinions regarding the severity of the Veteran's service-connected right shoulder condition, the relationship between his left shoulder arthritis and his service-connected right shoulder disability, the nature and etiology of any acquired psychiatric disability, and the relationship between his sleep apnea and his military service.

The Board has granted service connection for recurrent chronic sinusitis (also claimed as allergic rhinitis) and obstructive sleep apnea (OSA), but denied service connection for a right knee condition. The decision is based on the evidence showing that the Veteran's current conditions are related to his service-connected allergic rhinitis.

The Veteran's claims for increased ratings and service connection have been denied. The rating for tinnitus remains at 10 percent, the maximum schedular rating available. Service connection was not granted for arthritis or sleep apnea.

The Board denied the Veteran's claim of service connection for a lumbar spine disability, finding that there was no credible evidence to support his allegation of an in-service injury and concluding that any current lumbar spine disability is not related to service.

The Veteran's claim for service connection for bronchitis has been remanded by the Board.,Service connection for OSA and GERD with Barrett’s esophagus have been granted.

The Board has determined that the Veteran's service-connected PTSD caused or aggravated his obesity, which in turn caused his OSA. Therefore, the claim for service connection for OSA is granted on a secondary basis.

The Veteran's claims for increased ratings and TDIU were denied. The Board found that the current schedular evaluations adequately reflected his disability levels, and there was no evidence of exceptional or unusual factors warranting extraschedular consideration.

The Veteran's service connection for bilateral hearing loss is denied as he does not have a current disability recognized by VA.,Service connection is granted for obstructive sleep apnea, which was aggravated by his service-connected adjustment disorder with mixed anxiety and depressed mood with polysubstance dependence (psychiatric disability).,Service connection is granted for migraine headaches, which are proximately due to his service-connected psychiatric disability.,The issue of service connection for tinnitus remains pending as a remand is required.