12-11 219, 12-11 219

Veteran served multiple active-duty periods (1980–1981, 2002, 2007) and National Guard duty; retired after sleep-related problems following 2007 deployment.
December 2007 sleep study and February 2010 VA exam diagnosed moderate obstructive sleep apnea (OSA).
Veteran, spouse, and fellow-service member provided lay statements describing long-standing loud snoring, gasping, nighttime apneas, and daytime fatigue beginning during the 2002 deployment.
Private physicians (Dr. G.R. and Dr. D.C.) opined it was highly likely OSA existed during service or that deployment may have contributed to current diagnoses.
June 2016 VA examiner found aggravation less likely than not and offered an inadequate opinion on causation; Board afforded it little weight.
Board remanded in 2016 for development; after reviewing lay evidence and private opinions, the Board found the evidence in equipoise and granted service connection for OSA.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Entitlement to service connection for obstructive sleep apnea	Veteran: OSA began in service (symptoms during 2002 deployment); lay and private medical opinions support nexus	VA: Lack of contemporaneous service treatment documentation; VA examiner found aggravation less likely than not and questioned nexus	Granted — benefit of the doubt applied; Board found lay and private medical evidence credible and persuasive over the inadequate VA opinion

Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004) (elements required for VA service connection)
Charles v. Principi, 16 Vet. App. 370 (2002) (competency of lay evidence for observable symptoms and continuity)