Citation Nr: 21014202 Decision Date: 03/11/21 Archive Date: 03/11/21 DOCKET NO. 18-14 219A DATE: March 11, 2021 ORDER Entitlement to eligibility for a grant for an automobile and adaptive equipment is granted. FINDING OF FACT The Veteran’s service-connected Parkinson’s disease condition causes limitations in balance and propulsion that such function could be equally well served by amputation of a limb with prosthesis. CONCLUSION OF LAW The criteria for entitlement to eligibility for a grant for an automobile and adaptive equipment have been met. 38 U.S.C. §§ 3901, 3902, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.808. REASONS FOR FINDING AND CONCLUSION The Veteran had honorable active duty service in the United States Army from June 1968 to June 1970, including service in the Republic of Vietnam. For his meritorious service, the Veteran was awarded (among other decorations) the Purple Heart, the Army Commendation Medal, the Combat Infantryman Badge, and the Vietnam Service and Campaign Medals. In July 2019, the Board of Veterans’ Appeals (Board) issued a decision denying the claim on appeal. The Veteran appealed that decision to the Court of Appeals for Veterans Claims (Court). Per an August 2020 order granting a Joint Motion for Remand (JMR), the Court vacated the Board decision and remanded the matter for action consistent with the terms of the joint motion. The Veteran contends that he qualifies for the benefit sought as he has lost the use of a hand/hands and/or foot/feet. He is service connected for, inter alia, a psychiatric condition with dementia, a lumbar spine condition, diabetes mellitus type II and Parkinson’s Disease, and has a total disability rating during the period on review. Financial assistance may be provided to an “eligible person” in acquiring an automobile or other conveyance and adaptive equipment, or automotive adaptive equipment only. 38 U.S.C. § 3902 (a)(b). Eligibility for assistance to purchase a vehicle and adaptive equipment is warranted where one of the following exists as the result of injury or disease incurred or aggravated during active service: (1) loss or permanent loss of use of one or both feet; (2) loss or permanent loss of use of one or both hands; (3) permanent impairment of vision of both eyes, meaning central visual acuity of 20/200 or less in the better eye, with corrective glasses, or central visual acuity of more than 20/200 if there is a field defect in which the peripheral field has contracted to such an extent that the widest diameter of visual field subtends an angular distance no greater than 20 degrees in the better eye; (4) severe burn injury precluding effective operation of an automobile; (5) amyotrophic lateral sclerosis; or, (6) for adaptive equipment only, ankylosis of one or both knees or one or both hips. 38 C.F.R. § 3.808. The loss of use of a hand or a foot will be held to exist when no effective function remains other than that which would be equally well served by an amputation stump at the site of election below the knee with use of a suitable prosthetic appliance. The determination will be made on the basis of the actual remaining function, whether the acts of balance, propulsion, etc., could be accomplished equally well by an amputation stump prosthesis. 38 C.F.R. §§ 3.350 (a)(2)(i), 4.63. On review and critical reconsideration of our prior holding, the Board finds that a grant of the benefit sought is warranted as the evidence of record shows the Veteran’s balance and propulsion is at least limited to the degree he would be if a limb were amputated with a prosthetic. As noted in the JMR, a VA treatment record dated July 2, 2015 indicated that the Veteran cannot operate a manual wheelchair for at least 150 feet and has loss/loss of function of both lower extremities and one or more upper extremities as related to Parkinson’s disease. Further, the September 2018 VA Kinesiotherapy consultation showed that the Veteran was no longer ambulatory and uses his wheelchair for all mobility. The clinician recommended certain levels of vehicle adaptations/equipment in this report. The Board gives weight to the July 2015 and September 2018 entries noted above and finds the evidence at least in equipoise as to whether the Veteran’s service-connected disability rises to the level required for the benefit sought. Although the Board’s prior decision relied on evidence that demonstrated the Veteran’s ability to walk 200 feet with a walker, showed him being capable of standing to a limited degree, and being capable of walking 150 feet with a slow shuffling gait, the degree of ambulation cited cannot be said to be more than an average lower extremity amputee fitted with a prosthetic. The Board takes note of the advances in prosthetics and does not find any reasonable medical professional would conclude the Veteran’s balance and propulsion are superior than if he were so equipped. Accordingly, additional delay and remand for further examination or opinion is not required. Resolving doubt in the Veteran’s favor, the appeal is granted on the issue of qualifying disability for a grant for an automobile and adaptive equipment, subject to meeting other eligibility requirements of the program. Of final note, the Veteran’s commendable service record and sacrifice is acknowledged, as is the ongoing sacrifice now endured by his loved ones in caring for his disability. The Board expresses its sincere thanks and gratitude to the Veteran. Evan M. Deichert Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. C. KING, Associate 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.