Sleep apnea decisions — 2020

The Board has remanded the claim of service connection for a bilateral shoulder disability due to additional development being required.

The Veteran's claims for sleep apnea and a sleep disturbance are remanded due to incomplete service records.,The Veteran's claims for low back disability and associated peripheral neuropathy are remanded due to incomplete service records.,The Veteran's claim for COPD is remanded due to incomplete service records.,The Veteran's claim for exposure to tuberculosis is remanded due to incomplete service records.,Incomplete VA treatment records are needed for all claims.,Outstanding private and federal records need to be obtained for the Veteran’s claims.,A VA examination is required to determine the nature and etiology of the Veteran's sleep apnea, sleep disturbance, low back disability, peripheral neuropathy, COPD, and tuberculosis.

The Veteran's sleep apnea is not related to his time in service and was denied.,The Veteran's left knee ACL tear, PCL partial tear does not limit flexion to 30 degrees and the instability more nearly approximates slight instability. An increased rating for this condition is granted.,Right knee strain (painful limited extension) associated with left knee ACL tear is not limited to 10 degrees of extension and an increased rating is denied.,Right knee strain (painful limited flexion) associated with left knee ACL tear is not limited to 30 degrees of flexion and an increased rating is denied.,A separate 10 percent rating for right knee instability is granted based on history of slight recurrent subluxation and slight lateral instability.,Left hip abduction does not result in motion lost past 10 degrees and a non-increased rating for left hip strain associated with left knee ACL tear is denied.

The Veteran's sleep apnea was found to have begun during service and continued post-service, granting service connection for the condition.

The Board has determined that additional evidence is needed to determine the current severity of the Veteran's acquired psychiatric disability, primary open-angle glaucoma, and sleep apnea. The issues of service connection for diabetes mellitus, type II, and a thyroid disability are also remanded due to lack of medical nexus opinions. The TDIU issue remains inextricably intertwined with these other issues.

The Veteran's lumbosacral strain, now with degenerative disc disease prior to August 1, 2019, is denied a rating in excess of 10 percent.,The Veteran's lumbosacral strain, now with degenerative disc disease from August 1, 2019, is denied a rating in excess of 20 percent.

The Board has decided to remand the Veteran's claim for service connection for sleep apnea, including as secondary to his service-connected PTSD. An examination is needed to determine if the sleep apnea was caused or aggravated by his service-connected PTSD.

The Board has determined that the Veteran's right lower calf knot is not service-connected, as there is no evidence of a pre-service or in-service occurrence and it is not otherwise related to his active duty.,Initial compensable ratings are granted for hammertoes of both feet. The Veteran currently has hammer toe deformities of multiple toes without claw foot on each side.,The Board has determined that the Veteran's low back disability and sleep disorder, including insomnia and sleep apnea, are not service-connected due to lack of evidence showing a direct or secondary relationship to his active duty.

The Veteran's claim for service connection for obstructive sleep apnea is remanded due to the lack of a thorough examination and consideration of his lay statements.

The Board has remanded the issues of service connection for blindness, glaucoma, hypertension, TBI, rheumatoid arthritis, right shoulder pain, left shoulder pain, left elbow disorder, right shoulder disorder, right wrist disorder, left wrist disorder, numbness and stiffness in the right toes, numbness, pain, and tingling in the left leg, joint pain and swelling in the jaw, right hip disorder, left hip disorder, left knee disorder, right ankle disorder, left ankle disorder, bilateral pes planus, left foot bunions, right foot bunions, residuals of a rib fracture, right hand disorder, left hand disorder, tonsillitis, dizzy spells, chronic fatigue disorder, pharyngitis (inflammation of the throat), allergy disorder, breathing disorder, sleep apnea, heart disorder manifest by an irregular heartbeat, ulcer, gastritis, gastrointestinal disorder manifested by gas and stomach problems, GERD, kidney disorder, residuals of a left chest lipoma, obesity, left arm disorder, and numbness, pain, and stiffness in the fingers.

The Board denied an earlier effective date for the award of service connection for sleep apnea, finding that the earliest date upon which to award service connection was April 8, 2014.

The Board denied the Veteran's claim for an earlier effective date than March 17, 2016 for the grant of service connection for obstructive sleep apnea due to lack of evidence supporting direct service connection.

The Veteran's OSA is remanded due to a positive opinion linking his sleep apnea to service-connected allergic rhinitis and sinusitis. The Board cannot make a determination on the OSA claim until decisions are made on the claims for allergic rhinitis and sinusitis.

The Board has determined that additional service records are needed to properly adjudicate the Veteran's claims for diabetes, bilateral hearing loss, lumbosacral strain (chronic lower back pain), missing lower teeth, and permanent scarring of the lower lip. The VA will obtain these records and then readjudicate the cases.

The Board has remanded the Veteran's claim for service connection for sleep apnea due to conflicting opinions and need for additional medical evidence.

The Veteran's appeal for a compensable disability rating for service-connected bilateral hearing loss has been withdrawn.,Service connection for obstructive sleep apnea and hypertension is denied as the evidence does not support an in-service occurrence or relationship to military service.,The Veteran’s claim for left hand and finger arthritis remains pending, but requires further development including a VA examination.

The Board denied the Veteran's claim for service connection for obstructive sleep apnea, finding that it did not manifest during service and is not related to his service-connected hypertension.

The Veteran's increased ratings for osteoarthritis of the left and right knees are denied. The Board found no evidence that her knee disabilities caused or aggravated her lumbosacral spine disability, thus denying service connection for this condition.

The Board has granted service connection for sleep apnea and acid reflux, finding that both conditions are aggravated by the Veteran's service-connected right shoulder degenerative changes. The appeal is remanded for a rating in excess of 20 percent for his right shoulder disability.

The Board has denied service connection for obstructive sleep apnea due to lack of evidence showing its onset during service or a link between the condition and service. The claims for arthritis in all joints, irritable bowel syndrome, and an increased rating for depression are remanded for further development.