Sailor’s snoring ruling overturned
A veteran sailor with serious snoring problems has convinced a Halifax panel that the shift work involved with going to sea aggravated his obstructive sleep apnea.
The 49-year-old, who served in the Royal Canadian Navy’s regular force for nearly three decades, is not identified in the recent decision from the Veterans Review and Appeal Board, which made his disability benefit for pain and suffering retroactive to May 2022.
“The veteran draws a service connection as, ‘Developed over years of serving in a sleep deprived environment, working shift work onboard ships,” said the panel’s decision.
Veterans Affairs Canada denied his claim in November 2022.
A doctor who checked him out when he joined the military in November 1993 did not identify any pre-existing respiratory concerns.
SORE THROATS AND SLEEPINESS
“In 2016, you were referred for a sleep study due to complaints of snoring, sore throats in the morning and daytime sleepiness,” said the panel’s decision.
The same referral notes the sailor had a high body mass index at that time. That’s a measure of body fat based on height and weight.
In December of 2017, he was diagnosed with obstructive sleep apnea, but Veterans Affairs said there was no evidence to prove that the shift work and sleep deprivation he experienced at sea caused the problem.
Obstructive sleep apnea is a common chronic condition affecting between three and seven per cent of men in Western countries, according to the U.S. Government’s National Library of Medicine.
PUT ON WEIGHT AT SEA
On appeal, the veteran argued successfully that his 14 years of shift work in the Navy caused the problem.
The sonar operator first raised the issue in October of 2016. He had returned to duties aboard a warship after completing a posting on land for a couple of years.
The sailor had put on 25 pounds since returning to sea and was experiencing stress due to high workload and poor-quality sleep, said the panel’s decision.
“The diagnosis of the veteran’s condition and that it constitutes a permanent disability is not in dispute. He testified that the sleep apnea machine that he now wears at night has affected his quality of life in various ways such as he and his spouse cannot sleep in the same room and he cannot enjoy camping or scouting the way he used to,” said the panel.
“The remaining question to be determined is whether a service relationship can be established for the claimed condition.”
‘STOPPED BREATHING’
The veteran sailor told the panel that by January or February of 2016, “he began to have what he thought at the time were anxiety attacks, which would interrupt his sleep at home. In hindsight, these interruptions in his sleep were caused by his body reacting to him having stopped breathing. He continued to soldier on, but eventually sought medical attention in October 2016.”
During his career, the sailor completed eight sea postings.
“In addition to the shift work while at sea, he also spent two and a half years at a land posting in the United States, which involved shift work,” said the panel.
The sailor calculated he spent 11 to 12 years of his time in uniform serving on different warships.
When he got out of the Navy in December of 2022, the sailor’s body mass index was 38.06. When he joined in November of 1993, it was 35.7, and a military doctor described him as “obese but fit.”
‘RISK FACTORS’
A sleep study he underwent in December of 2016 noted the sailor’s neck size was 18 inches.
“The Merck Manual Professional Edition lists a neck size of greater than 17 inches as one of the anatomic risk factors for obstructive sleep apnea,” said the panel.
“No medical opinion on file grapples with the veteran’s BMI at enrolment or his neck size as risk factors.”
In previous cases in front of the appeal board, shift work was “found to aggravate but not cause” obstructive sleep apnea, said the panel.
It reversed the Veterans Affairs decision of November 2022, granting “entitlement in the amount of four-fifths for aggravation of” his sleep apnea.
‘AROSE OUT OF SERVICE’
“In drawing these conclusions, the panel gives the veteran every benefit of its doubt, draws all inferences favourable to the veteran and accepts the veteran’s uncontradicted evidence, both written and oral, as fact,” said the panel, which concluded that his sleep apnea “arose out of service in the regular force.”
Veterans Affairs wouldn’t comment on the specific case for privacy reasons.
But it pointed out that there’s a second hurdle former military folks and retired RCMP officers must clear before getting compensation for service-related issues that cause them pain and suffering.
“A condition that is fully related to service would receive full entitlement (fivefifths) while a condition that is aggravated by service or partially a consequence of a service-related condition would receive four-fifths,” Marc Lescoutre, who speaks for Veterans Affairs, said in an email.
“If entitlement is granted, the decision-maker will review the medical evidence on file and quality of life information to determine the level of an impairment and the impact on the veteran’s or member’s quality of life. The ratings for medical impairment and quality of life are added together to determine the assessment percentage.”