Citation Nr: 18154101
Decision Date: 11/29/18	Archive Date: 11/29/18

DOCKET NO. 18-32 699
DATE:	November 29, 2018
ORDER
Entitlement to service connection for Parkinson’s disease is granted.
Entitlement to service connection for dysarthria is granted.
Entitlement to service connection for dysphagia is granted.
Entitlement to service connection for left upper arm weakness is granted.
Entitlement to service connection for right upper arm weakness is granted.
Entitlement to service connection for loss of use of the left lower leg is granted.
Entitlement to service connection for loss of use of the right lower leg is granted.
Entitlement to service connection for other specified sleep-wake disorder, claimed as insomnia, is granted.
Eligibility for automobile or other conveyance and adaptive equipment is granted.
Eligibility for specially adapted housing is granted.
Eligibility for special home adaptation is denied as moot.
FINDINGS OF FACT
1. The Veteran’s Parkinson’s disease is related to in-service exposure to contaminated water at Fort Ord.
2. The Veteran’s dysarthria is proximately due to his service-connected Parkinson’s disease.
3. The Veteran’s dysphagia is proximately due to his service-connected Parkinson’s disease.
4. The Veteran’s left upper arm weakness is proximately due to his service-connected Parkinson’s disease.
5. The Veteran’s right upper arm weakness is proximately due to his service-connected Parkinson’s disease.
6. The Veteran’s loss of use of the left lower leg is proximately due to his service-connected Parkinson’s disease.
7. The Veteran’s loss of use of the right lower leg is proximately due to his service-connected Parkinson’s disease.
8. The Veteran’s other specified sleep-wake disorder, claimed as insomnia, is proximately due to his service-connected Parkinson’s disease.
9. The Veteran has a permanent and total disability due to a disorder that involves both lower extremities and causes a loss of use so severe that it precludes locomotion without the regular and constant use of a walker or wheelchair.
CONCLUSIONS OF LAW
1. The criteria for service connection for Parkinson’s disease are met.  38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a).
2. The criteria for secondary service connection for dysarthria are met.  38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.310(a).
3. The criteria for secondary service connection for dysphagia are met.  38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.310(a).
4. The criteria for secondary service connection for left upper arm weakness are met.  38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.310(a).
5. The criteria for secondary service connection for right upper arm weakness are met.  38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.310(a).
6. The criteria for secondary service connection for loss of use of the left lower leg are met.  38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.310(a).
7. The criteria for secondary service connection for loss of use of the right lower leg are met.  38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.310(a).
8. The criteria for secondary service connection for other specified sleep-wake disorder, claimed as insomnia, are met.  38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.310(a).
9. The criteria for eligibility for automobile or other conveyance and adaptive equipment have been met.  38 U.S.C. §§ 3901, 3902, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.350, 3.808. 
10. The criteria for entitlement to assistance in acquiring specially adapted housing have been met, thereby precluding a special home adaptation grant.  38 U.S.C. §§ 2101(a), (b), 5107; 38 C.F.R. §§ 3.350(a), 3.809, 4.63.
REASONS AND BASES FOR FINDINGS AND CONCLUSIONS
The Veteran had active service in the United States Army from April 1962 to April 1965.  In September 2017, the Agency of Original Jurisdiction denied service connection for Parkinson’s disease, dysarthria, dysphagia, insomnia, left upper arm weakness, loss of use of the right lower leg, loss of use of the left lower leg, and right upper arm weakness.  However, the Veteran submitted new and material evidence within one year of the rating decision.  Therefore, the September 2017 rating decision is not final.  The issues were most recently denied in a June 2018 rating decision.
Service Connection
Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active service, even if the disability was initially diagnosed after service.  38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303.
Service connection is also warranted for a disability that is proximately due to or the result of or aggravated beyond its natural progression by a service-connected disability.  38 U.S.C. §§ 1110, 1131; Allen v. Brown, 7 Vet. App. 439 (1995) (en banc); 38 C.F.R. § 3.310(a).  
1. Entitlement to service connection for Parkinson’s disease.
The Veteran contends that his Parkinson’s disease is caused by exposure to contaminated water at Fort Ord.
The Board concludes that the Veteran has a current diagnosis of Parkinson’s disease that is related to exposure to contaminated water at Fort Ord.  38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a).
The Veteran has submitted literature indicating that groundwater in Fort Ord was contaminated by trichloroethylene.  His personnel records confirm that he was stationed at Fort Ord. 
In May 2018, Dr. J.P., a VA Chief of Neurology, wrote that exposure to trichloroethylene led to the Veteran’s Parkinson’s disease.
There are no negative medical opinions of record. 
Based on the forgoing, service connection for Parkinson’s disease is granted.  38 U.S.C. §§ 1110, 1131, 5107(b).
2. Entitlement to service connection for dysarthria.
3. Entitlement to service connection for dysphagia. 
The Veteran contends that his dysarthria and dysphagia are caused by his Parkinson’s disease.
In February 2018, the Veteran was afforded a VA cranial nerve examination.  The VA examiner diagnosed dysarthria and indicated that the Veteran had severe difficulty chewing, swallowing, and speaking.  He opined that it was at least as likely as not that the Veteran’s dysarthria and dysphagia were caused by the Veteran’s Parkinson’s disease.  The VA examiner explained that dysarthria and dysphagia were caused by the natural progression of the Veteran’s Parkinson’s disease.  There are no negative medical opinions of record. 
The Board finds that the Veteran’s dysarthria and dysphagia are proximately due to his now service-connected Parkinson’s disease.  The claims are granted.
 

4. Entitlement to service connection for left upper arm weakness. 
5. Entitlement to service connection for right upper arm weakness. 
6. Entitlement to service connection for loss of use of left lower leg. 
7. Entitlement to service connection for loss of use of right lower leg. 
The Veteran claims that his bilateral upper arm and bilateral lower leg loss of use are caused by his Parkinson’s disease. 
In February 2018, the Veteran was afforded a VA peripheral nerves conditions examination.  The VA examiner diagnosed bilateral upper and lower extremity loss of function due to Parkinson’s disease.  He opined that it was at least as likely as not that the Veteran’s loss of use of the bilateral legs and bilateral upper arm weakness was at least as likely as not due to his service-connected Parkinson’s disease.  The VA examiner explained that, after reviewing the record and examining the Veteran, it was evident that the Veteran’s loss of use of the bilateral legs and bilateral upper arm weakness were caused by his Parkinson’s disease.  There are no negative medical opinions of record. 
The Board finds that the Veteran’s loss of use of the bilateral legs and bilateral upper arm weakness are proximately due to his service-connected Parkinson’s disease.  The claims are granted.
8. Entitlement to service connection for other specified sleep-wake disorder, claimed as insomnia. 
The Veteran claims that his insomnia is caused by his Parkinson’s disease.
In February 2018, the Veteran was afforded a VA examination.  During the examination, the Veteran met the diagnostic criteria for other specified sleep-wake disorder.  He reported sleep difficulties that caused daytime drowsiness and impacted his daily function.  His sleep difficulty was caused by anxiety regarding his breathing during sleep.  The VA examiner opined that the Veteran’s sleep disorder was most likely related to his Parkinson’s disease. 
There are no negative medical opinions of record. 
The Board finds that the Veteran’s other specified sleep-wake disorder is proximately due to his service-connected Parkinson’s disease.  The claim is granted.
9. Eligibility for automobile or other conveyance and adaptive equipment.
Financial assistance may be provided to an “eligible person” in acquiring an automobile or other conveyance and adaptive equipment, or 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 U.S.C. § 3901; 38 C.F.R. § 3.808.  The term “loss of use of a hand or foot” is defined as existing 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 elbow or knee with the use of a suitable prosthetic appliance.”  38 C.F.R. § 3.350(a)(2).
The Veteran is currently service-connected, by virtue of this decision, for Parkinson’s disease, dysarthria, dysphagia, bilateral upper arm weakness, loss of use of the bilateral lower legs, and other specified sleep-wake disorder.  The February 2018 VA peripheral nerve condition examination found that the Veteran was only able to walk a few feet with the assistance of a walker or a person and was mostly wheelchair bound.  The Board finds that the evidence has at least reached the point of equipoise regarding whether the Veteran has functionally lost the use of one or both feet due to his service-connected disabilities. 
Thus, eligibility for automobile or other conveyance and adaptive equipment is established.
10. Entitlement to specially adapted housing.
11. Entitlement to special home adaptation.
The requirements for special adapted housing and special home adaptation grants are very specific.  A veteran is eligible for assistance in the acquisition of housing with special features made necessary by the veteran’s disability if he or she is entitled to compensation for a permanent and total service-connected disability that is due, in relevant part, to the loss, or loss of use, of both lower extremities such as to preclude locomotion without the aid of braces, crutches, canes, or a wheelchair; 38 U.S.C. § 2101(a); 38 C.F.R. § 3.809(b).  The U.S. Court of Appeals for Veterans Claims (Court) has recently clarified that the “qualifications for SHA grants require that the individual must (1) have a permanent and total disability (2) due to a disorder that (3) involves both lower extremities and (4) causes a loss of use so severe that it precludes locomotion without the regular and constant use of assistive devices.”  Jensen v. Shulkin, 29 Vet. App. 66, 79 (2017). 
The Veteran is currently service-connected, by virtue of this decision, for Parkinson’s disease, dysarthria, dysphagia, bilateral upper arm weakness, loss of use of the bilateral lower legs, and other specified sleep-wake disorder.  The February 2018 VA peripheral nerve condition examination found that the Veteran was only able to walk a few feet with the assistance of a walker or a person and was mostly wheelchair bound.  As the evidence shows that the Veteran has a permanent and total disability due to a disorder that involves both lower extremities and causes a loss of use so severe that it precludes locomotion without the regular and constant use of a walker or wheelchair, the Veteran is entitled to special adapted housing benefits. 
Because the Board has determined that the Veteran is eligible for assistance under 38 U.S.C. § 2101(a) for specially adapted housing, the law precludes an award of special home adaptation grant under 38 U.S.C. § 2101(b).  Accordingly, the specially adapted housing claim is granted and the special home adaptation claim is denied as moot.

 
DAVID L. WIGHT
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	R. R. Watkins, Counsel 

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