Citation Nr: 22015035 Decision Date: 03/16/22 Archive Date: 03/16/22 DOCKET NO. 17-44 544 DATE: March 16, 2022 REMANDED The issue of entitlement to an initial compensable disability evaluation for the period prior to July 21, 2021, and in excess of 10 percent disabling for the period thereafter, for service-connected painful scars, right wrist status post ganglion cyst excision associated with ganglion cyst, right wrist status post excision, (painful right wrist scars) is remanded. The issue of entitlement to a compensable evaluation for service-connected scar right wrist with associated tissue damage associated with ganglion cyst, right wrist status post excision, (right wrist scar with associated tissue damage), is remanded. The issue of entitlement to a compensable evaluation for service-connected scar right wrist with no associated tissue damage associated with ganglion cyst, right wrist status post excision, (right wrist scar with no associated tissue damage), is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1991 to October 2000. In March 2021, the Veteran testified under oath at a virtual hearing before the undersigned Veterans Law Judge. A transcript of the hearing is of record. In March 2021, the Board remanded the remaining issues on appeal for additional development. For the issue of entitlement to an increased initial evaluation for service-connected ganglion cyst, right wrist status post excision (also claimed as right wrist pain, weakness and tingling), the Board remanded for issuance of a Statement of the Case (SOC). See Manlicon v. West, 12 Vet. App. 238 (1999). The Board directed that the issue should be certified to the Board only if the Veteran perfected an appeal. An SOC was issued in March 2021; however, the Veteran did not perfect an appeal of this issue. Accordingly, it is no longer before the Board. Following the March 2021 Board remand, the disability evaluation for service-connected painful right wrist scars was increased to 10 percent disabling, effective July 21, 2021. See Rating decision, July 2021. The increase is reflected in the issues on appeal. Similarly, service connection was granted for right wrist scar with associated tissue damage, as well as right wrist scar with no associated tissue damage. See Rating decision, July 2021. These issues have been added to the issues on appeal. 1. Entitlement to an initial compensable disability evaluation for service-connected painful right wrist scars. 2. Entitlement to a compensable evaluation for service-connected right wrist scar with associated tissue damage. 3. Entitlement to a compensable evaluation for service-connected right wrist scar with no associated tissue damage. The Board finds that additional development is needed prior to final adjudication of the issues on appeal. Specifically, the Board seeks clarification of the following. The July 2021 VA examination report indicates that the Veteran's two scars have, inter alia, "aching pain with use." Nevertheless, the report also states that the scars do not "result in limitation of function (to include limitation of motion)." The Board seeks clarification as to the limitations caused by the documented "aching pain with use." The Board notes that directions for the VA examination report indicate that for limitation of motion, a musculoskeletal DBQ should be completed. In clarifying any limitations caused by pain, the Board asks that the examiner clearly delineate the limitations caused by the service-connected painful right wrist scars (i.e., that is, the disability on appeal), versus the separately rated service-connected disability of ganglion cyst, right wrist status post excision. Finally, in evaluating the Veteran the Board asks that the examiner consider the entire period on appeal. For example, tissue damage is noted in the July 2021 VA examination report. However, the Board does not see that the April 2017 VA examination report for scars/disfigurement addresses tissue damage. Upon remand, the Board asks that the examiner address whether the tissue damage, identified in the July 2021 VA examination report, was present during the entire period on appeal. The matters are REMANDED for the following action: 1. After securing any necessary consent forms from the Veteran, obtain any outstanding treatment records, to include any VA and/or private treatment records, pertaining to the issues on appeal. All efforts should be documented in the claim file. If any records could not be obtained, this should be noted in the claim file. 2. Upon completion of the above, schedule the Veteran for a VA examination to address the current severity of the service-connected disabilities on appeal. In evaluating the Veteran, the Board asks that the examiner address the following: (a) The July 2021 VA examination report indicates that the Veteran's two scars have, inter alia, "aching pain with use." Nevertheless, the report also states that the scars do not "result in limitation of function (to include limitation of motion)." The Board seeks clarification as to the limitations caused by the documented "aching pain with use." The Board notes that directions for the VA examination report indicate that for limitation of motion, a musculoskeletal DBQ should be completed. In clarifying any limitations caused by pain, the Board asks that the examiner clearly delineate the limitations caused by the service-connected painful right wrist scars (i.e., that is, the disability on appeal), versus the separately rated service-connected disability of ganglion cyst, right wrist status post excision. (b) In evaluating the Veteran, the Board asks that the examiner consider the entire period on appeal. For example, tissue damage is noted in the July 2021 VA examination report. However, the Board does not see that the April 2017 VA examination report for scars/disfigurement addresses tissue damage. Upon remand, the Board asks that the examiner address whether the tissue damage, identified in the July 2021 VA examination report, was present during the entire period on appeal. The VA examiner should be given access to the claim file. The examiner should state that a review of the claim file was completed. The examiner must provide a comprehensive report including complete rationales for all opinions and conclusions reached, citing the objective medical findings leading to the conclusions. A detailed rationale is requested for all opinions provided. 3. If upon completion of the above action the issues are denied, the case should be returned to the Board after compliance with appellate procedures. E. I. VELEZ Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K. Foster, Counsel 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.