Citation Nr: 20003328 Decision Date: 01/15/20 Archive Date: 01/14/20 DOCKET NO. 19-20 476 DATE: January 15, 2020 ORDER Entitlement to a compensable evaluation for sexual dysfunction is denied. A 50 percent evaluation, but no higher, for unspecified depressive disorder is granted. Entitlement to an evaluation greater than 100 percent for Parkinson's disease with loss of use of the bilateral lower extremities is denied. Entitlement to an evaluation greater than 10 percent for anosmia (loss of sense of smell) is denied. Entitlement to an evaluation greater than 10 percent for ageusia (complete lack of taste) is denied. Entitlement to an effective date prior to March 9, 2017, for the grant of service connection for sexual dysfunction is denied. Entitlement to an effective date prior to March 9, 2017, for the grant of service connection for loss of automatic movements (masked facies, fixed gaze and blinking) of the right side is denied. Entitlement to an effective date prior to March 9, 2017, for the grant of service connection for unspecified depressive disorder is denied. Entitlement to an effective date prior to March 9, 2017, for the grant of service connection for disturbances of bowel function is denied. Entitlement to an effective date prior to March 9, 2017, for the grant of service connection for speech changes with difficulty chewing and swallowing is denied. Entitlement to an effective date prior to March 9, 2017, for the grant of service connection for Parkinson’s disease with loss of use of lower extremities is denied. Entitlement to an effective date prior to March 9, 2017, for the grant of service connection for loss of automatic movements (masked facies, fixed gaze and blinking) of the left side is denied. Entitlement to an effective date prior to March 9, 2017, for the grant of service connection for anosmia (loss of sense of smell) is denied. Entitlement to an effective date prior to March 9, 2017, for the grant of service connection for ageusia (complete lack of taste) is denied. Entitlement to an effective date prior to March 9, 2017, for the grant of service connection for tremor with muscle rigidity and stiffness of the right upper extremity is denied. Entitlement to an effective date prior to March 9, 2017, for the grant of service connection for tremor with muscle rigidity and stiffness of the left upper extremity is denied. Entitlement to an effective date prior to March 9, 2017, for the grant of Dependents' Educational Assistance is denied. Entitlement to an effective date prior to March 9, 2017, for the grant of specially adapted housing is denied. Entitlement to an effective date prior to March 9, 2017, for the grant of automobile or other conveyance and adaptive equipment is denied. Entitlement to an effective date prior to March 9, 2017, for the grant of special monthly compensation based on loss of use of a creative organ and the bilateral lower extremities is denied. REMANDED Entitlement to an evaluation greater than 10 percent for loss of automatic movements (masked facies, fixed gaze and blinking) of the right side is remanded. Entitlement to an evaluation greater than 10 percent for loss of automatic movements (masked facies, fixed gaze and blinking) of the left side is remanded. Entitlement to an evaluation greater than 10 percent for disturbances of bowel function is remanded. Entitlement to an evaluation greater than 10 percent for speech changes with difficulty chewing and swallowing is remanded. Entitlement to an evaluation greater than 30 percent for tremor with muscle rigidity and stiffness of the right upper extremity is remanded. Entitlement to an evaluation greater than 20 percent for tremor with muscle rigidity and stiffness of the left upper extremity is remanded. FINDINGS OF FACT 1. The Veteran’s sexual dysfunction symptoms do not more nearly approximate an internal or external penile deformity. 2. The severity, frequency, and duration of the Veteran’s unspecified depressive disorder symptoms more closely approximate occupational and social impairment with reduced reliability and productivity. 3. The Veteran’s Parkinson’s disease with loss of use of lower extremities has been assigned a 100 percent rating, the maximum rating authorized under Diagnostic Code 5110. 4. The Veteran’s anosmia has been assigned a 10 percent rating, the maximum rating authorized under Diagnostic Code 6275. 5. The Veteran’s ageusia has been assigned a 10 percent rating, the maximum rating authorized under Diagnostic Code 6276. 6. The Veteran’s claim of entitlement to service connection for Parkinson’s disease was received on March 9, 2017. 7. Service connection for sexual dysfunction, bilateral loss of automatic movements (masked facies, fixed gaze and blinking), unspecified depressive disorder, disturbances of bowel function, speech changes with difficulty chewing and swallowing, anosmia, ageusia, tremor with muscle rigidity and stiffness of the bilateral upper extremities, and the grants of Dependents’ Educational Assistance; specially adapted housing; automobile or other conveyance and adaptive equipment; and, special monthly compensation based on loss of use of a creative organ and the bilateral lower extremities were granted as a result of the award of service connection for Parkinson’s disease. CONCLUSIONS OF LAW 1. The criteria for a compensable rating for sexual dysfunction are not met. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.321, 4.3, 4.7, 4.20, 4.115b, Diagnostic Codes 7599-7522. 2. The criteria for a disability rating of 50 percent, but no higher, for unspecified depressive disorder have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.126, 4.130, Diagnostic Code 9435. 3. There is no legal basis for the assignment of a schedular evaluation in excess of 100 percent for the Veteran’s Parkinson’s disease with loss of use of the lower extremities. 38 U.S.C. §§ 1155, 5103, 5103A, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.6, 4.7, 4.71a, Diagnostic Code 5110. 4. There is no legal basis for the assignment of a schedular evaluation in excess of 10 percent for the Veteran’s anosmia. 38 U.S.C. §§ 1155, 5103, 5103A, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.6, 4.7, 4.88a, Diagnostic Code 6275. 5. There is no legal basis for the assignment of a schedular evaluation in excess of 10 percent for the Veteran’s ageusia. 38 U.S.C. §§ 1155, 5103, 5103A, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.6, 4.7, 4.88a, Diagnostic Code 6276. 6. The criteria for an effective date prior to March 9, 2017, for the grant of service connection for sexual dysfunction have not been met. 38 U.S.C. §§ 5100, 5102, 5103, 5103A, 5103A, 5107, 5110, 5126, 7105; 38 C.F.R. §§ 3.102, 3.155, 3.156, 3.157, 3.159, 3.326(a), 3.400. 7. The criteria for an effective date prior to March 9, 2017, for the grant of service connection for loss of automatic movements (masked facies, fixed gaze and blinking) of the right side have not been met. 38 U.S.C. §§ 5100, 5102, 5103, 5103A, 5103A, 5107, 5110, 5126, 7105; 38 C.F.R. §§ 3.102, 3.155, 3.156, 3.157, 3.159, 3.326(a), 3.400. 8. The criteria for an effective date prior to March 9, 2017, for the grant of service connection for unspecified depressive disorder have not been met. 38 U.S.C. §§ 5100, 5102, 5103, 5103A, 5103A, 5107, 5110, 5126, 7105; 38 C.F.R. §§ 3.102, 3.155, 3.156, 3.157, 3.159, 3.326(a), 3.400. 9. The criteria for an effective date prior to March 9, 2017, for the grant of service connection for disturbances of bowel function have not been met. 38 U.S.C. §§ 5100, 5102, 5103, 5103A, 5103A, 5107, 5110, 5126, 7105; 38 C.F.R. §§ 3.102, 3.155, 3.156, 3.157, 3.159, 3.326(a), 3.400. 10. The criteria for an effective date prior to March 9, 2017, for the grant of service connection for speech changes with difficulty chewing and swallowing have not been met. 38 U.S.C. §§ 5100, 5102, 5103, 5103A, 5103A, 5107, 5110, 5126, 7105; 38 C.F.R. §§ 3.102, 3.155, 3.156, 3.157, 3.159, 3.326(a), 3.400. 11. The criteria for an effective date prior to March 9, 2017, for the grant of service connection for Parkinson’s disease with loss of use of lower extremities have not been met. 38 U.S.C. §§ 5100, 5102, 5103, 5103A, 5103A, 5107, 5110, 5126, 7105; 38 C.F.R. §§ 3.102, 3.155, 3.156, 3.157, 3.159, 3.326(a), 3.400. 12. The criteria for an effective date prior to March 9, 2017, for the grant of service connection for loss of automatic movements (masked facies, fixed gaze and blinking) of the left side have not been met. 38 U.S.C. §§ 5100, 5102, 5103, 5103A, 5103A, 5107, 5110, 5126, 7105; 38 C.F.R. §§ 3.102, 3.155, 3.156, 3.157, 3.159, 3.326(a), 3.400. 13. The criteria an effective date prior to March 9, 2017, for the grant of service connection for anosmia (loss of sense of smell) have not been met. 38 U.S.C. §§ 5100, 5102, 5103, 5103A, 5103A, 5107, 5110, 5126, 7105; 38 C.F.R. §§ 3.102, 3.155, 3.156, 3.157, 3.159, 3.326(a), 3.400. 14. The criteria for an effective date prior to March 9, 2017, for the grant of service connection for ageusia (complete lack of taste) have not been met. 38 U.S.C. §§ 5100, 5102, 5103, 5103A, 5103A, 5107, 5110, 5126, 7105; 38 C.F.R. §§ 3.102, 3.155, 3.156, 3.157, 3.159, 3.326(a), 3.400. 15. The criteria for an effective date prior to March 9, 2017, for the grant of service connection for tremor with muscle rigidity and stiffness of the left upper extremity have not been met. 38 U.S.C. §§ 5100, 5102, 5103, 5103A, 5103A, 5107, 5110, 5126, 7105; 38 C.F.R. §§ 3.102, 3.155, 3.156, 3.157, 3.159, 3.326(a), 3.400. 16. The criteria for an effective date prior to March 9, 2017, for the grant of service connection for tremor with muscle rigidity and stiffness of the right upper extremity have not been met. 38 U.S.C. §§ 5100, 5102, 5103, 5103A, 5103A, 5107, 5110, 5126, 7105; 38 C.F.R. §§ 3.102, 3.155, 3.156, 3.157, 3.159, 3.326(a), 3.400. 17. The criteria for an effective date prior to March 9, 2017, for the grant of Dependents’ Educational Assistance have not been met. 38 U.S.C. §§ 5100, 5102, 5103, 5103A, 5103A, 5107, 5110, 5126, 7105; 38 C.F.R. §§ 3.102, 3.155, 3.156, 3.157, 3.159, 3.326(a), 3.400. 18. The criteria for an effective date prior to March 9, 2017, for the grant of specially adapted housing have not been met. 38 U.S.C. §§ 5100, 5102, 5103, 5103A, 5103A, 5107, 5110, 5126, 7105; 38 C.F.R. §§ 3.102, 3.155, 3.156, 3.157, 3.159, 3.326(a), 3.400. 19. The criteria for an effective date prior to March 9, 2017, for the grant of automobile or other conveyance and adaptive equipment have not been met. 38 U.S.C. §§ 5100, 5102, 5103, 5103A, 5103A, 5107, 5110, 5126, 7105; 38 C.F.R. §§ 3.102, 3.155, 3.156, 3.157, 3.159, 3.326(a), 3.400. 20. The criteria for an effective date prior to March 9, 2017, for the grant of special monthly compensation based on loss of use of a creative organ and the bilateral lower extremities have not been met. 38 U.S.C. §§ 5100, 5102, 5103, 5103A, 5103A, 5107, 5110, 5126, 7105; 38 C.F.R. §§ 3.102, 3.155, 3.156, 3.157, 3.159, 3.326(a), 3.400. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service in the United States Army from April 1978 to February 1988. These matters are on appeal from a May 2017 rating decision. In May 2018, the Board remanded the issues of entitlement to increased evaluations for a back disability, right knee disability, left knee disability, hypertension, and left carotid endarterectomy, and entitlement to a total disability rating based on individual unemployability for additional evidentiary development. These matters are still before the Agency of Original Jurisdiction and have not been recertified to the Board. They will be addressed in a future Board decision. Increased Evaluations In general, disability evaluations are determined by the application of a schedule of ratings, which is based on the average impairment of earning capacity caused by a given disability. Separate diagnostic codes identify the various disabilities. 38 U.S.C. § 1155; 38 C.F.R. Part 4. Where there is a question as to which of two ratings shall be applied, the higher rating will be assigned if the disability more closely approximates the criteria for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. When there is an approximate balance of positive and negative evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each such issue shall be given to the claimant. 38 U.S.C. § 5107(b); 38 C.F.R. §§ 3.102, 4.3. In evaluating the severity of a particular disability, it is essential to consider its history. 38 C.F.R. § 4.1; Peyton v. Derwinski, 1 Vet. App. 282 (1991). Where an appeal is from the initial rating assigned with the award of service connection, separate “staged” ratings may be assigned for separate periods of time based on the facts found. Fenderson v. West, 12 Vet. App. 119, 126-127 (1999). 1. Entitlement to a compensable evaluation for sexual dysfunction. In May 2017, the Veteran was granted service connection for sexual dysfunction and assigned a zero percent evaluation pursuant to Diagnostic Codes 7599-7522. Further, special monthly compensation based on the loss of use of a creative organ has been established. As there is no specific disability rating for sexual dysfunction in the VA Rating Schedule, the Veteran’s service-connected sexual dysfunction is rated by analogy under 38 C.F.R. § 4.115b, Diagnostic Codes 7599-7522, referring to deformity of the penis with loss of erectile power. Hyphenated diagnostic codes are used when a rating under one diagnostic code requires use of an additional diagnostic code to identify the basis for the evaluation assigned; the additional code is shown after the hyphen. Diagnostic Code 7599 is used to identify unlisted genitourinary disabilities not specifically listed in the VA Rating Schedule. See 38 C.F.R. §§ 4.20, 4.27, Diagnostic Code 7522 is used to rate deformity of the penis with loss of erectile power. In every instance where the schedule does not provide a zero percent evaluation for a diagnostic code, a zero percent evaluation shall be assigned when the requirements for a compensable evaluation are not met. See 38 C.F.R. § 4.31. Under Diagnostic Code 7522, the only schedular evaluation available is a 20 percent rating for a deformity of the penis with loss of erectile power. As “deformity” is not defined in the rating criteria, the term is given its ordinary meaning. See Prokarym v. McDonald, 27 Vet. App. 307, 310 (2015). In medical terminology, a “deformity” is a “distortion of any part or general disfigurement of the body.” See Dorland’s Illustrated Medical Dictionary 478 (32 ed. 2012). In this regard, the Board notes its reliance on a medical dictionary to define a term is appropriate. 38 C.F.R. § 20.903(b)(2) (while Board consideration of a medical treatise requires notice to the Veteran and his representative, such notice is not required if the Board uses the treatise or a medical dictionary for the limited purpose of defining a medical term and that definition is not material to the Board’s disposition of the appeal). Furthermore, a “deformity” under Diagnostic Codes 7599-7522 means either an internal or external distortion of the penis. See Williams v. Wilkie, 30 Vet. App. 134, 138 (2018). In this case, a noncompensable rating was assigned, even though the schedule did not provide criteria for one, because the requirements for the only compensable evaluation were not met. 38 C.F.R. § 4.31. A footnote to Diagnostic Code 7522 also instructs the rater to review the claim for entitlement to Special Monthly Compensation under 38 C.F.R. § 3.350. Here, the Veteran was granted Special Monthly Compensation for loss of use of a creative organ, effective March 9, 2017, which is the same effective date as his noncompensable evaluation for service-connected erectile dysfunction. The issue is therefore whether the evidence more nearly approximates penile deformity to meet the compensable rating criteria of Diagnostic Codes 7599-7522. For the following reasons, a compensable rating for service-connected sexual dysfunction is not warranted. In April 2017, the Veteran was afforded a VA examination. The VA examiner indicated that the Veteran had severe sexual dysfunction due to Parkinson’s disease that was manifested by erectile dysfunction that precluded sexual intercourse. There is no indication that the Veteran had penile deformity and he did not report any penile deformity at the examination. The Board is sympathetic to the Veteran’s difficulties, but it is bound by the laws and regulations that apply to veterans claims. 38 U.S.C. § 7104 (c); 38 C.F.R. §§ 19.5, 20.101(a). Those laws and regulations provide a compensable rating for erectile dysfunction only with deformity of the penis with loss of erectile power. Even considering the broad definition of deformity including internal or external deformity, there is no evidence of record, including medical and lay evidence, describing any physical deformity related to the Veteran’s penis, either internal or external, at any time during the appeal period. The symptoms to which the Veteran refers are specifically contemplated by the footnote to Diagnostic Code 7522 that provides for consideration of Special Monthly Compensation based on loss of use of a creative organ and that benefit was granted along with service connection for erectile dysfunction with the same effective date. Moreover, there is no other potentially applicable diagnostic code that would warrant a higher rating. For the foregoing reasons, the preponderance of the evidence is against a compensable rating for sexual dysfunction. The benefit of the doubt doctrine is therefore not for application and the claim must be denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 4.3. 2. Entitlement to an evaluation greater than 30 percent for unspecified depressive disorder. The Veteran contends that he is entitled to an increased evaluation for his unspecified depressive disorder. Under the General Formula for Mental Disorders (General Formula), the Board must conduct a “holistic analysis” that considers all associated symptoms, regardless of whether they are listed as criteria. Bankhead v. Shulkin, 29 Vet. App. 10, 22 (2017); 38 C.F.R. § 4.130. The Board must determine whether unlisted symptoms are similar in severity, frequency, and duration to the listed symptoms associated with specific disability percentages. Then, the Board must determine whether the associated symptoms, both listed and unlisted, caused the level of impairment required for a higher disability rating. Vazquez-Claudio v. Shinseki, 713 F.3d 112, 114-118 (Fed. Cir. 2013). The issue in this appeal is whether the Veteran’s associated symptoms caused the level of impairment required for a disability rating of 50 percent or higher. The Board concludes that the Veteran’s symptoms cause the level of impairment required for a disability rating of 50 percent, but no higher. The Veteran’s symptoms more closely approximate the symptoms associated with a 50 percent rating and result in a level of impairment that most closely approximates the level of impairment associated with a 50 percent rating. A 30 percent rating is assigned when symptoms such as depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, or mild memory loss (such as forgetting names, directions, or recent events), cause occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and normal conversation). A 50 percent rating is assigned when symptoms such as flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; or difficulty in establishing and maintaining effective work and social relationships cause occupational and social impairment with reduced reliability and productivity. A 70 percent rating is assigned when symptoms such as suicidal ideation; obsessional rituals which interfere with routine activities; intermittently illogical, obscure, or irrelevant speech; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); or inability to establish and maintain effective relationships cause occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood. A 100 percent rating is assigned when symptoms such as gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; or memory loss for names of close relatives, own occupation or own name cause total occupational and social impairment. In April 2017, the Veteran was afforded a VA examination. The VA examiner diagnosed unspecified depressive disorder. The Veteran was neat and clean at the examination. He was confused at times and his wife helped with the questions. No thought disorders were noted, and he was oriented to person, place, and time. The Veteran’s symptoms included: depressed mood; suspiciousness; chronic sleep impairment; mild memory loss, such as forgetting names, directions or recent events; and, impairment of short- and long-term memory, for example, retention of only highly learned material, while forgetting to complete tasks. He concluded that the Veteran’s unspecified depressive disorder was productive of occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or; symptoms controlled by medication. The Veteran also underwent a Parkinson’s disease examination in April 2017. The VA examiner noted severe depression with mild cognitive impairment or dementia. The Veteran’s VA treatment records document that he denied suicidal ideation and feeling hopeless in February 2017. However, the Veteran indicated that he had little interest in doing things nearly every day and felt depressed nearly every day. December 2018 private treatment records show the Veteran’s depression was stable. The Board finds the level of impairment caused by the Veteran’s symptoms more closely approximates the level associated with a 50 percent rating. The Board acknowledges that the April 2017 VA examiner found that the Veteran’s unspecified depressive disorder was productive of occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or; symptoms controlled by medication. However, the VA examiner also noted that the Veteran’s long- and short-term memory were impaired such that he only retained highly learned tasks. He was confused during his interview and required the assistance of his wife to answer. Additionally, the treatment records associated with the file reflect daily depression and a daily loss of motivation to do things. The Veteran experienced occupational and social impairment with reduced reliability and productivity. However, the Board finds that the evidence is against the assignment of a higher 70 percent evaluation. Throughout the appeal period, the Veteran has not demonstrated any symptoms contemplated under the 70 percent criteria and his unspecified depressive disorder has not caused occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood. As stated above, the April 2017 VA examiner found that the Veteran’s unspecified depressive disorder was productive of occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or; symptoms controlled by medication. None of the physicians who examined the Veteran found that his unspecified depressive disorder caused occupational and social impairment with deficiencies in most areas. In reaching its decision, the Board has considered the lay statements of record. However, the lay statements of record are lacking in detail to support an evaluation greater than 50 percent for unspecified depressive disorder. A disability rating of 50 percent, but no higher, for unspecified depressive disorder is granted. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.126, 4.130, Diagnostic Code 9435. 3. Entitlement to an evaluation greater than 100 percent for Parkinson's disease with loss of use of lower extremities. In a May 2017 rating decision, the Veteran was granted service connection for Parkinson’s disease with loss of use of lower extremities and assigned a 100 percent evaluation under Diagnostic Code 5110, effective March 9, 2017. Diagnostic Code 5110 provides a maximum rating of 100 percent for loss of use of both feet. As such, the Veteran is currently in receipt of the maximum disability evaluation available for this disability under Diagnostic Code 5110. 38 C.F.R. § 4.71a. In summary, there is no legal entitlement to an initial rating in excess of 100 percent for Parkinson’s disease with loss of use of lower extremities. The Board has carefully reviewed the rating schedule and finds no other Diagnostic Code that would provide a basis to grant a higher evaluation for this disability. In essence, the Veteran currently has the highest possible schedular rating provided for Parkinson’s disease with loss of use of lower extremities. Thus, the Board has no alternative but to deny the claim. See Sabonis v. Brown, 6 Vet. App. 426 (1994) (where the law is dispositive, the claim must be denied due to an absence of legal entitlement). Consequently, a rating in excess of 100 percent for Parkinson’s disease with loss of use of lower extremities is not warranted. 4. Entitlement to an evaluation greater than 10 percent for anosmia (loss of sense of smell). In a May 2017 rating decision, the Veteran was granted service connection for anosmia and assigned a 10 percent evaluation under Diagnostic Code 6275, effective March 9, 2017. Diagnostic Code 6275 provides a maximum rating of 10 percent for complete loss of smell. As such, the Veteran is currently in receipt of the maximum disability evaluation available for this disability under Diagnostic Code 6275. 38 C.F.R. § 4.88a. In summary, there is no legal entitlement to an initial rating in excess of 10 percent for anosmia. The Board has carefully reviewed the rating schedule and finds no other Diagnostic Code that would provide a basis to grant a higher evaluation for this disability. In essence, the Veteran currently has the highest possible schedular rating provided for anosmia. Thus, the Board has no alternative but to deny the claim. See Sabonis, 6 Vet. App. at 426. Consequently, a rating in excess of 10 percent for anosmia is not warranted. 5. Entitlement to an evaluation greater than 10 percent for ageusia (complete lack of taste). In a May 2017 rating decision, the Veteran was granted service connection for ageusia and assigned a 10 percent evaluation under Diagnostic Code 6276, effective March 9, 2017. Diagnostic Code 6276 provides a maximum rating of 10 percent for complete loss of sense of taste. As such, the Veteran is currently in receipt of the maximum disability evaluation available for this disability under Diagnostic Code 6276. 38 C.F.R. § 4.88a. In summary, there is no legal entitlement to an initial rating in excess of 10 percent for ageusia. The Board has carefully reviewed the rating schedule and finds no other Diagnostic Code that would provide a basis to grant a higher evaluation for this disability. In essence, the Veteran currently has the highest possible schedular rating provided for ageusia. Thus, the Board has no alternative but to deny the claim. See Sabonis, 6 Vet. App. at 426. Consequently, a rating in excess of 10 percent for ageusia is not warranted.   Earlier Effective Dates 6. Entitlement to an effective date prior to March 9, 2017, for the grant of service connection for sexual dysfunction. 7. Entitlement to an effective date prior to March 9, 2017, for the grant of service connection for loss of automatic movements (masked facies, fixed gaze and blinking) of the right side. 8. Entitlement to an effective date prior to March 9, 2017, for the grant of service connection for unspecified depressive disorder. 9. Entitlement to an effective date prior to March 9, 2017, for the grant of service connection for disturbances of bowel function. 10. Entitlement to an effective date prior to March 9, 2017, for the grant of service connection for speech changes with difficulty chewing and swallowing. 11. Entitlement to an effective date prior to March 9, 2017, for the grant of service connection for Parkinson’s disease with loss of use of lower extremities. 12. Entitlement to an effective date prior to March 9, 2017, for the grant of service connection for loss of automatic movements (masked facies, fixed gaze and blinking) of the left side. 13. Entitlement to an effective date prior to March 9, 2017, for the grant of service connection for anosmia (loss of sense of smell). 14. Entitlement to an effective date prior to March 9, 2017, for the grant of service connection for ageusia (complete lack of taste). 15. Entitlement to an effective date prior to March 9, 2017, for the grant of service connection for tremor with muscle rigidity and stiffness of the left upper extremity. 16. Entitlement to an effective date prior to March 9, 2017, for the grant of service connection for tremor with muscle rigidity and stiffness of the right upper extremity. 17. Entitlement to an effective date prior to March 9, 2017, for the grant of Dependents’ Educational Assistance. 18. Entitlement to an effective date prior to March 9, 2017, for the grant of specially adapted housing. 19. Entitlement to an effective date prior to March 9, 2017, for the grant of automobile or other conveyance and adaptive equipment. 20. Entitlement to an effective date prior to March 9, 2017, for the grant of special monthly compensation based on loss of use of a creative organ and the bilateral lower extremities. The Veteran asserts that he is entitled to an effective date prior to March 9, 2017, for the grant of service connection for sexual dysfunction, bilateral loss of automatic movements (masked facies, fixed gaze and blinking), unspecified depressive disorder, disturbances of bowel function, speech changes with difficulty chewing and swallowing, Parkinson’s disease with loss of use of lower extremities, anosmia, ageusia, tremor with muscle rigidity and stiffness of the bilateral upper extremities; and the grants of Dependents’ Educational Assistance; specially adapted housing; automobile or other conveyance and adaptive equipment; and, special monthly compensation based on loss of use of a creative organ and the bilateral lower extremities. Generally, except as otherwise provided, the effective date of an award of compensation based on an original claim will be the day following separation from active service or the date entitlement arose, if the claim is received within one year after separation from service; otherwise, the date of receipt of the claim, or the date entitlement arose, whichever is later. See 38 U.S.C. § 5110(a); 38 C.F.R. § 3.400. Effective March 24, 2015, VA amended its regulations to require that all claims governed by VA’s adjudication regulations be filed on a standard form. The amendments implement the concept of an intent to file a claim for benefits, which operates similarly to the informal claim process, but requires that the submission establishing a claimant’s effective date of benefits must be received in one of three specified formats. The amendments also eliminate the constructive receipt of VA reports of hospitalization or examination and other medical records as informal claims to reopen under 38 C.F.R. § 3.157. See 79 Fed. Reg. 57,660 (Sept. 25, 2014) (now codified at 38 C.F.R. §§ 3.1 (p), 3.151, 3.155). Initially, the Veteran filed a claim for service connection for depression on March 27, 2014. The claim was denied in a September 2014 rating decision. The Veteran filed a timely notice of disagreement in April 2015. On March 9, 2017, VA received an intent to file a claim for compensation from the Veteran. A statement of the case was issued with regard to the issue of entitlement to service connection for depression and the Veteran perfected his appeal with a timely VA Form 9. The Veteran’s claims were granted in a May 2017 rating decision. The Veteran was granted service connection for Parkinson’s disease and the other awards were granted secondary to the Veteran’s Parkinson’s disease. There is no basis for an earlier effective date for the grant of service connection for Parkinson’s disease. There are no claims for Parkinson’s disease that were received prior to the Veteran’s March 9, 2017, intent to file. A secondarily service-connected disability cannot have an effective date earlier than the underlying disability because entitlement to secondary service connection does not arise until the underlying disability is service-connected. See 38 C.F.R. §§ 3.310, 3.400. Therefore, earlier effective dates for the grants of service connection for sexual dysfunction, bilateral loss of automatic movements (masked facies, fixed gaze and blinking), unspecified depressive disorder, disturbances of bowel function, speech changes with difficulty chewing and swallowing, anosmia, ageusia, and tremor with muscle rigidity and stiffness of the bilateral upper extremities may not be awarded. Additionally, the grants of Dependents’ Educational Assistance; specially adapted housing; automobile or other conveyance and adaptive equipment; and, special monthly compensation based on loss of use of a creative organ and the bilateral lower extremities were granted as a result of the award of service connection for Parkinson’s disease. Therefore, the dates of entitlement for these awards is March 9, 2017, and earlier effective dates may not be assigned. In sum, the Veteran is not entitled to earlier effective dates of March 9, 2017, for the grants of service connection for sexual dysfunction, bilateral loss of automatic movements (masked facies, fixed gaze and blinking), unspecified depressive disorder, disturbances of bowel function, speech changes with difficulty chewing and swallowing, Parkinson’s disease with loss of use of lower extremities, anosmia, ageusia, tremor with muscle rigidity and stiffness of the bilateral upper extremities; and, the grants of Dependents’ Educational Assistance; specially adapted housing; automobile or other conveyance and adaptive equipment; and, special monthly compensation based on loss of use of a creative organ and the bilateral lower extremities. The claims are denied. See 38 U.S.C. § 5107(b).   REASONS FOR REMAND 1. Entitlement to an evaluation greater than 10 percent for loss of automatic movements (masked facies, fixed gaze and blinking) of the right side is remanded. 2. Entitlement to an evaluation greater than 10 percent for loss of automatic movements (masked facies, fixed gaze and blinking) of the left side is remanded. 3. Entitlement to an evaluation greater than 10 percent for disturbances of bowel function is remanded. 4. Entitlement to an evaluation greater than 10 percent for speech changes with difficulty chewing and swallowing is remanded. 5. Entitlement to an evaluation greater than 30 percent for tremor with muscle rigidity and stiffness of the right upper extremity is remanded. 6. Entitlement to an evaluation greater than 20 percent for tremor with muscle rigidity and stiffness of the left upper extremity is remanded. Loss of automatic movement (masked facies, fixed gaze and blinking), disturbances of bowel function, speech changes with difficulty chewing and swallowing, and tremor with muscle rigidity and stiffness of the bilateral upper extremities were noted at the Veteran’s April 2017 Parkinson’s examination. No other examination reports are associated with the record that address the Veteran’s loss of automatic movement (masked facies, fixed gaze and blinking), disturbances of bowel function, speech changes with difficulty chewing and swallowing, and tremor with muscle rigidity and stiffness of the bilateral upper extremities. The April 2017 Parkinson’s examination does not address the applicable rating criteria for the Veteran’s loss of automatic movement (masked facies, fixed gaze and blinking), disturbances of bowel function, speech changes with difficulty chewing and swallowing, and tremor with muscle rigidity and stiffness of the bilateral upper extremities. A remand is required to afford the Veteran adequate VA examinations. The matters are REMANDED for the following actions: 1. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected bilateral loss of automatic movements (masked facies, fixed gaze and blinking). The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran’s disability under the rating criteria. 2. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected disturbances of bowel function. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran’s disability under the rating criteria. 3. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected speech changes with difficulty chewing and swallowing. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran’s disability under the rating criteria. 4. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected tremor with muscle rigidity and stiffness of the bilateral upper extremities. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran’s disability under the rating criteria. 5. After the above development, and any additionally indicated development, has been completed, readjudicate the issues on appeal. If the benefits sought are not granted to the Veteran’s satisfaction, send the Veteran and his representative a Supplemental Statement of the Case and provide an opportunity to respond. If necessary, return the case to the Board for further appellate review. DAVID L. WIGHT Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board R.R. Watkins, Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.