Citation Nr: 21075248
Decision Date: 12/20/21	Archive Date: 12/20/21

DOCKET NO. 19-02 507
DATE: December 20, 2021

REMANDED

The claim of entitlement to service connection for manifestations of Parkinson's disease, including hydrocephalus, is remanded.

REASONS FOR REMAND

The Veteran serviced on active duty from June 1960 to August 1982. 

This appeal is from a September 2018 rating decision.

In November 2020, the Veteran had a personal hearing before the undersigned Veteran Law Judge; a transcript is of record.

In January 2021, the Board remanded the claim on appeal to the agency of original jurisdiction (AOJ) for further development.  After completing additional development, the AOJ continued to deny the claim (as reflected in a March 2021 supplemental SOC) and returned these matters to the Board for further appellate consideration.

The claim of entitlement to service connection for manifestations of Parkinson's disease, including hydrocephalus, is remanded.

The September 2018 rating decision denied service connection for symptoms of Parkinson's disease.  The Veteran timely appealed and, prior to the appeal reaching the Board, he was granted service connection for multiple manifestations of Parkinson's disease.  The Veteran is seeking service connection for all manifestations of Parkinson's disease, including hydrocephalus.  

The Board's January 2021 decision determined that a remand was necessary to obtain a comprehensive examination with "a full report on all manifestations of Parkinson's and an opinion on whether the hydrocephalus is also a manifestation that is causing Parkinson's."  The remand instructions required an appropriate examiner to address hydrocephalus and whether it is responsible for any distinct symptoms.

The February 2021 VA Examination reported that the Veteran's neurological deterioration was almost all from Parkinson's and that there is "no evidence that the hydrocephalus contributes to the current neurologic findings."  The Board finds this opinion inadequate since the examiner did not provide supporting rationale for this opinion.  Further the examiner failed to assess the Veteran's hydrocephalus and whether it was responsible for any distinct symptoms.  The examiner also failed to provide a comprehensive examination with a full report on all manifestations of Parkinson's disease. 

The Board regrets the additional delay, it is necessary to ensure that there is complete record upon which to decide the claims so that the Veteran is afforded every possible consideration.

As such, on remand, the Veteran must be afforded a new VA examination to determine the nature and etiology of all manifestations of Parkinson's, taking into consideration his statements, the evidence of record, and accepted medical principles.

Accordingly, the matters are REMANDED for the following action(s):

1. Obtain updated VA treatment records.

2. Thereafter, schedule the Veteran for a VA examination to assess the manifestations of Parkinson's disease.  

Special Instructions:

(a.) The examiner is asked to conduct a thorough examination, and to advise the scheduling authority if any manifestations would be more appropriately examined by another type of examiner.

(b.) The examiner is asked to provide a comprehensive examination with full report on all manifestations of Parkinson's.

(c.) The examiner is asked to address the Veteran's hydrocephalus, and whether it is a manifestation of Parkinson's disease and whether hydrocephalus is responsible for any distinct symptoms. 

(d.) If additional secondary disabilities are diagnosed on examination, please complete the DBQs for those disabilities as well.

(e.) All opinions must be accompanied by explanation. 

 

Nathaniel J. Doan

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	J. Brooks

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.