The rating for hypertensive heart disease was reduced from 100% to 30% effective August 1, 2013. The reduction was improper and the 100% rating is restored. A subsequent reduction to 60% effective December 11, 2018, was proper.

The Veteran is denied entitlement to an effective date earlier than March 8, 2016 for the assignment of a 100 percent disability rating for hypertensive heart disease with ischemic heart disease.,The Veteran is denied entitlement to an effective date earlier than March 10, 2016 for the assignment of a 100 percent disability rating for PTSD with major depressive disorder.,The Veteran is denied entitlement to an effective date earlier than March 8, 2016 for the assignment of a 30 percent disability rating for balance impairment and shuffling gait as a residual of Parkinson's disease.,Service connection for dysphagia, as a residual of Parkinson's disease, was granted with an effective date of December 18, 2012.,The Veteran is denied entitlement to an effective date earlier than March 8, 2016 for service connection for chronic constipation, as a residual of Parkinson's disease.

The Veteran's urinary frequency, due to his service-connected hypertension and medication use, is rated at 40 percent. The Veteran also meets the criteria for SMC based on need for regular aid and attendance due to his service-connected disabilities.

The Veteran's service-connected disabilities, including PTSD, alcohol dependence, diabetic nephropathy with hypertension, peripheral neuropathies, diabetes mellitus type II, and hypertensive heart disease, rendered him unable to secure or maintain substantially gainful employment as of December 24, 2011.

The appellant's erectile dysfunction disability does not warrant a compensable rating. The hypertensive heart disease was rated at 60 percent effective prior to May 19, 2008, but no higher evaluation is warranted thereafter. The hypertension disability did not meet the criteria for an increased rating.