Citation Nr: 18158701 Decision Date: 12/18/18 Archive Date: 12/17/18 DOCKET NO. 16-35 038 DATE: December 18, 2018 REMANDED Entitlement to compensation under 38 U.S.C.§ 1151 for residuals of left wrist ganglion cyst excision is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from May 1957 to December 1957. This case comes before the Board of Veterans’ Appeals (Board) on appeal from a November 2014 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in San Juan, the Commonwealth of Puerto Rico. This matter was remanded by the Board in December 2017. As discussed below, the RO is not in substantial compliance with the Board’s directives on remand. Stegall v. West, 11 Vet. App. 268 (1998). This appeal has been advanced on the Board’s docket pursuant to 38 C.F.R. § 20.900(c) (2018). 38 U.S.C. § 7107(a)(2) (2012). The appeal is REMANDED to the Agency of Original Jurisdiction (AOJ). VA will notify the appellant if further action is required. Entitlement to compensation under 38 U.S.C. § 1151 for residuals of left wrist ganglion cyst excision is remanded Unfortunately, the Board finds that the Veteran’s claim must be remanded to ensure compliance with the directives of the Board’s prior remand. The Board previously remanded the issue of entitlement to compensation under 38 U.S.C. § 1151 for residuals of left wrist ganglion cyst excision, to obtain complete copies of the signed consent forms for the Veteran’s surgeries that were performed on September 18, 2013 and October 9, 2013. Records from the San Juan VA Medical Center show that the Veteran underwent excision of a ganglion cyst on the left wrist on September 18, 2013 and again on October 9, 2013. The records also include an electronic informed consent form for each surgery, with a notation that the full document could be accessed through VistA Imaging. The Veteran contends that the September 18, 2013 surgery was done on the ‘wrong side’ of his left wrist. Given this, the complete informed consent form for that surgery may specify the side of the wrist contemplate by the surgery, which would assist in determining if the surgery was actually performed at the wrong site, or if it was intended to be performed at the site at issue. Consequently it is not sufficient to merely review the electronic indication that informed consent was obtained; rather, the actual informed consent document must be obtained. The Board also noted that the AOJ should obtain the complete informed consent form for the October 9, 2013 surgery, since it may shed some light on the need for the second surgery. In response to the prior remand, the Board has received surgery verification notes, a holding area nurses note showing that informed consent was verified by iMed Consent, and a page of an orthopedic surgery electronic consent form stating that the full consent document can be accessed through VisTA Imaging. To date, the Board has not received complete copies of the signed consent forms for the September 18, 2013 and October 9, 2013 surgeries, as available on VistA Imaging, and as requested in the prior remand. Again, the mere fact that an informed consent form was signed is not sufficient in this case; the records indicate that the actual informed consent forms for both surgeries are available, and so they should be obtained. Accordingly, the Board finds a lack of substantial compliance with the December 2017 Remand directives regarding the Veteran’s claim on appeal. Compliance with a remand is not discretionary, and failure to comply with the terms of a remand necessitates remand for corrective action. Stegall, 11 Vet. App. at 270-71 (remand by the Board confers on the Veteran, as a matter of law, a right to compliance with the remand instructions, and imposes upon VA a duty to ensure compliance with the remand). Therefore, the matter is REMANDED for the following actions: (Please note, this appeal has been advanced on the Board’s docket pursuant to 38 C.F.R. § 20.900(c). Expedited handling is requested.) 1. Associate with the claims file a complete copy of each of the signed consent forms for the September 18, 2013 and October 9, 2013 surgeries, as available on VistA Imaging. (Continued on the next page)   2. Then, readjudicate the claim. If any decision remains adverse to the Veteran, issue a supplemental statement of the case and allow the appropriate time for response. Then, return the case to the Board. THOMAS H. O'SHAY Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD T. Trowers, Associate Counsel