Acrobat XI Pro

Text and Images from Slide

Acrobat XI Pro

To work with accessible tagged PDF you must have Acrobat Pro aka Professional. Not Standard.
In X the UI removed menus, added tools down the right side of the document and removed keyboard commands for adding Tags, doing a Full Check and so forth.
Results are about the same if you use the built-in PDF conversion tool in Microsoft Office 2010 (free download for Office 2007) or Acrobat.
The bug where images added in Word 2007 or 2010 are thrown out of their reading order on a page and if you use Picture Styles all images are thrown to the top of the Tags Tree.