Citation Nr: 18140012 Decision Date: 10/02/18 Archive Date: 10/02/18 DOCKET NO. 16-03 421 DATE: October 2, 2018 REMANDED Entitlement to a rating in excess of 30 percent for Parkinson's disease is remanded. REASONS FOR REMAND The Veteran served on active duty from May 1969 to May 1973. This case comes before the Board of Veterans’ Appeals (Board) on appeal from a June 2014 rating decision by the Department of Veterans Affairs (VA). 1. Entitlement to a rating in excess of 30 percent for Parkinson's disease is remanded. The Veteran is currently assigned a 30 percent rating for his Parkinson’s disease under 38 C.F.R. § 4.124a, Diagnostic Code (DC) 8004. Under DC 8004, a minimum 30 percent rating is assigned if there are “ascertainable residuals” of the disability. VA must also analyze individual chronic symptoms residual to Parkinson’s disease under the appropriate DCs for that body system. See 38 C.F.R. 4.124a. In other words, the ratings schedule evaluates Parkinson’s based on its residuals. In accordance with the plain language of the diagnostic code, in order to receive the 30 percent minimum rating there must be at least one residual of Parkinson’s disease. If there is at least one residual, then DC 8004 acts as a ratings floor — regardless of the severity of the residuals, the mere fact that they are present entitles a veteran to at least a 30 percent rating. If the residuals, as evaluated pursuant to their own respective diagnostic codes or as rated by analogy, warrant a rating in excess of 30 percent, then DC 8004 is read in conjunction with 38 C.F.R. §§ 4.14 and 4.25(b), and the veteran is assigned separate ratings that do not overlap in symptoms. In a January 2016 statement, the Veteran explained that he disagreed with the original grant of a 30 percent rating for his Parkinson’s disease in part because he suffered from depression, sleep disturbance, urinary problems, and sexual dysfunction. With regards to the Veteran’s depression, the Board notes that he is separately compensated for a depressive disorder associated with his Parkinson’s disease. He has not disagreed with the assigned rating. As such, this issue is not on appeal. See Tyrues v. Shinseki, 23 Vet. App. 166, 176 (2009). As for his sleep disturbance, the Board notes that it is listed as a symptom of his depressive disorder and he has been diagnosed with obstructive sleep apnea. Therefore, additional compensation for a sleep disorder would constitute impermissible pyramiding. See 38 C.F.R. § 4.14. The Board notes that the Veteran’s claimed urinary problems and sexual dysfunction have not been previously addressed. A March 2016 VA medical record indicates that he has urinary incontinence. However, an October 2016 medical record contradicts this finding. Additionally, a May 2016 VA medical record includes the Veteran’s complaint of his inability to obtain an erection. The Board finds that a remand is necessary to determine whether he has urinary incontinence and, if so, the severity of the disorder. The examiner will also be asked to remark whether the Veteran’s erectile dysfunction is related to his Parkinson’s disease. See McLendon v. Nicholson, 20 Vet. App. 79, 83 (2006). The matter is REMANDED for the following action: 1. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any urinary incontinence and erectile dysfunction. The examiner must opine whether they are at least as likely as not related to an in-service injury, event, or disease, including the Veteran’s service-connected Parkinson’s disease and associated depressive disorder. 2. Given the progressive nature of the disorder, if any other residuals of Parkinson’s Disease have been identified in the record or by the Veteran, the RO should ensure that the appropriate disability ratings are assigned. All necessary development should be undertaken in this regard, to include any additional VA examinations. B.T. KNOPE Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Borman, Associate Counsel