Citation Nr: 21025269 Decision Date: 04/27/21 Archive Date: 04/27/21 DOCKET NO. 20-26 790 DATE: April 27, 2021 REMANDED Entitlement to an initial rating higher than 30 percent for Parkinson's disease with dementia is remanded. REASONS FOR REMAND The Veteran had active service in the U.S. Air Force from December 1964 to January 1969. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2016 rating decision. Following an April 2020 statement of the case, the Veteran submitted a May 2020 VA Form 20-0996, Request for Higher-Level Review. If accepted, this form would have allowed the Veteran to opt-in to VA’s modernized review system, also known as the Appeals Modernization Act (AMA). However, the form was rejected in June 2020 because the Veteran did not elect to withdraw his claims from the current “legacy” system. This matter was remanded in January 2021 for further development. 1. Entitlement to an initial rating higher than 30 percent for Parkinson's disease with dementia is remanded. A January 2021 Board decision remanded the Veteran’s claim for a mental disorders examination to determine the severity of the Veteran’s service – connected Parkinson’s disease with dementia. In correspondence received February 2021, the Veteran’s spouse payee communicated concerns regarding the adequacy of the VA examination. In particular she noted that the examination, which she was not allowed to attend due to Covid restrictions, lasted 10 to 12 minutes during which time no more than 8 questions were asked by the examiner. Further, there were no cognitive tests given, no discussion of his social-emotional relationships, no testing of the severity and/or frequency of his cognitive symptoms, no discussion of the symptoms which contributed to the reason the Veteran had to quit work or the medications that the Veteran required to control the symptoms of any mental disorders associated with the Veteran’s disability. A remand by the Board confers on the claimant, as a matter of law, a right to compliance with the remand orders. See Stegall v. West, 11 Vet. App. 268, 271 (1998). Once VA undertakes the effort to provide an examination when developing a claim, the exam must be an adequate one. See Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). The Veteran was afforded a VA mental disorders VA examination in February 2021. The examiner did not note any mental health diagnoses but noted that the Veteran was diagnosed with neurocognitive disorder with behavioral disturbances. However, no detail was given regarding either the neurocognitive disorder or the behavioral disturbance. The examiner opined that the Veteran was capable of managing his own funds and that he experienced occupational and social impairment due to mild or transient symptoms which decreased work efficiency or the ability to perform occupational tasks only during periods of significant stress, or symptoms controlled by medication. VA subsequently requested an addendum opinion because the Veteran was rated incompetent based upon a prior VA examination due to his cognitive impairment and difficulty with concentration. A March 2021 addendum provided an opinion regarding the Veteran’s occupational and social impairment as a result of his mental health symptoms. Taking into account the lack of specificity regarding the psychological examination, the Board finds that another examination must be obtained. The matters are REMANDED for the following action: Schedule the Veteran for a mental disorder examination by an appropriate clinician, to determine the current severity of his service-connected Parkinson’s disease with dementia. A telehealth examination should be considered. The Veteran and his spouse payee should both be in attendance. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran’s disability. The examiner must attempt to elicit information regarding the severity, frequency, and duration of mental health symptoms. To the extent possible, the examiner should identify any mental health symptoms and social and occupational impairment due to Parkinson’s disease with dementia alone. (Continued on the next page)   The examiner is asked to address the finding that the Veteran is incompetent to manage his own funds in determining the level of occupational and social and functional impairment he experiences as a result of his mental health symptoms. The necessary cognitive testing must be performed with which to determine the Veteran’s current level of disability. Jennifer White Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Alexander 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.