Sleep Apnea: what evidence wins at the Board

For sleep apnea appeals, how often the Board granted the issue when the record held each kind of evidence, and how often when it did not. Measured from the decisions themselves; every number carries its fraction.

What this is computed from: evidence types detected in the full text of 1,907,778 public Board of Veterans' Appeals decisions (va.gov/vetapp), joined to the issue-level outcome. The tables use only single-issue decisions with a clean parse in complete crawl years (1993–2025) — 852,152 decisions — so each evidence flag attaches to exactly one decided issue. A split is shown only when both sides have at least 30 decisions. Data build: 2026-09-02.

Service connection for Sleep Apnea (n = 19,220)

When the record had…Granted, with itGranted, without itDifferenceRemanded, with it
A medical source gave a positive nexus opinionEvidence in the record83% (2,095/2,527)57% (4,117/7,228)+26 pts21% (693/3,225)
Private physician opinion, letter or DBQEvidence in the record80% (2,804/3,488)54% (3,408/6,267)+26 pts24% (1,127/4,625)
Disability Benefits Questionnaire in the recordEvidence in the record71% (759/1,072)63% (5,453/8,683)+8 pts36% (601/1,675)
Third-party lay statements (spouse, buddy, employer)Evidence in the record71% (1,364/1,931)62% (4,848/7,824)+9 pts33% (955/2,892)
Service treatment records document the condition or injuryEvidence in the record60% (1,662/2,771)65% (4,550/6,984)-5 pts30% (1,198/3,979)
Service treatment records silent for the conditionEvidence in the record44% (1,765/4,032)78% (4,447/5,723)-34 pts20% (983/5,023)
Continuity of symptoms argued (38 CFR 3.303(b))Theory argued49% (808/1,657)67% (5,404/8,098)-18 pts22% (464/2,124)
Board hearing held or testimony takenProcedure64% (2,437/3,799)63% (3,775/5,956)+1 pts38% (2,408/6,410)
Social Security records in the fileEvidence in the record19% (12/64)64% (6,200/9,691)-45 pts38% (43/112)
Medical literature or treatise citedEvidence in the record61% (2,439/3,989)65% (3,773/5,766)-4 pts40% (2,614/6,607)
Functional loss / DeLuca factors argued (rating cases)Theory argued69% (185/270)64% (6,027/9,485)+5 pts41% (187/461)
Presumptive service connection discussedTheory argued38% (709/1,885)70% (5,503/7,870)-32 pts30% (830/2,725)
Secondary service connection (38 CFR 3.310) in playTheory argued64% (3,752/5,850)63% (2,460/3,905)+1 pts46% (5,092/11,069)
Combat service / 1154(b) in playTheory argued62% (339/547)64% (5,873/9,208)-2 pts32% (261/824)
A medical source gave a negative nexus opinionEvidence in the record62% (4,123/6,676)68% (2,089/3,079)-6 pts40% (4,451/11,136)
No nexus opinion of recordEvidence in the record24% (108/453)66% (6,104/9,302)-42 pts31% (209/664)
VA examination or VA medical opinion obtainedEvidence in the record61% (4,902/8,090)79% (1,310/1,665)-18 pts46% (7,008/15,142)
Board found a VA exam or opinion inadequateHow the Board read the record72% (2,391/3,341)60% (3,821/6,414)+12 pts59% (4,745/8,100)
Board found the VA exam or opinion adequateHow the Board read the record41% (255/616)65% (5,957/9,139)-24 pts9% (61/678)
Board found the veteran's statements credibleHow the Board read the record83% (1,364/1,639)60% (4,848/8,116)+23 pts6% (112/1,754)
Board found the veteran's statements not credible or inconsistentHow the Board read the record14% (26/185)65% (6,186/9,570)-51 pts8% (17/202)
Benefit of the doubt resolved in the veteran's favorHow the Board read the record97% (3,071/3,182)48% (3,141/6,573)+49 pts1% (25/3,210)
Preponderance of the evidence against / doctrine not applicableHow the Board read the record6% (156/2,833)87% (6,056/6,922)-82 pts0% (8/2,844)
Duty-to-assist error foundHow the Board read the record69% (265/382)63% (5,947/9,373)+6 pts87% (2,725/3,142)
Board ordered a new exam or addendum opinionProcedure37% (269/720)66% (5,943/9,035)-28 pts91% (7,151/7,898)
AMA favorable finding acknowledgedProcedure80% (1,400/1,760)60% (4,812/7,995)+19 pts36% (1,014/2,783)

"Granted" = share of issues decided on the merits (granted + denied); remands and dismissals are excluded from that fraction and shown separately. Fractions are the raw counts.

Increased rating for Sleep Apnea (n = 468)

When the record had…Granted, with itGranted, without itDifferenceRemanded, with it
Private physician opinion, letter or DBQEvidence in the record49% (19/39)28% (76/267)+20 pts11% (5/44)
Disability Benefits Questionnaire in the recordEvidence in the record31% (15/48)31% (80/258)+0 pts23% (15/64)
Board hearing held or testimony takenProcedure29% (19/66)32% (76/240)-3 pts25% (27/109)
Secondary service connection (38 CFR 3.310) in playTheory argued46% (45/98)24% (50/208)+22 pts13% (16/124)
A medical source gave a negative nexus opinionEvidence in the record47% (16/34)29% (79/272)+18 pts23% (11/47)
VA examination or VA medical opinion obtainedEvidence in the record32% (84/264)26% (11/42)+6 pts23% (81/353)
Benefit of the doubt resolved in the veteran's favorHow the Board read the record89% (32/36)23% (63/270)+66 pts3% (1/37)
Preponderance of the evidence against / doctrine not applicableHow the Board read the record13% (18/136)45% (77/170)-32 pts0% (0/137)

"Granted" = share of issues decided on the merits (granted + denied); remands and dismissals are excluded from that fraction and shown separately. Fractions are the raw counts.

All Sleep Apnea issues, every benefit type (n = 20,732)

When the record had…Granted, with itGranted, without itDifferenceRemanded, with it
A medical source gave a positive nexus opinionEvidence in the record82% (2,178/2,650)55% (4,539/8,249)+27 pts21% (705/3,362)
Private physician opinion, letter or DBQEvidence in the record80% (2,879/3,615)53% (3,838/7,284)+27 pts24% (1,141/4,767)
Disability Benefits Questionnaire in the recordEvidence in the record69% (805/1,174)61% (5,912/9,725)+8 pts35% (623/1,800)
Third-party lay statements (spouse, buddy, employer)Evidence in the record70% (1,389/1,972)60% (5,328/8,927)+11 pts33% (962/2,941)
Service treatment records document the condition or injuryEvidence in the record59% (1,726/2,904)62% (4,991/7,995)-3 pts29% (1,214/4,133)
Service treatment records silent for the conditionEvidence in the record44% (1,798/4,104)72% (4,919/6,795)-29 pts19% (993/5,109)
Continuity of symptoms argued (38 CFR 3.303(b))Theory argued49% (819/1,682)64% (5,898/9,217)-15 pts22% (468/2,155)
Board hearing held or testimony takenProcedure62% (2,553/4,086)61% (4,164/6,813)+1 pts36% (2,466/6,785)
Social Security records in the fileEvidence in the record23% (16/71)62% (6,701/10,828)-39 pts39% (50/128)
Medical literature or treatise citedEvidence in the record61% (2,478/4,056)62% (4,239/6,843)-1 pts39% (2,640/6,703)
Functional loss / DeLuca factors argued (rating cases)Theory argued64% (196/304)62% (6,521/10,595)+3 pts39% (197/507)
Presumptive service connection discussedTheory argued38% (741/1,945)67% (5,976/8,954)-29 pts30% (841/2,798)
Secondary service connection (38 CFR 3.310) in playTheory argued63% (3,938/6,210)59% (2,779/4,689)+4 pts45% (5,155/11,510)
Combat service / 1154(b) in playTheory argued61% (350/575)62% (6,367/10,324)-1 pts31% (267/861)
A medical source gave a negative nexus opinionEvidence in the record62% (4,210/6,811)61% (2,507/4,088)+0 pts40% (4,490/11,316)
No nexus opinion of recordEvidence in the record25% (117/470)63% (6,600/10,429)-38 pts31% (209/682)
VA examination or VA medical opinion obtainedEvidence in the record59% (5,202/8,754)71% (1,515/2,145)-11 pts45% (7,162/15,979)
Board found a VA exam or opinion inadequateHow the Board read the record71% (2,437/3,427)57% (4,280/7,472)+14 pts58% (4,812/8,256)
Board found the VA exam or opinion adequateHow the Board read the record41% (267/652)63% (6,450/10,247)-22 pts9% (61/714)
Board found the veteran's statements credibleHow the Board read the record83% (1,388/1,675)58% (5,329/9,224)+25 pts6% (112/1,791)
Board found the veteran's statements not credible or inconsistentHow the Board read the record14% (26/188)62% (6,691/10,711)-49 pts9% (18/207)
Benefit of the doubt resolved in the veteran's favorHow the Board read the record96% (3,158/3,276)47% (3,559/7,623)+50 pts1% (26/3,305)
Preponderance of the evidence against / doctrine not applicableHow the Board read the record7% (209/3,131)84% (6,508/7,768)-77 pts0% (8/3,145)
Duty-to-assist error foundHow the Board read the record66% (315/474)61% (6,402/10,425)+5 pts84% (2,782/3,296)
Board ordered a new exam or addendum opinionProcedure37% (277/756)63% (6,440/10,143)-27 pts90% (7,306/8,098)
AMA favorable finding acknowledgedProcedure79% (1,425/1,800)58% (5,292/9,099)+21 pts36% (1,017/2,828)

"Granted" = share of issues decided on the merits (granted + denied); remands and dismissals are excluded from that fraction and shown separately. Fractions are the raw counts.

Reading these tables honestly

Association, not cause. A positive nexus opinion appears in the records of granted appeals far more often than in denied ones. That does not mean any letter wins; it means the Board grants when the evidence supports the claim, and a nexus opinion is how that support usually reaches the file.

Appeals are not claims. Every decision here is an appealed denial. Grant rates at the Board say nothing about the share of initial claims VA grants.

Findings are outcomes in disguise. Rows under "how the Board read the record" — credibility, benefit of the doubt, an inadequate exam — describe how the judge decided, not evidence to gather. They are shown because they say which arguments the Board actually reaches for.

Detection is by text pattern. Each evidence type is found by reading the decision for finding-shaped language with negation handling; precision was read on samples before publication and is stated per feature in the method notes below. Expect a few percent of misclassified rows, not zero.

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See also: Sleep Apnea decisions · all conditions · outcome rates.